When was the last time you saw your pediatrician for a “well child check up”? Can you remember how much time you spent with your doctor? According to an article in the October issue of the journal Pediatrics, 33% of parents surveyed spent less than 10 minutes with their child’s doctor. Another 47% stated that they spent between 11-22 minutes with the doctor and 20% stated that they spent 20 minutes or longer.
This study really only reinforced what I already know…it takes longer than 10 minutes to do a comprehensive well child exam and have enough time to discuss all of the topics that need to be addressed, even if you are talking fast!
It doesn’t matter what aged child I am seeing, there are just so many issues to be covered. High on the list is anticipatory guidance. It is a look ahead at how your child will be changing and developing.
For a first time parent this may mean a discussion about their child beginning to crawl and the need to childproof the house. For a parent of an older child, it may be a discussion about a new driver and driving contracts, or a college bound student and the risks of binge drinking. The list of topics is enormous and the topics to be discussed continue to grow!
I try to cover the “list” of topics that I want to cover in each well child visit and then leave time for parents/children to ask questions or address any specific issues that they might have. In most cases it is not possible to accomplish this in the scope of a 10 minute exam.
As a child gets older, and many of the issues become more complex than “what is the first food I should feed my baby”, the time crunch is even more evident. I only wish that I could spend 45 minutes to an hour with each teen that I exam as there are just so many topics to cover, and most teens will talk if you just give them the time. Therein lays the rub; not enough time!
Unfortunately for both the patient and the pediatrician, medicine is becoming more and more about the insurance company, time and billing. Many insurance companies do not cover the time spent for preventative care and the numerous screening services that are recommended.
There is nothing more important than preventative care, especially in the pediatric population. The time (and therefore money) spent now may be the solution to more costly heath care issues at a later date. How can you discuss obesity, food choices and type 2 diabetes with an overweight 13 year old, whose parents are also overweight, yet they continue to buy fast foods.
The visit should also include discussing the child’s learning issues at school, throw in rules surrounding social media, sleep needs for teens, and round it out with gun safety in a 10 minute time span? Oh yes, you need to do a thorough physical exam too. I find these conversations hard to do with my own children during a dinner conversation, yet alone during 10 minutes with the doctor.
Next time you go in for your child’s check up, make sure your questions are all answered and see how long your average visit takes. I wonder why I am always “behind”; I just can’t do it in the 10 -15 minutes allotted. I want to answer all of my patient’s questions and concerns and if it takes a bit longer, so be it!
That’s your daily dose for today. We’ll chat again tomorrow.