How to Talk to Your Child’s Doctor
List Price: $18.95
Author: Christopher M. Johnson, MD
Publisher: Prometheus Books (www.prometheusbooks.com)
Rating: 
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It is fall and quickly moving to winter. Our children are in school or daycare, flu season starting up, and cold weather has us worried about our children becoming ill. Assuming they haven’t already had a case or two of sniffles.
Illness means doctors. Like it or not. And doctors frequently mean pulling our hair out in the attempt to make ourselves understood while trying to understand the doctor. What better a time to pick up “How to Talk to Your Child’s Doctor”? This book helps you understand better how to quickly communicate exactly what it is that your child’s doctor needs to know in order to help your child feel better while minimizing mis-communications and common diagnostic errors.
CONTENTS
This book is 288 pages long and has a table of contents and an excellent quick-reference Index. Below is a short description of the information contained in each section of the book.
Introduction The introduction talks about how often a child will end up getting the care he needs in spite of the interaction of parent and child, rather than because of their communications. In this chapter, Dr. Johnson underscores how important it is to get both physician and family on the same page in order for your child to be diagnosed and treated.
Chapter 1: Like Ships Passing in the Night This chapter talks about the “art” of diagnosis and how medicine is not an absolute science. It talks about the process of triage in the emergency room, and how often a doctor will be so over-worked by the time he sees your child that he might not spend more than a few minutes with your child before jumping into a diagnosis. Often the diagnosis will be close or correct, but frequently the diagnosis will be wrong. The author tells several stories about misdiagnosis to underscore his point and to allow you a glimpse into how the misdiagnosis happens. This lays the groundwork for the parent to understand how important accurate communication is between them and their child’s doctor.
Chapter 2: The Medical History: Where it All Starts Every medical visit typically starts with the taking of the patient’s medical history. I know that the medical history process has often seemed somewhat odd to me, especially when I go in with a rather straightforward complaint. However, this chapter explains why it can be so important for your child’s doctor to know your child’s medical history. This chapter brings you back to some of the case studies from the first chapter, where misdiagnosis could have been avoided had the physician been presented a more complete medical history.
This chapter also covers common medical terms that your doctor uses. These terms and the communication checklist for parents that is included at the end of this chapter are invaluable. I have used it to communicate with my dog’s veterinarian and my own doctor as well as my child’s doctor.
Chapter 3: Looking and Touching: How and Why the Doctor Examines Your Child After the medical history is taken, the doctor will typically examine the child. The exam performed is usually the same regardless of your child’s particular complaint (although the doctor will spend more time on the portion of the exam that relates to your child’s illness.) This chapter explains why your doctor does this and then goes on to explain what is checked during each step of the routine physical examination, and why. This chapter again ends with a communication checklist that is handy during your child’s physical examination.
Chapter 4: Sharp Needles and Cold X-Rays: How Doctors Use Common Tests Often the doctor will not be able to make a full diagnosis or proceed with treatment until diagnostic tests have been run. Maybe the doctor needs an X-ray to see the fractured bone, or maybe he needs to run a test on a swab to confirm strep throat. This chapter discusses the testing that doctors might use to help come up with a treatment plan. Covered are: common blood , spinal fluid, urine and stool tests, X-rays, computed tomographic scans, ultrasound scans and MRIs. Limitations and dangers of the different tests are discussed. Apparently wrong results frequently lead to wrong diagnosis and wrong treatment. The communication checklist at the end of this chapter covers important questions that you can ask to make sure that your doctor is going ahead with the right course of treatment.
Chapter 5: Putting It All Together: The Differential Diagnosis How do doctors use the medical history, physical exam and various test results to come up with a diagnosis? Sometimes it’s straightforward and other times it’s not. This chapter covers a long list of possible illnesses that can be causing a child’s complaints, and it discusses how a doctor might arrive at a particular conclusion. This chapter again underscores that medical diagnosis is an art and not a science. An important lesson to come away from this chapter with is that your doctor’s diagnosis might be wrong. If you don’t see improvement, if you see worsening of symptoms, don’t be afraid to contact your doctor and request that your child’s case be re-evaluated.
