Getting ready for work the other day, my 12 year old developed an ear ache. I knew it was nothing serious given her age and the fact that only minutes before she was fine. Yet, the temptation was too great to not take a quick peek. That is the blessing and curse of being a doctor-mom! So, peering in I confirmed what I already knew: nothing was going on. True, she had a tad of fluid from allergies but I didn't need an otoscope to know that since she was a known hay fever sufferer and the pollen count was through the roof that week. A touch of over the counter ibuprofen and allergy meds later, she was on the road to feeling better and without a "real" doctor's visit.
It occurred to me as I was driving to work that my day would likely be filled with similar complaints, as typical. Despite the fact that most kids truly are well, parents often have times believing in that wellness and come in very quickly at the first sign of trouble, or perceived trouble. You may think that this is because they are not doctor-parents but education doesn't seem to be a factor for the "must run to the doctor" switch to get thrown.
Intellectually, many of these parents often begin the visit by telling me they recognize I will likely find "nothing". Parents have also caught on that antibiotics are not quickly prescribed these days nor are xrays obtained that often for most injuries. Moments like this beg many questions such as why parents have trouble believing in the wellness of their kids and why as a medical profession we haven't been successful in helping parents feel comfortable with the same watchful waiting approach they use with themselves, the very one I used with my daughter.
True to form, my schedule that day was as predicted. At least half the patients I saw that day could have stayed at home. I saw the cough that had been present for 2 days. I saw the back pain that began that day after a flip. I saw the sore throat for 12 hours and the ear pain for 3 hours. Among these, there were also other visits that clearly needed to be seen that day such as a few small children with very high fever, coughs that had been present for over a week getting worse and now with fever, car accidents with concerning symptoms.
What drives parents to come in for the truly sick kids is always clear, but for the well kids I'm still at all loss to truly understand. I suspect that our inability to be comfortable with our kids wellness comes from our anxiety over the crazy lives we often lead and worrying about taking time out later for something missed. I also suspect that many parents operate out of a sense of guilt for not being home earlier in the week so at the first sign of trouble they worry that they may have missed something earlier.
All we can ever do is assess the situation as it is today. If your child looks well, not sick appearing, what ever the complaint is likely not as urgent as your anxiety may lead you to believing. Given that most situations in pediatrics are self-resolving and that most illnesses are viral, you really have more time than you may realize to let a situation evolve, assuming your child is otherwise well. The key here is the wellness factor. That should be your overall guiding principle - not guilt or anxiety or a sense of missing something. Believe in your child's wellness and in what your child actually tells you.
Health care is complicated and health visits only helpful when they tell you something you don’t already know. With our health care system over loaded one way we can help each other out is to begin to trust our instincts more and not use the doctor’s office for reassurance for what you already know as parents – phone calls and phone advice and often accomplish that for you more times than not and help guide you to when you really need the office visit.
We are always there for you but in the end I always sense parents are frustrated when we don’t find something but if you come to us hunting for a needle in a haystack, and get the needles, please don’t be upset with us. There is really only so much we can do.
Summer is here and I hope I see less of you than more of you. Keep in mid that my colleagues and I will always see your child if you want us to, but in my world, seeing you means your kids are sick or injured and my wish is always for healthy kids.
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