The Parents' Guide to Getting the Most Out of a Pediatrician by Mark B. Levin, M.D. The Pediatric Group, P.A., Princeton

This is the thirtieth article in a series written for Princeton Online. Click here for an archive of other articles.

It is unfortunate that we rarely take the time to "smell the roses". One of the joys a pediatrician treasures most is interacting with the cherubs that frequent his or her office. But managed care has pressured physicians to create a system that discourages prolonged interaction between doctor and patient, that deters return phone calls, that necessitates the expanded use of physician extenders, and discourages after hours visits for illness. These pressures have often made physicians, contrary to their desires, curt and frustrated in their efforts to offer high quality care to their patients. Although those doctors who have been lucky enough by fate or by design to avoid contracting with managed care can be more relaxed and spend more time with their patients, they, too, need to be efficient. Whether you have found a physician who takes the time to truly understand your concerns and your medical condition or you are forced by insurance constraints to use a physician whom you would rather not see, the following tips will make your encounters more productive, more accurate and more enjoyable.

1. Be Informed and Informing
If you have concerns, you must be comfortable asking questions and stating your concerns. Not having questions answered is a chief reason for patient dissatisfaction. Whether on the telephone or in person, your doctor can not answer a question that you do not ask. It does not matter if the question involves behavior or treatment alternatives. By talking to your doctor you are actually enhancing his or her ability to understand your child and make the most accurate diagnosis. Try to be specific and concise, but do not omit a question that you fear is "stupid". Remember that we all had the same questions raising our own children!

2. Make a List for Well Visits
We all can forget things. How frustrating is it to bring your child for a routine health maintenance examination with some special concerns and forget to ask about them? Prepare for your visit by making a list of your concerns. Bring enough paper to take notes on answers to your questions so you do not have to call back afterward to rehash the same issues.

3. Keep Focused on the Reason for the Visit
Most doctors try to schedule an appropriate amount of time for the type of visit. A visit for an ear ache is not a good time to raise questions about school issues or a sibling's behavior. The doctor faced with these secondary issues is likely to curtail his or her responses. The doctor gets behind schedule and you get inadequate information. No one is helped. It is appropriate, however, to ask when is the best time to call or make an appointment to discuss these other issues. The doctor will appreciate your consideration and you will appreciate his or her full attention to the illness at hand. After all, the doctor does want to help.

4. Bring the Whole Family
During infant visits when immunizations are due, parents can support each other and comfort the baby. Especially when a well child visit entails discussion about specific problems or your child has special health needs because of a chronic disease, it is most helpful to have all adult family members present. This avoids misinterpretations and allows each adult to ask questions. It makes your time more productive and saves the doctor follow up telephone calls over miscommunications.

5. Target Your Requests
If you have routine requests, for example, record releases, school forms, etc, these are appropriately addressed to the doctor's office staff. If your request is unusual, however, perhaps an after hours consultation or special appointment time or arrangements regarding travel preparations, these requests should be directed directly to the doctor. Office personnel are generally not permitted to make alterations in office policy. Only the physician can direct his or her staff to make exceptions. Insisting on special arrangements from the staff will only engender hard feelings and an unsatisfactory relationship. If a staff member is rude or inappropriate, tell the doctor. He or she can not address the issue if he or she is not aware of it.

6. Be Policy Perfect
All offices have policies regarding office visits, telephone calls, billing, etc. Most often, these are described in detail in an office brochure or on a practice web site. Frequently, useful information regarding first aid, emergencies and medication doses is included in these communication devices. The doctor has invested a great deal of time, thought and expense in these publications. Take the time to become familiar with them. This will answer many of your questions, saving you time otherwise spent waiting for return telephone calls. The doctor will be impressed and pleased that you know how the office functions.

7. Timing Is Everything
Since demand for the doctor's time is high, being punctual is critical. A sure way to irritate the doctor and staff is to be chronically late for appointments. Of course, a sure way to irritate you is for the doctor to be chronically behind schedule! Ask the staff when the slowest times are for the office and try to schedule your appointment then. The doctor and staff are least likely to be hurried and you will all enjoy the visit more. Mondays, Fridays, early mornings and late afternoons are usually the busiest times.

8. Maintain Good Form
When you submit forms to your doctor for school, camp, day care, etc. fill in as much as you can ahead of time. Unless you do not want the form completed, always fill in your child's name, address and birth date before sending it to your doctor. Keep and update a copy of your child's immunizations. It will be handy for forms and for checking on the most recent tetanus immunization in case of an injury.

9. Picture Your Pediatrician
When you send out birthday announcements and pictures of your children, include the pediatrician on your list. It makes the doctor feel more like part of your family and helps refresh his or her memory regarding who your children are.

With these tips, even in the face of a hurried society, the scent of those "roses" will permeate your relationship with your pediatrician.

Dr. Mark B. Levin 

Dr. Levin has been a member of the staff at The Pediatric Group since 1977. Currently an attending Pediatrician at the Medical Center at Princeton, he has been Chairman, Department of Pediatrics, Medical Center at Princeton, 1984 to 1986, 1989 to 1992, and past President, Medical and Dental Staff, Medical Center at Princeton, 1987 to 1988. Dr. Levin has served on numerous Departmental and hospital committees. He has published original articles both while at Upstate Medical Center in Syracuse and at The Pediatric Group. He has a wife and three children. Dr. Levin enjoys alpine skiing, jogging, hiking and camping, travel, computers and racquetball.

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