Five Things Pediatricians Do That Drive Me Crazy

I live in a small city, so we very seldom have to wait more than ten or fifteen minutes (sometimes less) to see the doctor. So at least I don’t have that.

But — I know what you mean about the question and answer. My son is has severe cognitive disabilities, articulation problems, and little speech. Yet the same doctors keep insisting on asking him questions he can’t possibly answer, making his anxious — and therefore much more uncomfortable during the session than necessary.

As for acting like they like my child — with some doctors and even practitioners who work specifically with children with special needs — that can be a problem. And, as you said, sometimes they don’t seem to like kids period. I have typically developing children who the doctors also seem to have little real caring about. It’s weird.

We do have a wonderful developmental pediatrician now that we see several times a year — but she’s not the one to call on for routine medical stuff — that’s covered by our rather blase pediatrican.

In fact, these are all valid. The office should not be an ad for medical products and they should not be charging for forms… way to make me feel like part of the medical practice.

Wow. I have no children, and after reading this post of yours perhaps I’d like to keep it that way.

They make you PAY FOR FORMS?? WOW, that’s the most absurd thing I’ve ever heard of.

One of my friends recently dealt with a rare and perplexing medical problem in her six-year-old. She was forced to sterilize and then mix up bags of goop, stick needles in his arm and then make sure he stayed hooked up to a pick line through the night.

All this – BY HERSELF, at home.

This is completely absurd to me. What would happen if she messed this up? She’s not a doctor – not even close! So basically the message I’m getting from this story is that any fool can do medical procedures.

Sheesh! Thanks for sharing, although I must say I’m even more disturbed than before.

Dina

Our pediatrician also charges for forms. But other than that I worship him. My son has autism and our ped is always on time and very patient. Of course, we had to go through 3 doctors who weren’t, and one who told us his language delay was us being anxious first time parents, but at least we did find a gem in the end!

I’ve never heard of charging for forms..that’s crazy. I hate waiting too. If I should be on time, then my doctor should see me close to that time.

I love my daughter’s ped except that I feel like he is rushing our visit. My daughter is 18 months so each visit there has been a ton of instructions about development, what to look for when, etc. He blows through all of this information really fast. I should bring a tape recorder so I can review all the information since I can’t process it all at once.

What is it with people and their sense of entitlement at the doctor’s office? The physician’s time is just as valuable as, say, a lawyer’s or accountant’s. If you were to ask your lawyer to complete some paperwork, there would naturally be a fee involved, based upon the hourly charges. The physician is simply doing the same thing. Bottom line is that you are asking the doctor to work “overtime”, therefore they need to be paid for it. Get over it.

Typically, the fee charged for the form is based upon the time taken to read the form, ensure that the information is correct (i.e. review the relevant portions of the chart), perhaps contact the relevant authorities, then sign and accept liability. I have been in a position where a $10 fee for a form ultimately resulted in being later subpoenaed and spending a whole day in court. I never did receive compensation for it. Thus, in effect, filling the form and spending a day in court netted me $10. I still had to pay my staff out of the $10 too, since they worked the whole day that I wasn’t there. Don’t underestimate the “liability” component.

As far as running late, I really find that one interesting. patients are quick to chastise the physician for running late, then have no problem running past their booked time with “just one more thing, doc…”. Oh, and my favorite – “can I just ask you something about my other child, even though he/she isn’t here right now…”

I guarantee that the doctor is not (as much as he/she would like to be) on a coffee break. Nor is there time for a nip out for happy hour, or a stop at the dry cleaners. Most times, there isn’t time for lunch, or even to go to the bathroom. I’d suggest that you ask next time, but that would only make him/her later still.

Those pictures that you don’t like looking at are typically there as teaching aides. They aren’t there for your amusement, so if you don’t like them, then feel free to decorate your home or office in a different style. Those pictures are put there so that the physician can educate the patient/parent as to what exactly is happening, and why a certain course of action is being taken. They also may be there to help parents identify certain disease states, and differentiate between what mandates an urgent visit, and what may be deferred for a few days. This in turn may help to avoid the overwhelming number of “emergencies” that turn out not to have been true emergencies. More often than not, the person seen is the one who screams the loudest, not the one who truly needs to be seen. This in turn compounds the issues discussed above.

