Tuesday, February 17, 2009

What's Up, Doc?

Yesterday I took Hazel in for her 4 month check up. She is 14 lbs 11.5 oz, 25.5", and has a 16.5" head. That makes her average-noggened, a little tall, and more than a little chubby. But overall, normal & healthy.

Going to the doctor is seldom a flippant or casual exchange. First of all, it's almost always preceded by some sort of calamity, which always flavors any interaction. The exception here is some of the prenatal care visits. Mine became so routine & boring I wondered why we were even going. But those visits were really nice for one reason: it gave me a chance to take note of how the office actually ran. I got to see Nurse Susan & Nurse Melissa actually talking to other patients on the phone as I passed them in the office. I've been on the other end of that line before, and I really had never made the connection that they were real people working with my doctor. I also started to understand that the medical business is just that -- a business. And just like any other business, everything has a cost associated with it.

Consequently, I started hoping that I was never that patient that took too much time (the doc's time being the cost). I imagined sessions around the Krispy Kreme box, with nurses & docs & lab techs all dishing on which patients were high maintenance. My ever-resurfacing need to be liked rose and inspired me to be easy & prepared; never asking too many questions or needing more time. This worked as long as I stayed healthy and felt sane. This approach, however, is really hard when your baby has been crying for way to long and you're dealing with post-partum hormone re-regulations and you just want some freaking answers. But still, I kept it cool, even if it meant settling. Because I just really didn't want to be that patient. I wanted to be liked. So much so, that after I would get off a 10 minute call with the nurse, I would seriously consider sending her flowers with a note saying something like, "Thanks again for the time you spent with me yesterday. We love you! You're the best!" Even though it wasn't that great (usually even a bit disappointing), but maybe if she liked me best she would do better next time. Sheesh! That's pathetic! But anyway, back to the present...

Yesterday I felt pretty rushed. My doc spent about 5 minutes with Hazel & I, remarking on her great trunk control and asking if she slept through the night. There were about 10 seconds spent on vaccines. She looks at Hazel, punches some things in the computer, and closes the file at her waist like she's ready to walk out the door. Seriously? I'm sure there are other cases in other rooms that are way more serious than a healthy baby (obviously), but can you tone down the body language a bit? I want her to see a lot of patients, and for her business to make good money so she can pay off those ginormous school loans. I want her to feel like she helped as many people as she could, and I want her to feel successful and make a lot of money. But not if it means that she hurries me out the door. ... ... After taking a breath, the bottom line is that I really do trust my doctor to care for us, and while she may miss small things here & there that cause us annoying discomfort, I do trust her with our lives. Gross issues, she's great; fine issues, she seems indifferent. I'm sure this works well for experienced moms who rely less on their physician's direction.

I left the appointment with a feeling of deja vu..... When had I felt this emotion before? (thinking, thinking, thinking....) Oh yeah -- it's the same feeling I had while dating! When you're dating a guy, and he's ok but not great. But you're not sure if you want to break up with him, because what if you don't find anything better? I kind of want to break up with my doctor! One time my doctor was gone, and I had to go to another doc -- her own pediatrician actually. And I LOVED that doctor! She was great, and I left feeling reassured and confident that I could handle whatever came next. (That was 4 days after I had Hazel, and if someone made me feel that ok under the duress of the cocktail of hormones I had in my system, then you know she was good!) But how can you leave your doctor for her doctor? They're both in the same company...you know it would get around. And really, my doctor is not that bad... It's hard because we have history, and you hate to ditch that. Even if it's not an A+ history.

Yesterday Hazel started running a pretty high temp. She was inconsolable -- just seemed miserable, absolutely miserable. It was after-hours, and not wanting to page a doctor I called Ask-A-Nurse. I've had great success with them in the past. I reached a nurse who was WONDERFUL. She took her time & went over all sorts of things with me. The best way to take a temp, what varying temperatures mean, when to be concerned, how long the temp should stick around, when and how to go about bringing it down -- all kinds of things. Also went over other symptoms of vaccines that I could expect. She said, "Didn't your doctor tell you any of this?" She asked if I had any questions, and waited patiently for me to think about things. I felt like she was actually in the room, holding Hazel & putting her hand on my shoulder. She was my favorite kind of professional -- a teacher. My HVAC guy has come by to check on our unit several times this summer. I love him because he shines his little flashlight all over our ductwork in the crawlspace telling me what is what, how it works, and what to look for in the future as signs of success or trouble. This is what I want in a professional, and it's just odd to me that I found it in Ask-A-Nurse, and not at all in my doctor.

I wonder whether all of this processing is just a result of me overthinking things (as usual), or if this is a process normal people go through. And I also wonder if doctors know this kind of thing happens with their patients, and whether they even care. I wish we could all have a forum of doctors teaching patients how to be better patients, and patients teaching doctors how to be better doctors. Seriously, I think a clinic should host it every year, and if you want to be a part of their service you have to attend. Seems like everyone could benefit and the whole shebang would operate more efficiently. And efficiency is great for the bottom line, right?

I recently rediscovered an old acquaintance on facebook. He's now a pediatrician in Maine -- also a passionate blogger (http://bleakonomy.blogspot.com). A few of his entries have just made me think about this topic more and more today. I want to be respectful of my doctor and the relationship we have cultivated so far. However, I want to be a student & proficient executor of the health of my child. And I'm not sure that those two desires go together. I don't know...I'm torn. We have our six month check up in April, so it is my goal to reach a decision by then.

And after re-reading my post, it kind of annoys me that I'm being so emotional. That so much feeling goes into a decision that probably should be 99.9% logic. Tory would approach it that way. He would just scrap the mediocre relationship & move on. But then again, he's not the one who would have to go through the pain of finding a new doctor, which is about as much fun as finding a new church.

4 comments:

Dan said...

And lo, I have come around to your blog. Thanks for the shout-outs.

No matter how pressed for time I am, I really strive to give every patient and family my full attention. It's taken a bit of work, since I came from New York City, where everything is as brusque and efficient as possible. But it's a skill that every pediatrician needs to learn, and one that I have variable success with myself, to communicate interest and concern, even if there are a billion patients waiting.

CareNet said...

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