Things Your Pediatrician Shouldn’t Say – Ever

It’s not easy to be in the trenches with sick kids and worried moms all day long, but some things are better left unsaid. I’ve made every one of these mistakes, usually followed by a cringe of regret … “did I really just say that?!”

Don’t be scared, this won’t hurt. This belongs in the file, “don’t make promises you can’t keep”. Adults can’t always know what will be perceived as pain by a child, and if you say it won’t and it does, the next visit could be a dreadful ordeal.

A better approach is, ” kids tell me this feels like … .” Children tend to trust the experience of other people their own size. You can intervene here, Mom, and ask “what does it feel like?”

And you must be Grandma? In this age of fertility technology and untraditional families this is one of the worst bloopers out there. Moms (and dads) come in all shapes and sizes, so if this is a first-time meeting it always pays to avoid making assumptions.

Variations on this faux pas include mistaking you for the nanny and being baffled by same-sex couples. A colleague told me about an awkward moment when he greeted two dads and a newborn with, “so where’s Mom today?” That kiddo is in kindergarten now and they all laugh about that first visit, but it definitely wasn’t a recommended relationship builder.

Kids get colds. It happens. While this is certainly true, and after seeing the 11th snotty nose and cough of the morning it’s easy to believe that it’s a normal condition, your sick kid is the one you are concerned about, and your doctor should be, too.

Yes, children under age 8 will get an average of 6-8 upper respiratory infections (colds) a year, and each one of them will stress you out. So ask what you can do to make symptoms milder and briefer (fluids, humidified air, and chicken soup … really) and don’t let ‘em make you feel bad about worrying.

I’m not sure what this is, but it’s not anything serious. Lots of childhood illnesses look alike, and viruses are notorious for being masters of disguise, so expect there to be times when your doctor can’t make a positive identification. But to guarantee that the unidentified cause is nothing to be concerned about is to tempt the wrath of the gods. We’re a superstitious bunch and we try to avoid this pitfall.

The good news? 99.9% of the time it’s true anyway. We’re not sure, and it’s not serious.

Hmmm … I’m concerned this could be … . The opposite of the example above, this is the alarmist reaction to a diagnosis we’re unsure about. Doctors are trained to be wary of the worst case scenario — the diagnosis you don’t want to miss because the results can be disastrous. Sharing this thought process can send worried parents right over the edge into catastrophe land.

Most of the time the dreaded illness is ruled out and quickly forgotten by your doc, but chances are you’ll remember that moment of terror forever. Take home message? Don’t panic if your doctor mentions a scary-sounding disease. Ask for any indicated referral or testing ASAP — that day if possible — and don’t let them make you suffer through a long weekend of not knowing.

Little Jenny (her name’s really Jessica) has grown SO much! This is one lapse that’s hard for moms to forgive. “WHAT?? You’ve been taking care of my precious darling since she was tiny AND YOU CAN’T REMEMBER HER NAME? Are you kidding me?”

Try to be kind. Chances are he’s got a lot of Jennys, Jessicas, Jennas and Joannes in his practice, and may have just left an exam room with one of them. It’s easy to get confused. Having said that, if you get the feeling that he doesn’t know you and your kid, that’s a red flag. The relationship is key, and if your doctor doesn’t seem to remember that your Jessica has had multiple bouts of strep throat in the last year, even if it’s clearly written in the chart, there’s a problem.

Your insurance company is really difficult. This is one of my pet peeves and you shouldn’t have to hear about it. It’s your doctor’s job to provide medical care for your child. Insurance issues are her problem, not yours. The only exception is if it prevents her from ordering a critical procedure or medication — then you may need to intervene.

According to the literature, tympanostomy tubes are indicated after 6 episodes of otitis media blah blah blah … . May as well be speaking Greek, because few moms are going to have any idea what the gist of that conversation was. Jargon is almost never indicated, and while it may make us sound smart it prevents us from doing our job — partnering with you to ensure the health your child.

I can’t say it enough: A good relationship with your pediatrician is about communication, and that goes both ways. An educated consumer is our best customer and knowledge is power. If your doc doesn’t agree you need to find one who does.

At the same time, cut us a break once in awhile. While our healthcare system often doesn’t work for patients (reform? what reform?), it’s broken for doctors, too. I’m not in those trenches every day anymore, and I have huge respect and empathy for those who are. They’re doing the best they can for your kiddos and need your help to make it work, the occasional blooper notwithstanding.