BUILDING THE PATIENT AND PAEDIATRICIAN RELATIONSHIP

By Chan Lilian

Looi is devastated and shocked that her 2 yrs old son is diagnosed with some developmental delay problem recently. As a mother, she suspected something is amiss with her child’s behaviour. So she decided to seek the opinion of a child psychiatrist in a private hospital, and consulted a neurologist in a large Government teaching hospital for a second opinion. When I asked if her child has been under the care of a regular paediatrician since birth whom would have noticed the problems, she lamented, “My paediatrician …mmm…we just visit him for the normal cold and cough and jab sessions. No monitoring of my child’s progress at all, no questions asked, in fact we are the one who are asking the questions…unlike what is mentioned in the books where the doctors actually monitor the progress of the child. I feel cheated!”

Looi is not the first parent I met who is upset with her child regular caregiver. A relative of mine also encountered a situation where her grandson was given treatment, which is less than satisfactory from a large private clinic. The child has shown obvious signs of some developmental problems but surprisingly, the medical professionals did not detect his condition until much later. Recently, I was also told of a baby who was born blind but his regular medical caregiver failed to noticed until his parents brought him to another paediatrician who discovered it.

Apart from these rather serious conditions, there are also gripes from other mothers whose children have the common childhood illnesses. Some of the usual statements are “In the past 6 days, we have been to 4 paediatricians. Yet, my girl is not getting any better.” or “I took my child to a few doctors and they tell me different things.”

All the above gripes about their respective doctors made me wonder - Is there a communication breakdown between these parents and their medical caregivers? Most of the mothers that I mentioned are highly educated and can afford specialists care in private hospitals. They would have equipped themselves with a certain amount of knowledge related to baby/childcare and their health through reading extensively from books, magazines, literatures and the internet. Therefore, they may be able to make some informed decision. Then why are they left with the feeling that they are not getting the kind of medical attention they expected?

What then can a mother do to make sure that she gets the optimum medical attention from her child’s doctor? A mother spends all the time with her child whilst the paediatrician spends only minutes. Looking at this situation, how the doctor diagnoses a condition will then greatly rely on the mother’s observation and explanation. I have 14 years experiences of taking care of my five sons, including one who was an oxygen-dependant baby and another who is asthmatic. Through my consultation with the numerous medical professionals in the last 14 years, I have learnt various tactics and techniques to ensure that I receive the kind of service I expected.