Doctor, Doctor

Every parent understands the stress of taking a child to the doctor. You may be worried about him if he's sick, or worried that she will have a terrible reaction to a shot. You wonder if your child will sit still long enough for the doctor to even listen to his or her heartbeat.

What you should not have to wonder, however, is whether your doctor will actually treat your child, and do it well.

Photo from www.sheknows.com

Unfortunately, there sometimes is a disparity in treatment received by patients with private insurance and patients with no insurance or state-sponsored insurance. The latter might have less access to quality care, which may not have an effect - until they get very sick, and then sometimes, they have trouble getting the tests or access to specialists that they need. They may have to jump through a number of bureaucratic hoops before they get the care they need - if they do.

Worse still, they may be treated differently by doctors and their staff. And there is absolutely NO justification for that, especially when it comes to our children.

I started thinking about this recently when I had to take Anna to a cardiologist so that her heart murmur could be evaluated. We have Anthem insurance. The cardiologist was great - he and his staff made Anna feel comfortable. They understand that a small child may feel scared about being hooked up to a big machine. That also understand that parents are naturally a little freaked out about bringing their children to a heart doctor even if the suspected condition likely is not problematic.

Her little EKG tabs had characters from Dora the Explorer on them. Her snuggly Stitch was allowed to accompany her on the exam table. The doctor asked her about him while he listened to her heart. And, although her heart murmur appeared to be normal, the doctor also decided to perform an ultrasound out of an abundance of caution. What's more, he actually spoke to her about what was going to happen next, rather than just speaking to me about her. I appreciated his thoroughness and professionalism, but most importantly, I appreciated the kind, simple way he explained things to Anna, which allowed her to feel as comfortable as possible.

In fact, Anna had such a good time with the machines, and the aquarium in the waiting room, that she didn't want to leave!

Stitch and I were tired out after my doctor visit!

What angers me, though, is that this type of experience - thorough, compassionate care and special attention to the feelings of little kids - isn't necessarily the norm. I'm not saying that rudeness is instead; I'm just pointing out that this is how it should always be, but it's not.

Contrast this with Anna's friend's recent experience at an appointment with a specialist. She is almost five years old and has insurance provided by the state. To begin with, it was hard for her to even get in to see a local specialist because her condition wasn't considered serious enough to warrant an expedited appointment, despite the fact that she had a visible, open wound. That in and of itself is ridiculous.

When her parents were able to get an appointment with a specialist, they had to drive over two hours to the appointment, all the while reassuring their child that everything would be okay.

Well, it wasn't.

Not only did the doctor spend less then ten minutes with them after their long trip and the anxiety they experienced about what may be wrong with their child, but he was incredibly rude the whole time. Both parents told me that they felt that the doctor acted as if he couldn't be bothered with them, like they and their child weren't important enough to merit his time and attention. He treated them in a rude and condescending manner and apparently felt that their child's condition wasn't bad enough to even deserve an examination.

That's right - after a drive of over two hours, and weeks of trying unsuccessfully at home to treat the condition, the doctor didn't even fully examine their daughter.

Angry on their behalf yet?  There's more.

When the somewhat shell-shocked parents asked what they could do to care for the wound, the doctor rudely instructed them to wash it with soap and water. You know, because that had clearly been working as the spot had gotten worse over time. (Picture me rolling my eyes.)

However, the most appalling thing to me is that this doctor didn't even engage with the little girl he was supposed to be treating. He apparently spoke about her as if she wasn't standing right in front of him. He made no attempt to talk to her, reassure her, or try to make her smile because, understandably, she was nervous.

Photo from www.bestwayguides.com

In short, the lack of care these friends received was appalling by anyone's standards. Even the receptionist they saw on their way out - in less than ten minutes - seemed apologetic, as if she knew that particular doctor was, to put it far too nicely, lacking in appropriate bedside manner.

All this is to say that treating patients disparately due to their type of insurance, or lack thereof, or perceived socioeconomic standing, is completely unacceptable. And, even if that wasn't what was going on (although I am sure it was), it is also horrible to (a) fail to properly examine and treat any patient and (b) ignore a child who is scared and knows she is at the doctor because something isn't right. It's deplorable.

Regardless of the perceived severity of a child patient's condition, it doesn't take a medical degree to know that a child is likely to be nervous, if not frightened, when visiting a doctor. Anna's cardiologist knew going into it that her regular doctor didn't think the murmur was a major concern, but had scheduled the appointment out of an abundance of caution. Still, he treated her with dignity and respect and also with an understanding that this wasn't exactly a trip to the park for her.

In addition, the physicians and nurse practitioners who treat Anna for her routine care are nothing short of phenomenal. They engage with her and ask her about her interests. They show that they care about how she is feeling. They tell her what they are going to do before they do it. They usually offer to listen to her stuffed animal's heart or look into its ears first, which she loves. They let me hold her hand if she wants. We have seen a number of different people in that practice over the years, and literally all of them have done the things I just described, even though it's not a pediatric-only practice. They see patients of all ages. And they are wonderful with children.

It should be like this for anyone, especially any child. Our children are the most vulnerable members of our society. They may not understand why they are at the doctor or that the doctor is their friend. It is therefore incumbent on the physician to make the little patient feel welcome and reassured. That's not too much to ask, no matter what insurance you have, and regardless of whether your child has a cut or cancer. Kids need that feeling of security. They deserve it too.

Photo from blog.scratchmenot.com

Don't get me wrong - I am not maligning the entire medical profession. I believe that the majority of doctors do their jobs well and demonstrate that they care about their patients. But it's important to call attention to the situation when a doctor doesn't meet these most basic standards because he or she is doing a disservice not only to the patient, but to the profession as well. It is a problem that can, and should, be addressed by the appropriate authorities within the state's medical system.

I guess my major point with this post was to rant about how appalled I am by our friends' experience, especially in light of my experiences with Anna. My friends, understandably, were stunned by this doctor's behavior. I would've been too. So, hopefully this can be a warning to all of you out there that you never know what may happen and, whatever it takes, you should insist on the best possible care for your child. Unfortunately, this proves that we may not even be able to trust our doctors to do this, so I guess we'll have to make sure of it ourselves.

If you have an experience like they did, you should write a letter to the practice and also complain to your state's board of medicine, as my friends will be doing. Not only will it hopefully provide some measure of relief for you, but you may also be doing future patients a favor.