How to Have an Intelligent Conversation With Your Pediatrician

So you are sitting at your pediatrician’s office and your doctor tells you that something is wrong with your child. Then he starts talking about running tests or giving medications or doing procedures. Tunnel vision sets in. Your heart breaks just a tiny bit. Your tummy gets that horrible roller coaster drop feeling. Snap back to reality and you realize that now is your chance to either:

  • Say “ok” and hop on the train with the ticket they just handed you, no questions asked.
  • Gird your loins and start asking some hard questions to be sure you understand what is happening and make a choice that is best for your child.

Truth: You are in charge of your child’s medical care. It’s time for you to own the decision making process.

Asking questions is hard. I get it. None of us wants to be perceived as “that” mom who is persnickety or argumentative. So it can feel easier to just go with the flow. It can be intimidating and emotionally challenging to question or even contradict people with perceived authority. When faced with medical decisions you need to be able to think on your feet and have intelligent conversations with your care providers.

Maybe it’s time to reframe your thinking. You are not arguing or demanding… from now on you are fact finding. Show your pediatrician that you honestly want to understand the situation at hand. There is no harm whatsoever in exploring the options verbally with your child’s doctor. You can to do it in a way that acknowledges (and takes advantage of) their experience while protecting your rights as a decision maker. There is even a handy acronym to help you remember what to say and ask.

B.R.E.A.T.H.E.

  • Benefits: What are the benefits to my child’s health right now or later?
  • Risks: What are the risks to my child’s health right now or later?
  • Exceptions: How often does this not work? how can we adapt this to our unique situation?
  • Alternatives: What else can we do?
  • Timing: What happens if we delay or decline?
  • Halt: Just stop. Breathe. Take time think or talk about it alone before making a decision
  • Establish: Decide what your position is and where you are willing to compromise

Let’s role play this out.

  • Doctor: “I think we need to do X for your child.”
  • <Brief pause, s/he is waiting for you to agree. This is your chance, don’t blow it!>
  • You: “I need help understanding X. Is there time to ask some questions?”
  • Doctor: “Sure, I guess so.” (Very rarely you are faced with an emergency with no time to discuss options. You will know that there is no time for questions just by the level of urgency in the room.)
  • Start your questions. Don’t argue and don’t contradict. Just ask and listen. You are fact finding so be persistent.
      • “What is the primary benefit of doing X right now?”
      • “What is unique about my child’s situation that makes you think X is the best option?”
      • “What are the short and long term risks involved with X?
      • “What is the likelihood X will work the way you want it to?”
      • “If X doesn’t work, then what would be the next step?”
      • “If we choose X, does it come bundled with other things that we must do?”
      • “Are there any alternatives to X?”
      • “If we accept X now, will I be able to change my mind later?”
      • “What is likely to happen if we wait a little while to do X?”
      • “What is likely to happen if we decline X?”
  • Now, the next part is crucial. You must halt the conversation!
      • “Wow. Thank you for all the information. I think I understand your reasoning behind X much better now. I need 15 minutes alone to think about this and talk to my spouse.”
  • Make sure everyone leaves. It’s easier to have this discussion without the pressure of your medical team listening. If your spouse is not with you, call him. It’s time for you to establish your position, so ask each other these questions in private:
      • “What does your intuition say about X?”
      • “Do the benefits outweigh the risks?
      • “Does the info I just received match my understanding of current research and medical evidence?”
      • “If we want to decline X now, under what circumstances are we willing to accept X?”
      • “If we accept X now, under what circumstances will we change our mind?”
      • “Do we want to choose Y or Z instead? Is there a compromise we can offer?”
  • Call your pediatrician back in and tell him or her your choice. Be courteous, clear and firm.
      • “Thank you for taking the time to give me the information I needed to make a decision. I have chosen X (or Y or Z). If Q happens or Z amount of time passes I would like the opportunity to revisit the decision with you.”

Have you ever had a hard conversation with your pediatrician that made you wish you had asked more questions? Share about it in the comments!

Tweetable Sound Bites

How to have an intelligent conversation with your pediatrician.
Making medical decisions for your kids? Just B.R.E.A.T.H.E.
How to ask your pediatrician questions without feeling intimidated.

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About Emily

Hi, my name is Emily. I’m a wife, mother, christian, momcologist, doula, writer, nerd, entrepreneur and dreamer. I like Apple products, chocolate, books, lists, being pregnant and the color purple. I fancy myself as a quirky combination of dreamy Anne Shirley and feisty Scarlett O’Hara but in a schizophrenic sort of way. Read on...

Comments

  1. Emily: Thank you for this great information. I especially liked the BREATHE questions. I have often gone into the office with a mental list of things to ask the doctor, but in the moment of actually being there, forget what I even wanted to know.

    Christy @ A Heartening Life
    http://www.ahearteninglife.com

  2. This was great and helpful. Thank you – and it was all so true. Ask asap and you get the attention. Later doctors seem almost annoyed :) BREATHE is a great way to remember.

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