In terms of drug-company paraphernalia, you can look at it two ways. If your physician is ethical (and despite what the media seems to indicate, the overwhelming majority are scrupulously ethical), then you should assume that the physician is simply using the drug company as a means of lowering costs, in order to avoid having to “churn” patients. The alternative, and equally valid, viewpoint, is that the physician may be selling out. This is a tougher call, though, since most have “stuff” from all of the companies, without a clear preference. If you really want to be sure, then I would ask these questions whenever given a prescription (I try to explain the answers to my patients as a matter of course, but it does tend to make me run a bit late): “is a drug necessary in this case?”; “is this particular drug the best option?”; “is there a generic or lower-cost equivalent that would work as well?” I’d be willing to bet that in most cases, you will end up with exactly the same course of action (same prescription/sample).

In terms of not caring, I can’t explain nor defend that. I would suggest, however, that your physician probably cares a whole lot more than you seem to believe. Physicians go into medicine because they care (I cannot be convinced otherwise – there are far too many easier ways to earn the same income). However, physicians are human. They are allowed to have up and down days. For some reason, however, people are quick to discount the ten years of pleasant encounters and complain about the one encounter that was marginally abrupt. What does that say about your own attitudes?

You say you sympathize with the financial constraints that the general practitioners are under. What most people don’t realize is that (where I work, as well as in many other parts of the country) many primary care physicians earn less then plumbers and electricians. The difference is that physicians start earning 6-10 years later, and start with an average of $150K in debt. They also generally have no pension plan, retirement plan, or drug plan. And then they go through days where patients crap on them (literally and figuratively), and they know that 30% of their billing submissions will be rejected for no discernible reason. Oh, and don’t forget the proposal on the table that may allow some un-named bureaucrat to penalize them if they don’t meet certain “performance ideals”. But still they should be like Mary Sunshine and always “put on a happy face”.

So in answer to your final question, yes, you are being a bit harsh.

Wow, talk about harsh. I’m glad MD is not my pediatrician.
But to address some of the points he/she made:
I think patients’ sense of entitlement comes from having paid for an appointment–you pay for something, you expect to get it–and for an appointment, part of that means being ON TIME (at least within reason, say no more than 10-15 minutes late??).
Now I understand that in the medical profession things cannot be totally predictable. Emergencies come up, etc. What REALLY bugs me is when things are running late, but no one in the doc’s office will inform the waiting patients, and give us the option to go for a walk, or even re-schedule (if we are just there for a wellcheck, I would rather come back another time rather than spend an anxious hour or two waiting and trying to entertain my child with autism–by the time we’d actually get to see a doc my carefully planned timing for the visit would be totally shot, my child would be climbing the walls and I could no longer hope to concentrate on whatever the doc might have to say, much less offer well-thought-out answers to questions.
Not to mention the other obligations in our lives as parents–other children who may be with a babysitter with a time limit or who need to be picked up from school…patients’ time and schedules need to be respected.
If a parent begins asking an unreasonable number of questions about other topics unrelated to the current visit, it is up to the doc to diplomatically explain that other patients are waiting and further discussion about other things will need to be done at another appointment.
Blaming patiient B for patient A’s attempt to get the doctor to answer extra questions is completely unprofessional.

Now about the forms. If there is a long complex form to be read and multiple answers to be filled out, I can see charging for it. But if there is a simple “yes this child received a well-check and is in reasonable health” statement to sign–that should be well within the “15 minute” appointment time that seems to be fairly standard now–and not require extra charges. As for the liability bit, that is part of the package of being a doctor–that is in part what they are paid for in the first place.

Regarding the posters on the walls. I don’t have a problem with them as my kids are curious and not really freaked out. But since some kids are, what is so hard about having another piece of cardboard covering them that could be flipped open when needed? Come on, this would be simple to fix and the unwillingness to address it reflects the arrogance that patients resent in some doctors.

I have to say that I live in a big city and do not have the issues previously cited with my pediatrician (though I’ve had them with other doctors). My one main complaint is about the information that could be shared by doctors but isn’t because they don’t bother–especially with parents who are new to a particlar situation. When I had my first child, I didn’t know what I didn’t know. It would have been so helpful if the doctor had given me quick rundown on basics such as “you should call us if a fever reaches such and such a level” or “here is our procedure if you need to call outside of office hours” or even a reminder to write down any concerns and bring them to the next appointment. These things may sound basic to a veteran parent or doctor, but to a new mom who hasn’t had lots of experience in navigating healthcare systems and is busy learning to manage parenthood, they may not be so obvious. So please docs, take the extra minute to explain WHY giving an antibiotic to your child for a cold is not appropriate; explain about developmental milestones and let parents know where they can learn more about them – maybe even hand out a pamphlet (if only I had known years earlier how significant a lack of eye contact is). When I think of how often I was told by medical professionals: “gee your son sure is, uh,…busy,” but no one ever thought to suggest perhaps I might consider getting him screened. Perhaps we would have recognized what was going on years earlier.

i must contradict. i have only met one bad pediatrician in my life, seriously, why, besides their love of children, would anyone go into the LOWEST PAYING of ALL medical specialties?

if you are uninformed as to why pediatricians sometimes make you wait for so long, go volunteer at a ped office, and you will find out hy it takes so long and why they are STILL rushed.

