by Karen Doyle
In today’s climate of managed care, primary care physicians are busier than ever. How do you get the most out of those precious few minutes in the examining room? Try these tips.
For a sick child visit
● When you call to make the appointment, tell the nurse about the symptoms you have noticed. Describe all the symptoms, even if you don’t think they are related. Give the nurse all the information that you are going to give the doctor. If you bring up additional issues with the doctor, there may be additional testing required, and that takes more time. Provide enough information when you make the appointment so the nurse can plan the appropriate amount of time for the visit.
● Come in prepared with a list of your child’s symptoms. If your child is running a fever, note the temperature and the time you took it for each reading. If you have been giving your child over-the-counter medication (ibuprofen, acetaminophen, cough syrup, etc.), write down the dose and when you gave it.
“Put the list on your cell phone or PDA,” suggests Julian Huang, M.D., of Scituate Pediatrics in Scituate, Massachusetts. “We all know that the more kids you have, the more things you forget, but you always have your phone with you. If your child has a rash or some other visible symptom, take a picture with your cell phone and bring that.”
● If you have done some research on your child’s symptoms, let the doctor know. If you have an article that you think is relevant, bring it with you. Just keep in mind that not all websites are created equal, especially when it comes to medical information. “I like sites that end in ‘edu’ or ‘gov,’ because they are usually peer-reviewed,” says Dr. Huang. “The ones that end in ’com’ can contain information from almost any source. The exception is medscape.com, which is usually reliable.”
● Ask about follow-up. Your child may be the 27th case of norovirus your doctor has seen that day. She may think she has given you complete instructions, but it is easy to see how she might forget to tell you what to do if the symptoms do not abate in three days.
For a well child visit
● Come prepared with a list of your questions. Just as for a sick child visit, a list is important in this situation as well. It will help you to remember all the questions that have arisen since your child’s last visit. For babies, keep a running list on your cell phone between visits so that you don’t forget anything.
● If you have concerns about developmental or behavioral issues, consider asking your doctor for a consult without your child present. The doctor probably will not be able to accurately assess the behavior in a 15-minute appointment with your child anyway, and you will be able to describe your child’s behavior in detail (from the list you’ve brought with you, of course).
● Do not hesitate to ask for an appointment with the nurse practitioner. For a well child check-up with no extenuating circumstances, a nurse practitioner may be able to spend more time with you, or have more availability.
The insurance factor
Providing the most appropriate care for each patient is the overarching goal of every pediatrician. The reality is, however, that insurance companies pay the lion’s share of health care costs, and they are demanding that doctors meet certain quality standards. These standards mean that doctors have less discretion in how long they spend with patients and even which treatments and medications they prescribe.
If a doctor doesn’t meet the insurance company’s quality standards, that insurers’ subscribers may have to pay a higher copayment, or the insurance company may refuse to credential that particular doctor.
There's nothing more important when parenting children than health, and you and your pediatrician are partners for your child. Understanding the constraints that doctors operate under today can help make that partnership more productive.
Karen Doyle is a freelance writer who lives with her husband and three children in Scituate, Massachusetts. She writes on parenting topics and personal finance issues, as well as writing what she hopes is humor.