5 Things Your Pediatrician Won’t Tell You

In the unlikely event that you don’t already know it, let me clear something up.

Medicine IS more art than science.

Sure, we know a gazillion times more about the physiology of illness than we did a generation ago, and every scientific advance makes us better able to understand and cure disease.  But the truth is that everything we learn in school, every new medical gadget invented to measure physical function, and every imaging test developed to scan every millimeter of your innards is being interpreted and applied by a human being.

That human being has opinions, points of view and life experiences that color how they see what’s going on with patients.  That’s why we say that if you put 5 doctors in a room you’ll get 6 opinions. And nowhere is that more true than in pediatrics, where our patients often can’t speak for themselves, and their ‘interpreters’ (parents) may be scared, upset, and vulnerable.

How kid doctors look at a problem when they walk into an exam room has everything to do with what happens next. Your pediatrician won’t tell you this stuff, but it matters.  Big time.

1)  What we think of you DOES make a difference. We all have impressions of people. You think that mother down the block yells too much, so you don’t encourage your kids to hang out over there. You’d rather have her kids at your house.  I think my neighbor across the street is too nosy and intrusive, so when I drive into my driveway and see her at her mailbox I quickly wave and scoot inside before she can stop me.

Your child’s doctor is no different. She has an impression of you as a parent. And that impression may come from her view that your parenting style matches hers.  Or doesn’t. It’s not good or bad, it’s a question of fit.  If she assumes you think the way she does, she may share more of the power in the relationship. She may tell you to watch and wait rather than fill that prescription right away.  Or she may rely more on your description of how that injury happened, and feel comfortable skipping the x-ray.  The result is more collaboration.

Do you feel like the two of you have  a meeting of the minds?

2)  We often depend on YOU for answers. You know your child way better than we do.  You notice subtle changes in behavior and activity that we couldn’t possible catch.  A good pediatrician listens carefully to your description of the problem because it often makes the diagnosis.  You are our patient, too.  If you feel ignored that’s a BIG red flag.

The flip side of this is that we can’t read minds. If you don’t tell us, we can’t know. We also don’t have x-ray vision. If you suspect that the pea Tyler stuck up his nose may be causing that green stuff that’s pouring out, PLEASE speak up.

3)  We CAN be bullied into prescribing antibiotics. Not all of us, not all the time, but many of us are occasionally vulnerable to begging and nagging.  So even though little Megan is on her third awful cold since school started and it’s not even Thanksgiving yet, and you just know the cough is going to linger for a week and keep the whole family up at night, please reconsider blocking the doorway until we give in and hand over that prescription for Zithromax. It won’t cure the viral cough and it’s bad for her.

Antibiotic resistance is a huge problem.  Help us curb it.

4)  Most medications in tablet or chewable form DO NOT go bad by the expiration date on the bottle. The pharmaceutical companies don’t want you to know this, but most meds in solid form are perfectly safe and effective for at least 6 months after the date printed.  There are a few notable exceptions, so ask your doctor or check a reputable reference site, but for the most part you’re just fine using that chewable Augmentin you never opened 6 months ago instead of refilling and re-paying.

NOTE: This isn’t true of most liquid meds, which tend to become unstable quickly.  And please don’t pour the old stuff (solid or liquid) down the sink where it can end up tainting our water supply.

5)  A lot of the time kids’ illnesses get better all by themselves (but we’re happy to take the credit). This is the beauty of pediatrics.  Children are amazing little beings who have incredible resilience and recuperative powers.  Their little bodies can take insults that would floor the average adult, and bounce right back.  This is not to say that you don’t need us — you do, but maybe not quite as much as you think.

I often tell parents that as long as your child will drink fluids, eat a little bit of the foods that appeal to him, and is fairly perky, it’s fine to wait 48 to 72 hours to see if Mother Nature will take care it. If things aren’t improving by then, come on in.

So there you have it — a few of our secrets revealed.  Stay tuned … there are plenty more.

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?

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