“Your child has a cold. It’s just going to have to get better with time.”
Between now and St. Patrick’s Day, I expect to repeat variations on the above phrase roughly 17,000 times. With each beleaguered parent I encounter during cold and flu season, I try to take a tone of sympathy as I forlornly explain that I cannot make their kid’s cough go away.
It can be tense even when I don’t have to talk parents out of a demand for antibiotics, since it’s frustrating under the best of circumstances to be told you’re simply going to have to endure some unpleasant symptom or another until it goes away.
However, frustration can be a two-way street. There are a handful of recurrent annoyances that, in the snot- and fever-filled months to come, are best avoided to help your child’s doctor have a slightly brighter day.
We do not offer “buy one, get one free” deals.Often enough, patients who are scheduled to see me have a sibling or two tagging along for the visit. There is absolutely nothing wrong with this, and I’m happy to have a small posse in the room if circumstances demand it.
The problem is when parents ask if I can briefly examine one of the tag-alongs when they’re not actually registered to see me that day. Often they have a minor variation on the symptoms that brought their sicker brother or sister in for an actual appointment. For whatever reason, the “while we’re here, can you also check other child’s lungs/ears/throat/etc.?” request is common enough.
Asking me to examine another child who isn’t scheduled to see me is asking me to deliver a service, however small it’s perceived to be, for free. It’s not all that different from going to a restaurant and trying to snag an extra side dish that isn’t included in your meal. Examining patients is what I get paid to do.
Getting asked for free advice is something that goes along with being a member of certain professions. I’m willing to dole it out (within reason) to friends or family as a perk of being willing to put up with me. However, I’m less enthusiastic about it when it happens in my office.
When I’m asked to do so, I usually sigh inwardly and explain to parents that if things really are brief and the thing I’m asked to check is normal, I’ll go ahead and perform the exam on the house. (Mentally, I write off the deferred cost as “public relations.”) But if there is something abnormal I have to treat or anything else that may add to the visit’s complexity, they need to register the other kid as a patient that day, too.
No matter how superficial and simple the question may be, I’m liable for every piece of advice I give out in my professional capacity. (Caveat emptor, those of you who corner me at cocktail parties!) Even if the lungs and ears are totally copacetic, it’s prudent for me to document what I observed and what I said. If there’s any actual medical decision-making being done, that means I have to write a note in the chart explaining it. This takes time from my already-busy day, especially during peak season.
My time is valuable. It takes chutzpah to ask me to give it gratis.
Brief visits are for straightforward complaints.
Some days, “by the way” are the most terrifying words I can hear.
When the waiting room is packed with sleep-deprived parents and miserable children coughing and blowing their noses, we try to offer as many sick visits as necessary to see patients promptly. Our staff asks when they book these appointments what the reason for the visit might be, and they try to schedule things appropriately for the complexity of the issue at hand.
If the reason given for the visit is a straightforward concern like a possible ear infection or strep throat, they set aside less time than if it’s for something that will take longer to discuss and manage. (And even a seemingly basic complaint can end up being more complicated than it first appears.) Booking a visit for simple concern while leaving unspoken “and also my kid has chronic constipation and an anxiety disorder I’d like to talk about, too” flings a monkey wrench into my day.
At the end of every visit, I ask if parents have any other questions before I exit the room. I do this because I never want anyone leaving my office feeling confused or as though their concerns weren’t thoroughly addressed. It’s a commitment I take quite seriously. But it’s not an invitation to bring up an unrelated, complex problem that warrants a whole separate appointment (or several) when the visit was booked for a simple issue.
If there is an urgent need that really needs to be addressed, monkey wrench or not I will take the time to address it. But if the additional concerns can wait, I will politely explain that I can’t keep a waiting room full of patients lingering while I spend another half-hour on a problem that deserves a lengthier appointment to be appropriately managed. I have them schedule a follow-up appointment and move on to the next patient.
Please don’t touch my stuff.
As diligently as I try to see patients as promptly as possible when they’re waiting for me in an exam room, sometimes I get behind. Despite the books and toys available to entertain small children as they bide their time, I understand it can be boring. Even when everyone and their cat has a smartphone, it’s tedious to sit around.
But that doesn’t mean the medical supplies in my office are playthings.
Tongue depressors and rubber gloves make for amusing little puppets and balloons, I’ll grant. Even so, I’d really prefer that people not help themselves.
We use the stuff in our exam rooms for various medical purposes. When supplies are low, we need to replace it. Even if any given handful of cotton swabs is affordable, to quote every parent who’s ever lived, they don’t grow on trees.
Do I worry that we’re going to go bankrupt replacing non-latex five-fingered balloons? Not really. But it’s flagrantly inconsiderate to let your kid rummage through our office supplies for distractions while you wait. Pack a snack and a few toys instead, please.
I totally get that nobody is happy to languish in my office with unhappy children suffering from uncomfortable, vexing symptoms. I work really hard to fix problems when I can, and reassure when I have little more to offer. Being a pediatrician in December means listening to parents and offering sincere commiseration when there’s little else to do but persevere. My own kids get sick and cough all night, too, after all.
But even when we have little to offer but a diagnosis of a viral illness that will pass with time, we’re doing our level best. It’s a tough season on everyone, phlegm-wise. Help us make it through our day by respecting our time and our space, and together we’ll make it to spring.
