Episode 9: Be an Empowered Parent in Healthcare Settings

Ask Questions

Let's be very clear, your child's doctor is likely overworked and sometimes even distracted.  Bring your list of questions, make sure they get answered and if something sounds off or you aren't understanding their treatment method, slow the whole thing down and ask more questions. Here are some words, "Can we check in about diagnosis again?  I want to make sure I am clear on what you have in her chart." "I've read that this approach can have a negative impact on height, weight, behavior etc., can you help me understand why you have chosen this treatment?" "Getting 9 hours of sleep each night is not really a goal for our family right now, can you help me understand why you added it to the treatment plan?" "What are the side effects of that medication and help me understand why we are trying it?"  I appreciate it when parents do this, they bring insight to the situation that I just don't have access  to when first meeting a child. I am human, I make mistakes.  Sometimes I do not make myself clear.  A parent's questions give me the opportunity to explain exactly what I am doing and why, this is clarifying for me and hopefully for them, it helps build trust in our working relationship. But at the end of the day it doesn't matter if your provider appreciates this or not- it's your child's health and it's your right to ask a zillion questions.  I encourage you to ask all the questions you want, until you understand.  I also encourage you to fill up your self-care so that when these questions do come out they sound calm and respectful.  That is always a good starting point for any relationship and as your child may be in the room with you, it's an opportunity to model your values.

Let your provider know if you have concerns

Have you ever left somewhere just fuming and then went home to tell someone you love all about it- "I am so mad or I am really concerned about this!"  And they ask, "Did you tell them?"  This is a very logical question.  It's also a sure way to catch the death stare.  But since I am not sitting accross the table from you, space and time and geography protects me from your death stare,  I'll ask- Did you tell them?  Did you clearly express your concerns? Did you say, "Can we slow it down, this approach makes me uncomfortable. I need to get more information from you before I will agree to proceed." Most care providers will stop in their tracks then and there, horrified that you have been made uncomfortable.  But what if they brush you off?  Start documenting your communication attempts.  Many health organizations have patient advocates that can help you navigate the situation, support the dialogue between you and the provider or help you figure out the next course of action.   You may also need to reach out to the hospital or licensing board and you may at this point decide you will find another povider.  

What to look for in a provider

1. They have good interpersonal skills.  When you speak with the professional are they warm?  Are they focused on what you are telling them?  Are they empathetic?  These qualities will help you and your child feel comfortable enough to share all the important information about what is going on.

2. They create a "working alliance" with you.  Do they understand your goals for your treatment? Are they on the same page with the outcome you desire?  Do you feel comfortable with their proposed route for achieving this?  Listen to your gut.  If after a few appointments you do not feel this alliance, reach out to another professional to gain some perspective.

3.  They can explain what is going on with your child in a way you understand.  As a parent (or a patient) you should fully understand the assessment and treatment process.  What is the diagnosis?  How will the professional relieve the symptoms of concern?  The professional should welcome your questions and feedback concerning progress.  Feeling comfortable communicating with them is key.

4. They give you enough hope that you feel invested in the treatment plan.  You may be seeking support in a moment of crisis for your family and it can feel extremely vulnerable.  Does the professional help you to see the potential for growth?  Do they help you to feel confident about the challenges you will overcome?  If the professional makes you feel hopeful this will create a ripple effect for your child that will greatly benefit the treatment outcome.

5.  They stay deeply engaged through out the process.  There are ups and downs in therapy, with our child's behavior at daycare, and with a developing mind and body,  as in any process, but the alliance with your professional is a tool to help you understand why this may be happening.  Is your provider invested in your child's progress every time you see them or does it feel inconsistent?  Do they show care and concern for your child's well-being and progress?

6. They are willing to be wrong and willing to refer out! if it means getting to the bottom of your child's issue a well-trained and ethical professional will acknowledge when their idea or suggestion was wrong and when other professional support is needed.

7. They ask the hard questions.  Are they curious and engaged in understanding everything about your child's issues?  A well-trained professional has practiced asking tough questions and examining uncomfortable material necessary to create an accurate treatment plan and diagnosis.

8. They make recommendations that your family can follow through on.  It is crucial that the provider understands your family's strengths and resources so that you can follow through on actions that will support your child.  Example: If you have explained that you are short on money but have a lot of time in the afternoons to spend with your child a therapist could suggest low to no cost activities you can do daily with your child.  Or in the doctor's office they have a caring team that helps you navigate how much your insurance will cover for a follow up treatment or testing recommnedation.  

9. They do not use your time for themselves. (This is more specific to mental health professionals but in general I think it's good for a professional to hold boundaries and not leak their personal issues onto you). This is a big one and at first it can be a real draw for some people.  If a professional shares a lot about themselves (their own family, their daily life and values) it can be immediately comforting to some, especially when they perceive the professional to be similar to themselves or even hold some ideal characteristics.  But a good professional should be able to connect with you and your child with out taking up all the space.

10. They know their research and they love to learn.  Health and wellness fields are constantly evolving so it it is of utmost importance that we, as health professionals, stay up to date on the best evidence based treatments for the clients we serve.   It is our ethical duty to refer a client to someone who is more up to date on, or specialized in your child's issue if we are not.

For healthcare providers

I'm reading the book Attending, Medicine, Mindfulness and Humanity by Ronald Epstein, MD.  He shares how to use mindfulness skills to better serve our patients.  We talked about how busy physicians can be, and so using the mindfulness skill of  focused attention can help to slow down the treatment process, and help doctors attend to an individual patient with out being on auto pilot.  This is where mistakes can be made. With out taking this approach to fully see your patient, it is hard to forge a working alliance that is foundational for trust and communication, which will make treatment progress quicker and more accuaretly.  Working on the practice of curiosity helps a doctor to ask more questions, again not just run through a questionnaire on auto pilot but connect symptoms with the individual in front of them.  It also helps the doctor let go of their ego and see the patient as an expert on his or her self.  Here a better relationship flourishes, doctors get more accurate information and the patient is empowered.  So if you do any assessment or patient care in the healthcare setting I highly reccomend you check this book out yourself and even bring it in to share with colleagues for a supervision or training.

Links

How to Choose the Best Therapist for Your Child and Yourself

How Doctors Can Communicate Better with Patients

Attending: Medicine, Mindfulness & Humanity, Ronald Epstein, MD

Questions to Ask Your Child's Doctor, Stanford Children's Hospital

Kirsten Kuzirian