my visit to the pediatrician

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I have a new grandson--that is the good news.

He lives in Boston with his parents and older brother--that is the bad news from my perspective

I was lucky to be able to spend the first two weeks of his life with him, and the day of my departure was the date of his two-week checkup. I was excited to be going to the pediatrician's office with my daughter and the baby. I love to see pediatricians interact with children, and I enjoy observing how different practices behave in their provision of care. This is the same pediatrician who has cared for the older boy for the past year; someone I "found" through my contacts in the pediatric medical community. He came highly recommended and appears to be locally "famous." Of course when my first grandson moved there I wanted to be sure he had the best doctor possible. My daughter was forced to accept the recommendation of my friends, as she didn't know anyone there with children at that time, and NONE OF THE PRACTICES SHE CALLED WOULD ALLOW HER TO ASK ANY QUESTIONS PRIOR TO SIGNING UP AS A PATIENT. After every visit of my oldest grandson to the pediatrician I heard some things that I didn't really like. No anticipatory guidance given; outright dismissal of the boy's food allergies (evaluated and documented by several physicians here in Roanoke) simply because he was growing well--attesting to my daughter's willingness to severely limit her own diet. After over a year of visits, the pediatrician still doesn't seem to "know" him or remember my daughter. Calls to the office are often met with replies such as: "Your doctor is so busy it is not likely he can call you back."

Hmmm....Not terribly patient and family friendly.

Nonetheless, I was glad to go to the office for this visit. It really seemed unremarkable. We arrived, signed in, and waited for about ten minutes. The waiting room was not crowded, and the front office person was pleasant. In the room, the nurse was appropriate and kind. We learned that he had gained one pound and 5 ounces in his two weeks of life. When the doctor entered he was pleasant, asked a few questions, I introduced myself to him. He seemed impressed that I was Chair of Pediatrics at a NEW medical school, but had never heard of us. He noted a problem that he wanted to treat with antibiotics, and was almost apologetic, when he turned to me to explain his rationale. From an "anticipatory guidance" standpoint, the only thing he said to my daughter was: "So you are putting him to sleep on his back?" He didn't ask where the baby was sleeping, how the older child was dealing with the birth of the baby. Didn't ask anything about the father, plans for child care, or any of the topics I would expect to be covered in the two week visit. We left with a prescription and a follow up appointment.

My daughter turned to me and said: "I am glad you were here. That is the most he has ever said to me."



I would love to hear your experiences, as well as your expectations for what your visit with the pediatrician should include.

Recent Comments

As a primary care doc, that group seems to be one of the "big volume/big reputation" practices that we have a few of here in Atlanta...these are usually a little older men who the young trendy moms (which grow into older moms with teens) flock to (often the well off families) who just want to be told they are doing well/are great moms and their kids are fine...that's it. The ones who want to hear more get info from their nurses or from friends/internet once they get home. I actually met with one of these guys one time (for an interview getting hospital privileges) who was told the child had right ear pain. He listened to one point only on the chest, looked in the right ear and wrote the Rx. Kissed the mom (!!) and told her she looked marvelous, and was out to see his other 55 patients that day. And he has a very busy practice!! We have anticipatory guidance in our practice first with our nurses, then with our docs, then at each check up you go home with a packet of info specific to that age (including vaccine info as we are an all or nothing group for vaccines). And we see max of 30+ on a busy day. There has to be a better practice. Have her talk to her friends...Yelp/Kudzu tend to be only the very good and very bad reviews (no true moderate reviews). Your grandkids deserve better and better is out there.

Thanks, Amy for your comments, and for stopping by! It is so important that physicians, especially pediatricians take the time to connect to their patients. To me, that would be the joy of primary care. Otherwise, you are just a prescription-writing, billing machine. Yes, my daughter is now searching for another practice. Hopefully, her friends and social media groups can help to guide her.

And you thought only surgeons were dogs.

Sandy, I never have thought any such thing! Some of my best friends are surgeons.

Wow. I'm in New York and every pediatrician's office I called allowed for parents-to-be to have a free visit to interview the pediatrician and see how the practice works. This seems like such a basic and smart thing to do from a patient/customer satisfaction standpoint.

The ped practice we chose is responsive, detail-oriented and give lots of "anticipatory guidance" about feeding, sleeping, diaper and skin care, play, development, etc. And they take the time to answer questions. I didn't love how quick our ped was to tell us to cry it out (at 3 months old!) and ignored him on this, but that's a small thing next to all his good advice and the illnesses he's caught and treated quickly.

I've assumed this was standard for a "recommendable" ped office. It surprises me that a ped could be "famous" and recommended on so much less than that!

Kate, thanks for your comments. Yes, I assumed it was Standard Operating Procedure as well, to get the free visit. Of course, once you have a child and you are just looking for a new pediatrician, may be they don't act the same? I am happy you have found a Pediatrician you can feel comfortable with, and who takes time to know you and your child as well as to educate you as a parent. As an educator of future pediatricians, that makes me very happy.

Thanks for your visit. Come back soon.

Yikes...if nothing else, your shared experience with your grandson's pediatrician's office is a lesson for all of us in healthcare...and the biggest lesson learned is to take time with the patient and to listen. It doesn't matter if we are talking about a pediatrician's office, a podiatrist's office or a dentist's office...patients and patient's families put their trust and faith in the offices that they choose and we owe it to the patients AND to our professions to be the very best possible healthcare provider that we can be. Thank you Alice for sharing this story!

Thanks for the comments, Claudia. Amazing to think of how badly some people can be treated and still go back for more. And some folks may just assume that this is the way doctors are. I don't think so. Whenever we get to thinking we are too important to spend that time with our patients or their family members, its time (in my opinion) to hang up our hats. We must never forget it is a privilege to be part of someone's life as a health care provider. Glad you stopped by.

How come my post was removed? I didn't say anything offensive.

I have had nothing but good experiences here in Roanoke with pediatricians! My daughter is almost 6 months old and I am a first time mom so I'm sure I have ridiculous questions at times, but the doctors never act like any question is to small! They always go over eating, sleeping, diaper care, and developmental milestones at every visit. I'm glad we have a better system here!

I see an NP at a Carilion Family Practice. I have tried the peds offices in my area and find the same thing as reflected in your article to be true. In fact, Im a nurse, and during clinicals while training, I was shocked to see how "cattle auction like" the peds offices were. But the unfortunate truth is, most of my friends go to offices like this and ask me advice when they were just at the doctors office that morning! I ask them why they dont ask there doctor and most of them dont feel comfortable asking questions, like they are being hurried and nothing is important if its not immediatly life threatening! I love our NP, (Lori Foster) and her Nurse, Ms Karen, and even on busy days they make us feel like we are the only patients they have that day. I love the unrushed feeling and the personal interaction and the relationship they have developed with our family. I think that we have to think outside of the peds office in this area, and start looking into family care, they are doing it right!

During my first pregnancy, I began looking into pediatricians. I found Carilion Pediatrics Associates in Botetourt. Before my daughter was born, I was able to go in and meet the physician, see the practice, ask questions. It was a wonderful experience. Dr. John Fernald was my daugther's physician until he moved. I cannot say enough about him and his nurse, Susan. I was a worry wart new mother and every time I called, my worries were easied in a calm, non-judgemental manner. My daughter continued to be a patient at that office until she was 2. I had an extremely bad experience with the office staff (not the physicians). I changed practices, which I did not want to do because I loved Dr. Moore, Dr. Kryder, and Dr. Kraft, but I would not continue to take my daughter there after that experience. I have since recommended the practice to others with a warning about the supplemental staff.

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About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

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