Friday, January 07, 2011

So I Dumped My Daughter's Doctor

Ah, the doctor-patient relationship.

I explored it a lot in Life Disrupted, but it is frequent fodder for this blog, too: seeing doctors as our advocates, knowing the importance of speaking up, and realizing I can just say no, for example. I’ve compared finding the right doctor to dating, and will tell anyone who cares enough to listen how wonderful my lung doctor is.

All of this is to say, by now I know what to look for, and I know what I will and will not tolerate. And then I had a baby, and I became the mother of a patient, and became her voice when it comes to health problems and doctor appointments.

Before she arrived, I did my due diligence. I researched pediatricians, ran some interview questions by my best friend, who is a pediatric nurse practitioner. I liked this pediatrician’s experience, and when I met with him before my daughter’s birth, I liked his approach. Our talk went well, and I left feeling reassured she would be in good hands.

Since she had jaundice and had trouble feeding because of it, we saw him a lot her first couple of weeks. I appreciate his close monitoring of her bilirubin levels and getting us to a lactation consultant, but even in those first early days we began to see signs Things Weren’t Quite Right with this relationship. And as her first days turned into first few weeks and more health problems emerged for my little girl, the evidence mounted:

No appointment, from a jaundice check to her 2-month check up (shots included), lasted more than five minutes. Five minutes. I am not exaggerating. Just enough time to weigh her, give a cursory listen to her lungs, and answer the one question I managed to spit out in time with “yes” or “no.”

I would mention discomfiting symptoms to him and he would brush them aside (real, legitimate symptoms—I won’t get too specific here to respect my daughter’s privacy, but trust me, legit) or, dash off a prescription.

When I would call to discuss her lack of improvement and ask for advice, we didn’t get anywhere. No investigation into what else could be causing the problems, no wanting to examine her when her symptoms got even worse, nothing.

Never once did he engage with my daughter aside from the perfunctory weight check; never once did he ask me how she was doing (or sleeping, or eating, or interacting, etc). Never once did he ask me how I was doing as a first-time parent, or if I had any concerns, etc. Developmental milestones? What, are those something you’re supposed to discuss with your doctor, ever?

Lastly, he said family medical history wouldn’t matter for a long time and would not discuss it, (like, walked away when my husband tried to discuss it). Um, hello? My family’s medical history is as complicated and lengthy as my own, and given some of her symptoms, very relevant.

One day, as I was about to call his office because she had gotten much worse, I stopped mid-dial. I was sick of hitting the same brick wall, and fighting to get him to pay attention to my daughter’s symptoms. She deserved a lot more than that.

I’d wanted this to work out because I’d invested time and energy into selecting him, had really liked him during our interview, and I kept hoping the doctor I thought he was would show up. I gave him the benefit of the doubt at first because I was the new parent and he was the seasoned doctor, but I know my kid. And I know when Things Aren’t Quite Right with her.

She is the most precious thing in the world to me, and I entrusted him to do right by her. Enough.

So that same day, I called a different practice. They worked us in that afternoon. In fact, their words were, “An infant with XXX? Bring her in right away!” With those words, I officially dumped her former pediatrician.

Her new practice took down her medical history, her family’s history, spent a long time discussing various possibilities and plans of actions with me, and got her in for necessary testing the very next day. From day one they were proactive in getting her the help she needed, and have been wonderful about answering my questions, following up on her specialist consults, etc. Together, we’re getting to the bottom of a few different issues.

I have been angry with doctors many times before, but never as angry as I was with her former pediatrician when her new team figured out some of what’s wrong with her, things he would have and should have found if he’d cared enough to listen and know, do his job.

Rest assured she is a thriving, happy, smiley little baby but we are very, very lucky we did not have a much bigger crisis on our hands due to his apathy.

I am so grateful she has such amazing doctors working with us now, and that’s what is important. But I forgot how crummy it feels to be so disappointed in a doctor.

I have long said that communication is central to a good working relationship. Since I'm her advocate in the exam room, if I don’t feel I can speak with my daughter’s doctor about her health, then that is obviously not a tenable situation. I don’t need my hand held, I don’t need excessively long conversations, and I don’t call unless there is something significant going on, but I do need someone who listens, who asks appropriate questions, and who cares enough to look for answers.


Rachel said...

How incredibly frustrating - one thing to face that apathy yourself, another for your little one who cannot advocate for herself. Ugh. I'm glad things have improved with her and with the new practice.

Laurie said...

Thanks! Yes, very frustrating indeed. Thank goodness we moved on from him. It was difficult holding my tongue when I stopped by to pick up all her medical records, that's for sure. I'm not sure what the issue was--burnout, maybe? Checking out because he was close to retirement? Either way, no excuse.

