The increasing complexities of the health care system — from co-pays to referrals to crowded waiting rooms — make it critical for parents to take an active role in overseeing their child's medical care.
This is especially important in the wake of an alarming new study that reveals that kids who regularly see the doctor get appropriate medical care only 47% of the time.
Looking at the medical records of more than 1,500 children in 12 U.S. cities over a 2-year span, the researchers also found that it's not just kids without health insurance who are missing out on quality care — most kids in the study (82%, in fact) were insured. Also surprising: Only half of the children under age 2 had been fully immunized.
Here's the nuts-and-bolts report card on how often kids got the right care:
- 92% of the time for upper respiratory infections (like colds)
- 67% for acute (short-term) medical problems (like viruses)
- 53% for chronic (long-term or continuous) conditions (like asthma or diabetes)
- 15% for annual weight checks for teens
With jam-packed, sometimes overbooked schedules full of routine appointments and last-minute sick-kid visits, doctors often are pressured to see more patients each day and to spend less time with each. Perhaps as a result, the study showed that many doctors don't spend much time on preventive care: Appropriate care and advice was given just 41% of the time about how to keep kids healthy now and in the future.
What This Means to You
You don't need a special degree to advocate for your child's health — instead, stay informed, speak up, and build a trusting relationship with your doctor.
To make the most of each sick visit or routine checkup:
- Have realistic — and reasonable — expectations and trust the doctor's ability to diagnose and treat minor illnesses. Though you may want the doctor to help make it all better, sometimes the best remedy is time and TLC.
- Keep a medical journal or running list of symptoms and issues to address.
- Do a little research, but be aware that you can't always trust what you read, especially on the Internet. If you find material you'd like to discuss, make sure your doctor has it before your visit. But don't go overboard — stick to one manageable article or small document.
- Know what should be covered at each routine checkup — immunizations, weight and height measurements, screenings, growth and/or BMI charting, etc.
- Discuss all concerns, even if the doctor doesn't ask about certain symptoms or issues. Be as specific as possible.
- Ask age-appropriate questions about your child's current and future health and development — "What should my child be doing at this stage?," "What should I watch for before the next visit?," and "What can I do to help keep my child safe and healthy at this age?"
- Take notes so you can remember the doctor's instructions.
- Ask the doctor for reliable resources, such as brochures, printouts, and website recommendations.
- Request a referral to a specialist if you think you need more specific help.
- Don't leave confused and frustrated if you feel your questions weren't adequately answered. Politely explain that you're not sure you understand and ask the doctor to elaborate — either at the present visit or at one scheduled for the near future when there's more time to talk.
- Make sure you have all the information — and paperwork — needed for follow-up appointments, tests, and prescriptions before leaving the office.
- Follow up if symptoms or issues continue.
- Follow your gut — you know your child better than anyone and are the very best judge of when something is wrong.
Above all, try to work together — as a team — to make sure all decisions, diagnoses, and treatments are based on your child's best interests, not what makes you feel better or what's easier for you or your doctor.
Reviewed by: Steven Dowshen, MD
Date reviewed: October 2007
Source: "The Quality of Ambulatory Care Delivered to Children in the United States," The New England Journal of Medicine, October 11, 2007.
