List Price: $18.95
Author: Christopher M. Johnson, MD
Publisher: Prometheus Books (www.prometheusbooks.com)
Rating:

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.