Chapter 6: What to Do: How Doctors Choose Therapies for Your Child Once a diagnosis has been reached the doctor will need to choose how to treat your child’s symptoms. This chapter discusses treatment plans, including one very interesting question: What does the doctor do if, after all of the tests and exams, he still has no idea what is wrong? Specific and supportive therapies are discussed and the parent is introduced to the concept of a “therapeutic trial” where a doctor that has no idea what is wrong with the child will try a medication that might help the child’s symptoms. This chapter covers quite a few common treatments including different categories of medications. The communication guide at the end of this chapter is particularly useful for parents as it helps them explore and understand the treatment options more thoroughly.
Chapter 7: Why We Are This Way: How Doctors Are Trained This chapter takes you even more deeply inside of the mind of the doctor by explaining the training that a doctor receives and how it structures their thoughts when they approach the problem of your child’s illness. You get to learn how the doctor is trained- from medical school and residency. You get to read common sayings which give you an insight into the way a doctor’s brain is taught to work. These common sayings can give you a good idea of what mindsets you should be cautious of. “When in doubt, cut it out” for example, is the surgeon’s mantra. Understanding the different forces that have shaped your doctor helps you understand their motivations for acting a certain way.
Chapter 8: Knowing More and More About Less and Less: Managing Specialists Doctors have become medical assembly lines. Your general practitioner sends you off to a dermatologist who then sends you off to a mole specialist who then sends you to a surgeon to remove the mole to send it to a diagnostics lab to determine whether you should see an oncologist for cancer therapy or a plastic surgeon to get rid of your new scar. While it’s wonderful that each doctor is highly skilled at what they do, how do they keep their communications straight? This chapter discusses common specialists that your child might need to see, how a specialist is different from a general practitioner, and how to choose a specialist.
Chapter 9: When the Conversation Turns Sour: How to Handle a Difficult Doctor Sometimes all attempts to communicate will fail and you will realize that you simply have a difficult doctor. This chapter talks about the different reasons that a doctor may be difficult: poor conversationalist, poor explainer, non explainer, disbeliever, non-listener, disparager, the judge, the egotist, the defensive, the avoider, and the poor examiner. Best of all, it offers great suggestions on how to deal with each of these types and hopefully get your doctor to give you and your child what both of you need.
Chapter 10: Putting it All Together: Solving Problems as the Doctor Does The last chapter of this book actually involves you in the diagnostic process by presenting you with a variety of case studies and asking you to make use of what you’ve learned to diagnose each case study as the doctor goes through the process of medical history, examination, diagnostic testing, and planning the child’s therapies. It’s interesting to see each step of the way how what you would do or what conclusions you would reach are the same or different from those of Dr. Johnson.
ABOUT THE AUTHOR
Christopher M. Johnson, MD, is a pediatrician in private practice at Pediatric Intensive Care Associates, PC. He has served as a professor of pediatrics and as director of the Pediatric Intensive Care Unit at the Mayo Clinic in Rochester, Minnesota.
BOTTOM LINE
This 288 page by Christopher M. Johnson, MD is a great read for any parent. It really helps you get inside of the mind of your child’s doctor and figure out how to best communicate. It tells you why most miscommunicatoins happen, how to avoid misdiagnosis, and gives some of the best information I have ever seen on how to deal with a difficult doctor. This book is actually useful for communicating with any medical professional. Dentists, pediatricians, general practitioners, surgeons, and even your veterinarian. I cannot recommend it highly enough.
What annoys me the most, is that most are so self confident, they are almost cocky. It’s good to be sure of yourself, but it gets old after a while.
I have had great docs and bad docs and once they transfer I lose the good ones and start over. I get disgusted because they do not listen to what the patient- the child is saying or the parent..I know by experience that some are in a hurry and don’t hear what you are saying.. I have had more attentive nurses who listen
they don’t seem to really be listening, just going through the motions
I hate when there are multiple interruptions when I am talking to the Dr. – the pager, the phone, a knock on the door. We’re only slated for 18 minutes…can we at least get that?!!?
What annoys me is they sometimes talk in such technical terms. I’m not a doctor-I don’t understand!