This is my beef: Why do pediatricians talk to my children about things like bike safety and proper nutrition?I get that these are important things, I just think that intellegent parents are already on top of these things. it feels offensive to have a man that spends 15 minutes a year with my child ASSUME there is a need for such lessons.Talk to me, if you leave feeling that i’m incompotent then do your thing. But if after talking to me you see that your dealing with an informed eduacated proactive parent then backoff. DEFER. And please do not ask me to leave the room in front of my children in order to discuss topics which you have not even talked with me about first. I love my pediatrician, i know he’sjust doing his job. i actually think he’s especially wonderful (that’’s why I choose to bring my children to him) but, I just want a little respect, that’s all.

There are a lot of good and honest comments listed above and some I just shake my head at. Just as there are different people in the world, there are different types of doctors. Heck, you can substitute the whole attitude thing with the teaching profession in many ways. Some people should just know when they have burned-out. However, I will say this as another pet peeve–I spent 18 months trying to get former doctors (one practice, 3 docs) to “see” the developmental issues I saw. As mentioned above, I was just an overanxious Mom–until we hit the magic age of 3. In defense of doctors–I believe many parents come in believing their child has the latest issue sensationalized on your favorite news bite. However, doctors do need to consider when a Mom comes in with a handwritten laundry list of issues that are often displayed right in your waiting room! My youngest son’s current doctor has “info” sheets that are handed out at each well-child visit and then ones specifc to each immunzation, sickness, etc. It does help especially when you are trying to prevent your child from launching themselves off the examing table while listening to the doctor respond to your question. It is something tangible that parents can walk out of the office with and then can call and speak to the on-call nurse with if they have questions later. It keeps the doctor free to see patients but still provides an opportunity to ask questions for clarification if necessary. I am also blessed that my doctor’s office knows I travel an unholy distance to see my specific doctor. They keep that in mind when scheduling. In return, if I am late I have to show the same courtesy and call. I’m sure many doctors would agree that is helpful. Finally, I want to put my son’s pediatric cardiologist on a pedistal. When my son needed to see him as an infant–he understood babies don’t “get” appointment times. I will never forget the time his office scheduled my son’s appointment after his regular doctor’s appointment so we wouldn’t have to travel so far twice in one week, tried to be as gentle and soothing as possible with a mobile above the examination site for his echo-cardiogram, and then gave me time to feed him DURING the appointment. (He left to make a phone call; but said he knew my son needed the break.) To finish, he spent 15 minutes afterward to answer questions with my husband and me. UNBELIEVABLE! Totally unrealistic for most medical offices…but nice to know the fairy tale does exsist.

OH MY GOSH!!WHINE WHINE WHINE.
NO-ONE EVER SAID THE DOCTORS OFFICE WAS ENTERTAINMENT CENTRAL. NEITHER IS IT A HIGH CLASS SPA WHERE U CAN BE TAKEN IN FOR YOUR PROCEDURE ON THE DOT OF 8. PATIENCE IS A VIRTUE. WISDOM CANNOT BE BOUGHT, COMMON SENSE IS DEFINITELY NOT COMMON.

PEOPLE, PLAN FOR UNEXPECTED!!! TAKE BOOKS, TOYS,ROPES OR APPROPRIATE DISTRACTIONS FOR YOUR KIDS TO PLAY WITH AT THE APPOINTMENTS.

SOME KIDS ARE SICKER THAN OTHERS. IM SURE YOU WOULD BE GRATEFUL IF I TOOK MY TIME TO ENSURE YOUR LITTLE JOHNNY WAS GIVEN THE BEST CARE WHEN HE IS SICK, PLS DONT GRIPE WHEN I DO THIS FOR YOUR NEIGHBOR.

