Help me figure this out. (Vent ahead): I am furious.

[Sahamamama]

Long story, short: We moved to a new county last year, and my nine year old daughter was due for a physical. I took her to the new pediatrician today, and... :cursing: I need to vent here. Hope it's okay.

 

Along with all the usual paperwork to fill out at the start of the visit, there was a survey I'd never seen before entitled "Next Gen Environmental Risk Assessment." Something like that. Anyway, this survey asked all sorts of what I will call "social worker" type questions. Now, please understand that before I had children, I was a social worker. These were the types of questions that I might have asked, for example, questions about mental illness in the home, guns in the home, use of drugs and alcohol, presence of pets, and so on. There were other questions about trampolines, bicycles, helmets, use of seat belts when in the car, swimming pools, and more. I don't remember all of them. I'm fairly sure the survey asked us to list all the members of our household, their names, and birth dates. :confused1:

 

On the other side of this form was a short section for medical history, with extremely broad categories. The bulk of the information being collected was what I consider to be intrusive and not really necessary medically. I mean, if something comes up, and we have a rapport with this physician, then perhaps we'll share, KWIM? But just WHO is collecting all this information, and what are they doing with it?

 

With this in mind, I wrote across that entire side of the form DECLINE TO ANSWER.

 

Enter the pediatrician. She introduced herself, settled in behind her laptop, and began to ask my daughter the same questions that were on that form. I think she was hoping I wouldn't notice? "Do you wear a helmet when you ride a bike? Do you wear a seat belt in the car? How many brothers and sisters do you have? How old are they? Do you have any pets?"

 

I tolerated this for the sake of breaking the ice, but my daughter, who had heard my explanation for declining (earlier, in private), was clearly uncomfortable with this line of questioning. When the pediatrician asked, "And do you have a trampoline at home?" I broke in and said, "I declined to answer those questions on the form, and yet you are asking my nine year old those very questions? When I said that we decline to answer them, I meant it."

 

She said that she is responsible for her patients in a broader sense, not just a "narrowly bodily focus."

 

I responded, "Let's say that we do have guns or a trampoline or pool or a Burmese python at home, or that we don't wear helmets on bikes or seat belts in cars, then what?"

 

She said, "Then we would advise you on safety issues and conduct a risk assessment."

 

"You would parent the parent? If I, as a parent, have made the decision to have the gun or the pool or the python or the trampoline, then I, as the parent, am responsible for my child's safety in those situations. I'm responsible for doing the research to ensure that I am handling those personal, private aspects of my life safely.

 

The doctor said, "Clearly, you are not the usual parent. But regular parents are not doing this, and so it is my job as a pediatrician to find out what is happening in the child's broader environment and address it by assessing and reducing risk factors."

 

I responded, "Well, I was a social worker before having children, so I have a good idea of the spectrum of parenting. I do understand what you're saying to some extent. Still, if any parent clearly states that he or she declines to answer those questions, which I consider intrusive, then that decision should be respected. In our case, I would think that a question more pertinent to a medical exam would be the fact that this child is entering puberty, or that her mother had cancer. Not questions about trampolines. Is this a new trend in pediatrics?" [The thought occurred to me at this point that since the doctor is poised to tell me how she thinks I ought to parent my child, then I am poised to tell her how I think she ought to doctor my child.]

 

We discussed this a bit more, without a direct answer to my last question. Basically, the doctor asserted her responsibility to ask, and I asserted my right to refuse to answer. The doctor then spent about 30 seconds examining at my daughter's actual body, and that was the visit. The doctor barely looked at her ears, nose, and throat; did not palpate her abdomen or any other area; did not check her feet or hands; did not check her neck (I've had thyroid cancer, which was listed and verbally stated); listened to her heart and lungs for a few seconds; and asked NO (what I would think of as) medical questions -- things like, "Do you exercise? Do you eat vegetables? Do you sleep well?"

 

I'm sort of :huh:  and :cursing: . I shouldn't be surprised at the Information Gathering, should I? I was (and am) quite provoked that even after I stated in writing "Decline to Answer" the pediatrician was trying to pry answers to her survey questions out of my nine year old.

 

When did this become standard pediatric practice? What is the Next Gen Environmental ___________?

 

BTW -- Go easy on me, if you take the doctor's part. I'll listen to the medical perspective, learn from it, and file it away for future reference -- but not if you beat me up.

 

 

 

 

 

 

 

[Catwoman]

I think that sort of thing is becoming increasingly common, but I'm not comfortable with it either, as I think many of the questions are unnecessarily intrusive.

[VaKim]

I had the exact same experience when I took my dd a while back. I find it disgusting.

[Sahamamama]

Catwoman and VaKim, what do you do?