[...] Give-away contest for my book Commenta 30th March , 2009 The parenting site Gruntlings is featuring my latest book in a give-away promotion. If you want to register to win one, you can enter the contest here. [...]
I hate that I always feel rushed.
I hate that they are always in a hurry and I always forget the questions I want to ask cause there in and out all the time.
What I hate about Doctors
… that in the five minutes they occasionally spend with one or other of my children they have them sitting up, listening, agreeing to take medicine (sometimes actually taking medicine) and answering ALL questions somewhat truthfully. Do they not realize that just getting one of these things to happen usually takes hours, involves bribery and often results in a glass of wine before 5pm? I hate that about Doctors …
I have only been 4 times, but I hate how the doctor I saw on Friday (not her regular pediatrician) made me feel like an idiot for bringing her in. On a Friday. During her first major cold. After she woke up yelling and pulling on her ear. Like, why on earth would I think she had an ear infection? Just because she was clearly not having a life-threatening, go-to-the-er illness doesn’t mean I’m not going to be concerned about my 4 month old’s ears!
I mostly enjoy my child’s doctor and our visits, however I do wish that I felt more free to bring up or ask about alternative treatments, such as more natural approaches. I also wish our doctor wasn’t always in a rush to get back out the door….
I hate that I have to wait forever to see them and then only give five seconds to talk to them!
They are always in a hurry and don’t always answers mt questions fully.
Good luck, Christopher!
All they do is rush, rush rush.
I wish our pedi wouldn’t interrupt me every time I try to answer a question.
I’ve found all your comments fascinating to read — and, sad to say, very true. I’ve often wondered if physicians would behave differently if they could see (and hear) themselves on videotape when they interact with parents. I wrote the book to help parents, but I wish physicians would read it, too. Unfortunately, I fear many of my colleagues may be beyond changing much. Many physicians also have quite a strong sense of entitlement, and that is a problem, too.
I hate when docs are too busy (appointments overscheduled/etc) to spend the time you need. I also hate when they use medical jargon that most of the general public doesn’t understand!
I think the toughest thing is that they seem to act like we are too panicky!
What a great contest ~ thanks for posting!
My daughter’s last pediatrician actually laughed at me when I brought her in with a rash! He said every baby gets a rash like that after a fever– how would I know that!
i hate how they always give the excuse that you are just worried b/c you’re the parent
What annoys me the most is how little time doctors spend with patients nowadays – I feel as if my kids are on a conveyor belt!
It annoys me that it seems to take forever and they always seem in a rush. THank you
tatertot374@sbcglobal.net
We need to learn how to enjoy life instead of always being rushed!
it annoys me when they don’t listen
I often get annoyed by the arrogance of the doctors I deal with. They are often condescending in their tone and make you afraid to ask the questions that you really want to know the answers to. Since many of them deal with the same problems every day, they forget that this is a new experience for you.
They don’t listen and rush you.
What annoys me most is when I have several things to discuss but we get rushed and sidetracked and I forget to ask half my questions
Some doctors do not like to have questions asked of them.
I hate the long waits to get appointments
For my Dr’s I don’t like when they won’t listen to my family history and won’t order a test that later turned out to be necessary. For my sons pediatrician communicating is hard because they don’t listen to what my child says his symptoms are. They seem very quick to chalk things up to whatever the current strain of stuff is going around. I guess my complaint is not listening!
What annoys me most is that I have to wait forever to see them and then they only give me a few minutes to talk to them! Thank you for the opportunity to participate in this giveaway!
They dom’t feel the need to communicate with you. Either they think your questions and concerns are irrelevent or they want to get through your appointment as quick as possible.
This book is right on especially to first time moms. We tend to be afraid of things that are relatively unimportant and ignore some that are.
It annoys me when doctors try to rush you and don’t take the time to really listen to you.
I dislike the long wait in lobby and exam room and then doc rushes in and out and u forget why u r even there.
I hate feeling rushed and not really well listened to. A dr’s bedside manner is extremely important in choosing a dr.
I had some behavior concerns about my son, and when I told them to my doctor, she looked into his eyes and said, “Well, he’s not autistic!”
Thanks for that diagnosis; that wasn’t even what I was trying to say!
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