ALSO DONT EXPECT ME TO WORK FOR FREE… I AM A TRAINED PROFESSIONAL, SINCE MY TIME IS VALUABLE I EXPECT TO BE PAID TO FILL OUT THOSE FORMS, EXAMINE YOUR CHILD AND DISCUSS LITTLE DETAILS YOU MAY ALREADY KNOW BUT THE NEXT PERSON DOES NOT KNOW ABOUT CHILDREN. AFTERALL, YOU PAY YOUR MECHANIC TO FIX YOUR CAR AND YOU WAIT DILIGENTLY WHILE HE DOES THIS. WHAT IS MORE IMPORTANT- YOUR CAR OR YOUR CHILD??

ONE LAST THING… PLS DONT EXPECT ME TO PUT UP WITH YOUR ILL MANNERED KIDS. THEY ARE YOURS, ITS OK FOR U TO HAVE TO DEAL WITH THEIR BRATTY ATITUDES. BUT I DONT. SITTING STILL FOR 30 MINS OR 1 HR IS NO EXCUSE FOR BAD BEHAVIOUR. SO PLS REIGN IN UR KIDS, BEG OR BRIBE THEM TO BE ON THEIR BEST BEHAVIOUR WHEN THEY ARE OUT- BECAUSE THEIR BEHAVIOUR REALLY IS A REFLECTION ON YOU!!!

Ok I am a pediatrician and let me try and explain why the pediatric office stinks (besides the dirty diapers). Primary care, especially peds and family practice is basically a failing business model. This is really what it boils down to.

Your reimburesement for care from insurance companies has not changed or has actually gone down over the past 10-20 years. So like most jobs where you get a raise every few years, we are actually making less.

Since I have been out of my residency I have never worked less than 2 jobs, sometimes 3. I basically live paycheck-to-paycheck. Every summer I ask families where the go on vacation (I very rarely meet a family that hasn’t gone somewhere), me I haven’t gone anywhere in 3 years with my family, cannot afford it. Gosh I thought I was gonna be a rich greedy doctor, guess not.

The only way physicians have to remedy this problem is to SEE MORE PATIENTS. Its the only way to increase revenue. Most pediatricians need to personally see 15-20 patients to simply break-even on their practice model. In order to make an actual profit (and trust me not a very good one) is to see 30-40 patients per day. You have to understand that’s a BUSINESS like anything else. Our overhead is tremendous. For example our computer sytem, about 100K, my malpractice about 20K. I have approx 100K worth of immunizations in my fridge (I had to buy them with $, they didn’t magically appear there.

So all I can do is see more patients, I get maybe 10-15 minutes a patient at the most. This is what happens, this is why you have to pay for THE STUPID FORMS. Look if I had my way I wouldn’t have you pay for the forms but this what’s happening to the business of pediatrics, its just a fact of life.

So basically as I said the only way to make more money is to see more patients and decrease the time and care given to your child.

Many practitioners and patients are sick of this so are starting to convert to a concierge style of care as I have. Basically for a retainer fee you can contact your physician directly day or night and even have the availablity for house calls.
So yes I am making you put your money where your mouth is. You say you want more time with your pediatrician then its going to cost you.

Most practices will convert to this style at some point since the present system is unsustainable. So you can either wait at the ER or Minute Clinic for 4 hours or you can pay someone to care about your kid.

Have a nice day

I have no problem paying a retainer to my pediatrician. However, now that we are doing “business” and I am now a “client, here’s what I expect:

To speak to a nurse right away when I call or a phone call back within the hour to address my concerns.

No nasty receptionists. I want my children and I to be greeted with a smile with lots of eye contact.

I want all of the laminated rules that appear throughout the office removed:
Watch Your Children,
Clean up after your children use the bathroom,
no drinking out of the drinking fountain – use cups only,
no cell phone use,
sign in here,
Your insurance company may not cover all of the costs that have incurred
Second copy of camp or health forms is an additional $10.00 Charge

Doctors on time or a phone made in advance letting know that they are running behind so many minutes.

No charge for calling a doctor on call that night

All state health forms needed for school should be on hand at the office in hard copy or electronic form so if I request them they can be filled out and sent back to me in a timely manner.

Lots of good bedside manner.

Hey Momofpjm. This is exaclty how my practice works. You never speak to a receptionist or nurse. You just call me personally. My patients can contact me day or night via private cell or email. I make myself available for housecalls as well. The retainer fee allows me to have less patients, cut overhead, and provide more personalized care.

The fee is $3500 per year per family and $150 per visit.

my mom always says the same thing. i think they should change the pictures on the wall. they are ssooo boring.lol….