[Melissa in Australia]

here pediatricians are medical specialists and are only for children who have a serious medical issue or disability.

[Lara in Colo]

I agree-- the Dr has definitely skewed her job--- meaning-- do the Dr part (which was skimpy) and leave the parent part to the parent.

 

Stories like these make me very hesitant to take my children in for "regular" visits.

[ktgrok]

I was asked, and answered. I said yes, we have guns. Yes, we lock them up. Yes we have dogs. No one ever said anything more about it. 

[TechWife]

here pediatricians are medical specialists and are only for children who have a serious medical issue or disability.

 

Here in the US, they are considered general practitioners. There are also pediatricians who specialize within the field, such as developmental pediatricians, pediatric endocrinologists and trauma care specialists. 

[idnib]

Complete BS. I'm glad you declined to answer. 

 

"Do you have a trampoline at home?"

"Do you? I'm performing a Next Generation Physician's Assessment."

 

:sneaky2:

 

 

[Guest submarines]

I find this infuriating and intrusive as well. I'm afraid this is a part of the new "reality." There isn't even an illusion of privacy anymore.

[SKL]

That would bug me as well.  I do not mind them asking about things that are clearly health-related and legally regulated.  For example, I do not mind that they ask about the seat belt because it reinforces that my kid is required to wear a seat belt, which is not really a choice at any level nowadays.  I also don't mind that they ask if there are smokers in the house (possibly because my answer is "no" anyway).  I haven't been asked about guns or helmets or any of that.

 

I have no problem declining to answer things I don't want to answer.  In my case it's race / ethnicity stuff.  They never ask the right questions, so I never answer them.  Haven't been denied services yet.  As far as I know, every question is optional.

 

I would have been very tempted to tell that doctor to take her "responsibility" and shove it you know where.  More likely I would have just said "let's move on to the medical exam, shall we?"

 

Research another doctor when you get your cool back.

[Murphy101]

They did ask me all that stuff in the hospital. Everything including whether or not I had running water and indoor plumbing. I was like what the heck, there are people who don't?!

Well yes. Lots actually.

 

Which is none of their business unless they think that's why you are there.

 

For example, I'd be annoyed if I went to the ER bc I had a car wreck and they are drilling me about my house conditions.

[SKL]

Sometimes I get all big and bad and ask, "why do you need to know this in order to do ___ for my daughter?"

[Laurie]

I don't like this new hands-off but nosy style of medicine.   They should change the name from exam room to the interrogation room.

 

You weren't describing this, but I especially don't like the way the computer keyboard seems to be the focus more than the live body in the room.    I hate having my doctor sitting across the room at a computer most of the time and only looking in my direction occasionally.  I really hate having a computer in the exam room at all...all I can think of are those news reports where they tell you how germy things like keyboards are.  And now there's one in the doctor's exam room.  Yuck. 

 

I don't blame you for being furious.   And thanks for letting me join in on the venting. 

[Butter]

I don't know... a lot of parents don't know really how to parent or what is safe.  Adrian just had his 6 year old check-up and the ped asked if he was in a booster and said to keep him in it until 4'9" and I said "Yup" and that was it.  She asked where he fit in birth order.  I said youngest, obviously, and she laughed.  Last year they asked if we had guns in the home.  I said no and they said I hadn't been in Texas long enough, and if we get one to make sure it's locked up.  Those things don't bother me.  What *would* bother me is a 30 second physical exam with obviously missing parts.

[SKL]

And then the one time I got the report back on a visit for my 6yo daughter, and halfway through the narrative it starts talking about "she can pull herself up but cannot cruise around the furniture yet" ....  I'm like, at what point does the part about my kid stop and the part about someone else's baby start???  What a waste of paper.  And everything else about that visit. Blah.

[Murphy101]

Really? Barring homelessness, which homes in a city don't have indoor plumbing?

 

Guess I live under a rock!

Many people have their water turned off for lack of payment or can't afford to get a toilet fixed if it breaks. You'd be surprised. It's not at all unusual. Don't get me wrong. It's not the norm either. But yes, it's not at all unheard of. For most, it's an on again/off again cycle not an always situation.

 

You don't live under a rock. Most people live their lives oblivious to the plight of those around them. After all, it is a shame to live that way. Those who do rarely admit it to anyone if they can avoid it bc they are ashamed or scared of being punished for it.

[In The Great White North]

 

 

For example, I'd be annoyed if I went to the ER bc I had a car wreck and they are drilling me about my house conditions. 

 

The ER is getting a reputation for irrelevant questioning. Last time I was in the ER (with flu symptoms - fever, headache, dehydrated, etc), FOUR different people, in four different rooms interrogated me as to whether or not my dh was abusing me.  All before giving me any fluids, which I clearly needed.  