Never That Easy said...

I'm so glad you found somebody who worked for your daughter - how frustrating that must have been! On the other hand, a definite plus to having been a patient for a long time: you know when a doctor is just not cutting it, and that waiting around isn't going to change things... It's so nice when there's a plus side. :) Hope you are all doing really well!

Heather Laurie said...

Laurie, you are absolutely right. The more time and effort put into these doctor/patient relationships the more I try to make them work. Frankly in my rather intensive life of doctors that has only worked out once.

Sadly the doctor's attitude maybe what I faced as a young mom with a sick child. By the point I was a mom I had a lengthy list of health problems. The office manager took my calls and always tried to talk me out of coming in. When I did get there I was patted on the back as I was rushed through with a 'just because you have a few problems doesn't mean your child will'. I quickly got the feeling they thought I was projecting. sigh... I got the hint and like you changed doctors.

Praying your little one is on the mend and your household can calm down now.
God bless
Heather Laurie

Jake said...

Glad to hear things improved. Sounds like a horribly frustrating experience; nice job protecting your daughter!

Anonymous said...

If he is getting burn-out or getting uninvolved because he is close to retirement he should not have taken her case in the first place.

Cassandra said...

I'm so proud of you for advocating so well for your daughter. I have chronic issues of my own, and so does my toddler, and we've definitely been down the road of having a doctor who brushes aside concerns, doesn't listen to me, or ignores glaring problems. It was really hard for me to be able to advocate properly for my son when we encountered that situation, but I'm learning. I hope that things go well for your daughter in the future :)

Unknown said...

Way to go, Mama. I would advocate, however, that you make it known to the former doc why you left. It doesnt have to be mean, just honest. After I was blown off by docs who were not thorough/brief/etc with me and my concerns, and got taken care of by a great doc, I made sure to call each and explain not only my (laboratory confirmed) diagnosis they overlooked, but express to them my concern in their treatment and management of my case. I think these insubstantial practices might come partially from from the lack of "feedback" and the sense that these guys are not "held accountable" by patients. frustrating. my 2 cents.
congrats on finding a great doc with great care:-) thanks for all you do!

Aviva said...

Whew! I'm so glad that you found a new doc (and practice) that took your concerns seriously and figured out the cause of your baby's issues. Especially when our kids are pre-verbal, but even for a long time after they can speak, it really falls to us to describe the symptoms and our concerns to the doctor(s). And 5 minute or less visits with a sick kid?! You made the right call!!

I'd like to encourage you to follow Sarah's suggestion and send a letter (or call) the practice and tell the MD why he won't be seeing your daughter again. It probably won't change his behavior with other families, but he may be completely unaware of his faults.

I came very close to changing pediatricians because, although I loved our job-sharing docs, I found their medical assistant (are they even RNs anymore??) patronizing, poor at following up with phone calls, and had a lousy bedside manner/rapport with my kid as well as me. In fact, a friend I'd recommended the pediatrian to, who liked the doc, took her kids twice and said she refused to ever deal with that MA again.

We went to what I expected to be the last visit, and I was delighted to discover that the MA had been fired for undisclosed reasons. I then told the pediatrician that I'd come prepared to tell her that we wouldn't be returning despite all the things we like about her and her practice because of how patronizing and unaccommodating the MA had been at our last visit. She was appalled that she had lost at least one family of patients (my friends) without ever knowing the reason, and thanked me for deciding to talk to her about it before leaving.

I know it's not the same since in this case it would be the MD you have the issue with, but especially if it's a group practice, I think it could be beneficial for them to get the feedback.

G.N. Jacobs said...

Doctors! I would like to invite you and your readers to check out Dr. Nancy Appleton's blog to see if there are prevention techniques that can avoid having to see such incompetent doctors. Mostly we're about sugar...

Thank You

G.N. Jacobs for Nancy Appleton

Genevieve said...

I'm so sorry you had to go through the frustration with her Doctor. I will say Hannah's current Pediatrician has been wonderful, very conservative and almost OCD about things which makes me feel he is over protective in a good way. He interacts with her and already decided to schedule a sweat test to check for CF just in case. Her state metabolic panel was negative, thank God! But since I have this rare form of non classical CF per Cleveland Clinic's diagnosis, it's best she be checked. She just got over her first cold, her chest rattled like a cage, I freaked.

I've had to fight hard enough for my care. The Doctors I've dealt with for my own issues, well...some of them have been down right pathetic. I hope I never have to deal with this with her care. I wish you the best with her new Doctor!

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