It’s the Relationship, Stupid

Apologies to James Carville aside, I loved Michelle Cottle’s recent essay in TIME explaining why she dumped her pediatrician.

It’s long been my contention that families turn to holistic, integrative pediatricians not because we embrace complementary and alternative therapies, but because we take our time with them, we believe in family- and relationship-centered care, and we work to establish faith and trust. These “old fashioned” values are often at odds with modern medical practices, sometimes derided as “high-tech, low-touch.” Yes, monetary compensation (read: insurance reimbursement) is not proportional to time spent communicating and building trust. Still, those of us who practice integrative medicine are motivated by parents like Ms. Cottle to continue practicing our highly-individualized, intangibly-rewarding brand of medicine. Long live Dr. P.

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From TIME magazine:

“Why I Dumped the Baby Doctor”

Pediatricians often treat parents like children. That’s why I got a new one

By MICHELLE COTTLE

Feb. 27, 2006

I’m in love with my children’s pediatrician. Yes, Dr. P. is many years my senior, I’m pretty sure he’s married, and I generally prefer my men without beards. But there’s just no resisting the man’s charms. He never tires of discussing the intimate quirks, habits and bodily functions of my beloved offspring, listening raptly to harrowing tales of vomit and fever. He knows all the tricks to turn my shot-phobic toddler from shrieks to smiles. (A bouncy tennis ball and a Thomas the Train sticker usually do the job.) And he keeps on taking my phone calls despite knowing better than almost anyone my capacity for neurosis and hysteria. (“Are you sure that’s diaper rash and not Ebola?”) We talk early in the mornings (call-in hours start at 7) and on weekends. During ear-infection season we see each other about once a week. Lately I’ve been thinking about asking him to move in with me and my husband, but I’m not sure there’s room in our driveway for a third car.

Admittedly I might be less susceptible to Dr. P.’s magnetism were I not still smarting over a bad breakup with my old pediatricians. It’s not that my exes were incompetent or unprofessional (although I could have done without the multi-hour waits). It’s more that they treated me and my husband with the sort of arrogance and unresponsiveness that, upon consulting with other moms, I’m discovering is not uncommon in parent-ped relationships.

Take the time I went in for my son’s four-month check up. After the requisite poking and prodding, the doctor consulted my child’s chart and casually noted that his head was growing very quickly and that we should “keep an eye on that.” Then she was gone.

I was halfway home before I began obsessing about exactly what it was we should be watching for. My first move was to consult the Internet, where I was horrified to find research suggesting a correlation between fast-growing heads and autism. Three hours later my husband came home to find me surrounded by medical-journal articles and two steps shy of a nervous breakdown.

We called the doctor for follow-up, but she was unavailable. Hours later, a nurse rang to say the doc was too busy to talk–and there was really nothing more she could tell us anyway. Hello? The woman to whom I had entrusted my firstborn child’s physical well-being had just breezily raised the specter of his winding up like Dustin Hoffman in Rain Man. Even if she didn’t have any answers, she should have had the decency to call me back.

That said, at least my old doctors never lied to me (at least, not that I know of), which is more than I can say for my friends’ peds. Last fall a handful of us wanted to get our tots flu shots without the mercury-based preservative thimerosal, which some people suspect is a risk factor for autism. Still searching for a new pediatrician, I asked a friend’s doctor about the issue and was assured that kids’ flu shots never contain thimerosal. A second friend was told the same thing by her doctor. It was very comforting–and very untrue. Another friend’s doctor, meanwhile, informed her that all childrens’ flu shots contain thimerosal. Also not true. In reality, a less prevalent thimerosal-free version can be had for a few extra bucks.

Since most pediatricians regard the hubbub over the possible risks of vaccines as silly (which it may be) and the growing trend among some parents not to vaccinate as dangerous (which it almost certainly is), I’m sure those docs thought they were doing us hysterical moms a favor by fudging the truth. And 20 years ago, we may never have realized what they were up to. But these days, any parent with a PC can do a quick Google search to determine the exact degree to which their physicians are treating them like children. Even the most obscure medical studies are easily accessible. Forget Dr. Spock. I can peruse Danish researchers’ findings on the connection between bed wetting and the color blue or whether being exposed to Donald Trump in utero makes my daughter more likely to fail the third grade.

Is this sort of home diagnosis a good idea? No. Are Type A parents going to do it anyway? You betcha. But this only makes it all the more urgent that we have access to approachable, communicative, truthful medical professionals who can talk us down off the ledge when we become convinced that our child’s hay-fever sniffles are actually the onset of avian flu. I’d offer you the marvelous Dr. P.’s number, but I’m afraid that if his reputation spreads he’ll be swarmed by desperate mommies. I wouldn’t want anything to cut into our quality time together.