So, this year we finally left Kaiser Permanente. Although this is a VERY GOOD thing, it has left me in the position, for the first time in 20 years, of having to actually choose doctors myself, rather than the random selection, among dozens of doctors reading from the same playbook, that Kaiser calls "choice." In trying to choose a new pediatrician for my daughter, I did the usual things: asking friends, etc. However, I find myself stymied by a general lack of the information I really need in order to make a good decision. Yes, I prefer a doctor with short waiting room times, one who has a good rapport with children and who seems generally up on the latest medical information. When I have had bad doctors, though -- I mean bad enough that I swore never to go back again -- it has not been because of longs waits or poor bedside manner. And I have been through enough bad doctors of all kinds -- pediatricians, general practitioners, so-called "specialists" who seem to know very little about their specialties -- that I am loathe to subject my sensitive daughter to another tone-deaf idiot. I have decided that what I need to do is to send a letter to prospective pediatricians stating my requirements (I am , after all, the paying customer). Something like a request for proposal. So, here it goes:
Dear Doctor,
As the parent of your possible future patient, there are some basic ground rules I would like to present up front:
1) I know my child is overweight. You do not need to waste valuable office visit time explaining this. She also knows she is overweight. She knows this because she does not live under a rock. She spends way more time with her body than you do and you can be assured that she is hyper-aware that it does not meet society's approval. You can also rest assured that it is a constant source of unhappiness and low self-esteem for her. She does not need you to make her feel worse. If you believe in any type of "fat shaming," tell me now so I can stop wasting my time with you.
2) Since I do not live under a rock, I also know that TV and junk food are unhealthy and that fruits, vegetables and exercise are healthy. You don't have to waste time on this either. Nor do you need to encourage the minimizing of the former and the maximizing of the latter. Nor do you need to suggest new and novel ways of getting exercise, such as walking. This is not knowledge available only to those who completed medical school. I know. EVERYONE knows. I am sure you spent a lot of time and money on medical school. Give me something I can't get from my grandmother.
3) I do not care what my child's BMI is. It is a useless, one-size-fits-all measurement that doesn't take into account individual variations in a person's build. If you think I need this information, please see #1 above.
4) Do not spout conventional wisdom, such as "calories in, calories out," which is wildly inaccurate, given that is completely discounts such variables as heredity and individual metabolism.
5) If my daughter comes in with a certain complaint, address that complaint. If I ask questions, answer THOSE questions. If you have other issues you want to address, that is fine, but in addition to our concerns, not instead of them.
6) If my daughter says she is in pain, assume that she is. And try your best to do something about it. Do not assume that a problem does not exist just because the cause is not immediately obvious. Also, empathy is no substitute for medical care. I don't need you to feel her pain. I need you to fix it.
7) If you make a mistake, apologize. I do not expect doctors to be infallible but I require them to be honest. I will not be angry if you make a misdiagnosis, but I will be angry if you try to convince me that it is correct when it obviously is not. By the same token, if you don't know what's wrong, just say that and be willing to work WITH me to find the answer.
8) Decisions about my child's healthcare ultimately rest with me, not with you and not with her. I am entitled to reasonably disagree with you. You are entitled to state your case, but unless you honestly believe that I am endangering my child, any treatment or lack thereof is my call.
9) Finally -- and this is really what it all boils down to -- assume that I am just as smart as you are. No, I did not go to medical school. My talents lie in other areas. But I am an intelligent, educated adult and, as such, I expect to be treated as one. Do not talk down to me or omit information because you think a layman couldn't possibly understand it. If I don't understand, I will ask. Respect is a two-way street, not something that your diploma entitles you to without question. Treat me with respect and I will do the same for you. I know this letter makes me sound like the type of pushy, trouble-making parent you try to avoid, but I am actually a very quiet, polite person who tries to avoid conflict at all costs. However, I am also a mama-bear who will not let anyone mess with her cubs. If you are a parent, I am sure you are no different.
Sincerely,
Pauline
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