In pediatrics, no visit is a wasted one

The last patient of the day rushed to the office before closing time. When I entered the room, the dad was texting as the nurse finished recording the child’s temperature.  He shook his head in disbelief and confessed that he just sent his wife this message, “I feel stupid.  No fever here.”

Parents apologize to me everyday because they feel like they wasted my time and/or their co-pay.  Coordinating a doctor’s visit between parental work schedules and office hours is stressful, and there is no ideal timing.  Yet inevitably parents feel silly for bringing a child too soon or guilty for bringing a child too late.

Kids can get sick suddenly and better quickly.  Their eagerness to play often conceals early signs of illness.  Even when children are old enough to provide a history, parents must decipher the severity of the complaint which for unusually stoic or sensitive children can be challenging.  Sometimes a complaint that’s initially attributed to too much pizza or a missed nap results in a doctor’s visit that uncovers a more significant problem. In these cases, parents often ask if they waited too long to seek care.  Nothing makes a doctor swallow her pride more than being a parent.  I’ve been there.

When my daughter was six months old, she fell off the bed and hit her head, a common injury that almost never results in any harm.  However, I could not calm her down and her crying seemed excessive.  Fast forward six years and it turns out that my daughter is sensitive, intense and passionate.  Falling off the bed rattles any child, but add that to her temperament, mix in my anxiety and guilt, and it’s no wonder I failed to console her.

I jiggled her like jello, nervously patted her back, paced, worried and thought, “How could I let this happen?  What if she’s never the same again?”

Completely irrational?  Yes.  But I even convinced my husband, who is also a pediatrician, that we needed to take her to his office.

As soon as we arrived, she stopped fussing.  I felt ridiculous sitting before my husband’s eighty year old partner explaining what happened.  This lovely man still had a microscope even if technically he was not allowed to use it.  He percussed heart borders and reflexively tested nuchal rigidity because meningitis actually killed several of his patients.  This lovely man had not a trace of judgement in his eyes only compassion.

I remember that visit each time I say, “It’s only a virus, just a cold, or bump on the head.”    I want parents to know that I value their time and understand the unpredictable nature of  both medicine and children.  I like “unnecessary” sick visits even if it leaves parents with a bit of buyer’s remorse.  If I wanted a day filled with admitting children to the hospital, calling consultants, and ordering tests, I would have chosen emergency medicine not primary care.  And if I wanted a vulnerable population with no parental advocates, I would have chosen geriatrics. Parent advocates never inconvenience me even when they bring in kicking and screaming children.

Kids can fool the most experienced mother of five whether she is an attorney, police officer, teacher or health care provider.  Our concern clouds our objectivity as parents.  When in doubt, call your doctor and get advice or insist on an appointment.  No visit is a wasted one, at least in pediatrics. That’s why we give out stickers and lollipops.

Denise A. Somsak is a pediatrician who blogs at Pensive Pediatrician.

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  • LBENT

    As a pediatric specialist–ENT, I cannot agree more. So many times I have had kids brought in for “nothing” and it is a very serious matter. And when it isn’t, it’s a good time to reinformce other health issues that might be on a parent’s mind. Good post.

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