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In my last blog post, we discussed how to approach your child’s doctor with developmental concerns. The advice included:  

  • Know that YOU are the expert on your child. 
  • Find trusted resources on developmental milestones so that you can assess your own child’s development. 
  • Understand that each child develops at their own pace. 
  • Attend all recommended clinic visits. 
  • Ask for additional time when scheduling if you have concerns. 
  • Share your concerns with your provider. 
  • If more evaluation or interventions are needed, advocate for the plan that you feel best meets your child’s needs. 
If you are not feeling heard by your child’s pediatrician or health care provider, I would encourage you to consider what barriers to effective communication might be present.

This purpose of this post is to respond to the follow-up question, “What if I bring a concern to the attention of my child’s heath care provider and I don’t feel heard?” 

Pediatricians and other health care providers who care for children enter this profession with a passion to promote the health and wellbeing of children. We enjoy building relationships with our patients and their families that grow over time. It is a unique, collaborative partnership between the physician, patient, and parent.   

The relationship triangle adds complexity to decision-making because it is a balance between what the provider feels is in the best medical interest of the child and what the parent feels is in the best interest of their child and family. We share the common goal of the health of the child but may have different ideas about how to achieve that goal. Effective communication is key to building this relationship. 

If you are not feeling heard by your child’s pediatrician or health care provider, I would encourage you to consider what barriers to effective communication might be present. 

There are many barriers to effective communication that may occur in a clinical setting. These barriers include language or linguistic differences, overuse of medical terminology, and time limitations during the visit. They also include cultural biases and differing expectations. 

The basis of communication involves the patient and parent understanding the words that are being spoken. The use of interpreters or translators can help if the patient and family speak a different primary language or are hearing-impaired. Any medical terminology should be clearly defined, and parents should feel empowered to ask for clarification if they don’t understand the terminology being used. It can help to have a friend or family member present if detailed discussion is needed. We know that people often forget about 50% of the information provided at the time of the visit, so the more ears to hear it, the better! After-visit summaries or handouts on the diagnosed condition can help parents to recall important information. 

Effective communication in the health care setting requires cultural competency. Cultural competency means understanding how a patient’s cultural values and beliefs might impact their understanding of their health, their expectations of care, and their preferences regarding treatment options.  

Finally, differing expectations can create a communication barrier. As an example, a 9-month-old baby sees their pediatrician for their routine check-up. During the visit, the parent mentions that their baby is not yet crawling, and they are concerned that their child has not yet met that developmental milestone. The provider evaluates the child and notes normal growth, a healthy physical exam, and a baby who is meeting most developmental milestones other than crawling. They might say to the parent, “Your baby is healthy, there is no reason for concern.” The provider feels like they have done their job of reassuring the parent. However, it is possible that reassurance wasn’t the parent’s goal. In that situation, the parent may need to ask a different question or frame the question differently. For example: 

  • “Can you help me to understand why my baby isn’t crawling if they are meeting their other milestones?”  
  • “Are there things that I can do to help my child develop that skill?”   
  • “At what point should I become concerned if my child still isn’t crawling?”   

These questions should stimulate additional discussion to achieve clarity.  

Many people choose their child’s health care provider based on word-of-mouth recommendations from family or friends. Ask the people who are important to you whether they feel their pediatrician listens.

If at any point in the relationship with your child’s health care provider the communication barriers seem insurmountable, then it may be in your best interest to find another provider. Many people choose their child’s health care provider based on word-of-mouth recommendations from family or friends. Ask the people who are important to you whether they feel their pediatrician listens. Ask if they feel they receive enough information about their child’s diagnosis and if they know what to do if they have additional questions. Ask if they feel their culture is considered and respected. The answer to these questions should help to point you in the right direction. 

 


 

Click here to read Dr. Bies’ recent blog post, “Addressing Concerns About Your Child’s Development.”


 Rachel Bies, MD FAAP is a pediatrician at Wayzata Children’s Clinic. She has worked at the clinic since 2009, practicing general pediatrics with an emphasis on special-needs patient populations. She has served as medical director for the organization from 2011 to 2019. She is also an assistant professor of pediatrics at the University of Minnesota, working with medical students and residents. Rachel graduated from St. Olaf College in 1999 with a Bachelor of Arts degree in Biology. She attended medical school and residency at the University of Minnesota, completing a chief residency in 2009. Rachel joined St. David’s Center as the medical director in 2017. Rachel and her husband live in Plymouth, MN.

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