I work as a pediatrician in a bustling metropolis, in an outpatient setting of a world-renowned academic center. One of those non-profit hospitals you see in television ads. For the last three years, our outpatient encounters have plummeted, and the mothership has put all efforts into recuperating financial losses. Meanwhile, our office phones are ringing off the hook, and we cannot seem to hire enough nursing staff to deal with the phone volume and our patients’ needs — not to mention the dreaded “patient portal” that allows patients free and direct access to their doctor. It’s a full-time job to reply to these patient messages in and of itself. So, in a lucrative and secure business such as health care (which will exist as long as human beings exist), why are hospitals and private practices struggling to keep their clinic slots full? Obviously, this is a question that is multifaceted in its causality, but one of the most important contributing factors is that people are expecting free and convenient care, and are becoming all too good at obtaining it.
While I practice pediatrics full time, I’m also a mom of two and the wife of a full time working physician. We were the stubborn couple who tried to do it all without a nanny and without local family. Our children went to daycare as of six weeks of age, contracting every illness from RSV to the flu to hand foot and mouth to colic and terrible toddler tantrums and every hurdle in between.
In some ways, my children are lucky their mom is a pediatrician, but parenting is challenging either way. Sure, I may have more medical knowledge than the average mom, but that doesn’t mean I don’t freak out over a high fever, struggle to grocery shop with kids or find potty training and healthy eating to be more challenging than life itself. What surprises most people is that I turn to my own non-physician mother for advice. She’s one of the few people that is willing to listen to me talk about my children without getting bored or tired of it. When she’s not available, I turn to my friends (those with kids and, sometimes, those without!). The person I do not turn to, however, is my pediatrician.
Somewhere along the way, people became too reliant on their physician for day-to-day challenges. Back in the day, a mom may not have gotten a prompt reply on a non-medical question from their pediatrician’s office. If they asked their doctor a non-medical question in person, they may have gotten an answer, but it may not have been a very kind one. Nowadays, with the pressures of patient satisfaction and direct and easy access to physicians’ and their staff, it is common for us to get inundated with questions like:
“Should my child’s blanket be made from fleece or cotton?”
“What type of dog should we buy?”
“My daughter has peach fuzz on her tummy. What should I use to remove it?”
“I took a picture of my son’s stool. Can you look at it and tell me if it looks normal?”
“Can you see from the picture I took if his teeth are breaking through his gums?”
“What should I use on a plane to keep my child occupied?”
“What brand of honey should I use?”
Brutal truth 1: You need to figure these things out on your own. There are libraries of books dedicated to parenting, products, consumerism, behavior, discipline and healthy diets. The person who does not have the luxury of the time needed to answer these questions is your doctor. For the simple fact that he/she is busy ordering chest X-rays and labs, treating asthma, prescribing medications to sick children with chronic conditions, navigating the epidemic world of autism and ensuring that your child is healthy and thriving. It’s hard for us not to think that the only reason parents are inundating our phones with these questions is because we are worried they are going to go on Yelp and give us a bad review, or because we don’t charge for our time the way lawyers do. “Easy” and “medicine” should not go together.
Brutal truth 2: If this trend continues, the future looks bleak for our profession. Physicians are already dealing with an inordinate amount of burnout, bureaucracy, documentation and clerical work. They have to battle with insurance companies threatening not to pay for payable services; a problem that does not really exist in any other industry. They also have to worry about the day-to-day stress of being a physician — e.g., making the right diagnoses, not overlooking something important while treating each patient as if they were their blood relative. They have to be the emotional support for people’s families in times of distress in life-altering cancer diagnoses and unexpected deaths. To add this daily influx of non-medical expectations and questions to our plates will only take us away from our true calling in life: taking care of patients. It will also bog down our phone lines for those who really need it.
This doesn’t mean your questions aren’t valid or important. It only means you may be going to the wrong person for advice. One thing that surprises me every day is how little people turn to their own families for input. Sure, we know more now than we did back then, but for the most part, our parents did many things right.
Common sense also really goes a long way. The old saying is definitely true; it, indeed, does take a village to raise a child. It’s just that everyone in the village has a specific role and your doctor’s role is to take care of them when they are sick.
The author is an anonymous pediatrician.
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