Tuesday, June 10, 2008

dealing with parents

I just read an interesting article in the NYTimes, http://www.nytimes.com/2008/06/10/health/views/10case.html?ex=1213761600&en=ef2909e401d524f0&ei=5070&emc=eta1. I think all of us have families with challenging members. I know which families are non-compliant, which ones go to the local emergency room to get the antibiotics that I wouldn't prescribe for their colds, which ones treat themselves first with medicines from across the border, and which ones just plain don't like me. These relationships can be difficult because I come to dread the visits - I see their names on my schedule, and I immediately feel on the edge. But I have also had the wonderful opportunity to see some of these interactions change for the better. I work hard to communicate, to explain my thinking behind my actions, and my office staff also works very hard at it. The author talks about the mother not believing in preventive care, which is our middle name, and that interfering with his relationship with her. Would he fire families who don't immunize? I doubt it. This group of patients frustrate me no end, but I encourage them to keep coming to see me, so that at least their children are getting care when they're sick. I wouldn't dream of "firing" them, even though their beliefs are so opposite mine.

Sadly for my patients, I'm all they've got; if they don't like me, then they have to drive 75 miles up or down the interstate to find another pediatrician. And with that in mind, I would not feel right for taking the author's position and firing the patient because I don't like his mother; if they fire me despite my efforts to establish rapport, so be it, you can't please everyone!

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