 

I could understand if I came in with a broken arm, but a FEVER?  How on earth could dh have caused that?

[MercyA]

Ridiculous!  :cursing:

 

You did great.  It sounds like you clearly and articulately expressed your very legitimate concerns.  There's nothing left for you to do, except find another doctor.  :glare:   

[Murphy101]

I don't like this new hands-off but nosy style of medicine.   They should change the name from exam room to the interrogation room.

 

You weren't describing this, but I especially don't like the way the computer keyboard seems to be the focus more than the live body in the room.    I hate having my doctor sitting across the room at a computer most of the time and only looking in my direction occasionally.  I really hate having a computer in the exam room at all...all I can think of are those news reports where they tell you how germy things like keyboards are.  And now there's one in the doctor's exam room.  Yuck. 

 

I don't blame you for being furious.   And thanks for letting me join in on the venting.

 

After spending the entire, yet brief appointment looking over the computer at the PA, I stopped mid sentence and asked, "You know, I could have googled this myself on my iPhone, I didn't need to come in here so you could do it on the computer?" They were rather huffy about it, but I had a difficult time taking them serious when they said, "oh no Marsha! I'm just making sure I get your facts into the record."

 

Yeah. Start with my name is MARTHA.

[Seasider]

I was waiting for you to say you got charged for an extended visit.

 

Good for you for standing up to her! These docs need to get some pushback to realize these questions are too intrusive. If someone is living in irresponsible squalor to the point it affects their child's health, that's going to be evident - IF the practitioner looks closely enough at the patient.

[SKL]

The ER is getting a reputation for irrelevant questioning. Last time I was in the ER (with flu symptoms - fever, headache, dehydrated, etc), FOUR different people, in four different rooms interrogated me as to whether or not my dh was abusing me.  All before giving me any fluids, which I clearly needed.  

 

I could understand if I came in with a broken arm, but a FEVER?  How on earth could dh have caused that?

 

I don't mind them asking that question 1 time.  I think it might be some women's only chance to escape an abusive situation.  But four times?  They need to coordinate better.

 

Never mind the fact that a person with a fever high enough to put them in the ER might get confused and say "yes" one of those four times, and then what would happen?

[SKL]

Another thought jus popped into my mind.  Doctors are mandated reporters.  What if they decided that there was something you said that made them uneasy about your child's safety - and decided to report it?  No thanks.  "Decline to answer" sounds good to me.

[J-rap]

We've run into a little of this even with our older girls.

 

When my daughter was about 17, we went to a doctor.  I was in the room with her because my daughter wanted me to be there, and it was for a health problem that we had discussed a lot together.  During the check-up, the doctor told her she wanted to get a good look at her spine and could she walk down the hall for her (so that she could observe her back as she walked).  My daughter told me later that she had her walk down the hall and then into a little room where she could ask her more private questions apart from me.

 

I get why they do that, and I wasn't particularly upset or anything.  There probably are a lot of girls that age who have sex or do drugs or whatever without their parents knowing, and the doctor wanted a complete picture.

 

Another daughter (20) was going down to a big clinic to meet with an internist about a multitude of health problems.  It was in a city four hours away and I was out of the country for several months.  My daughter asked her aunt -- who lives in that city -- to attend the appointment with her because she thought a second pair of ears would be good.  The doctor would not allow her aunt in the room.

 

The funniest experience we had was when my 8 or so year-old daughter was meeting with a speech/hearing specialist for the first time through the public schools.  At the first appointment, she was asked a long list of questions.  They wanted to know her career plans and how she plans to accomplish them.  They also wanted to know what colleges she was considering applying at.  This was an 8-year-old!  Ha, it was pretty ridiculous.

[Tammi K]

I've never had to deal with that type of situation but perhaps it is because we see a family doctor rather than a pediatrician. Our doctor knows us from our own personal conversations with him rather than just as our children's parents.

 

A few years ago I had a practitioner say to my child, "I see that you haven't had Gardasil yet so we're going to do that now, okay?" to which I spoke up and said, "I clearly indicated that we are not considering that immunization at this time. It's in her chart."  They were quick to say, "We have to offer it and make you aware."  I suspect it might come up again depending who sees her next time. It seems to be an individual provider issue in this case, not a practice of the office.

 

Our doctor did ask if our hockey playing on wore his mouth guard. When son said it was not required for his age group the Dr pointed out that it does more than protect teeth, it protects the brain for trauma in a face shot.   That kind of advice I do find helpful. But questioning our everyday life to see if we're doing things the way they feel we should feels not just wrong but actually aggressive - "You better answer correctly or you're going to be in big trouble"

 

If you are not tied to this particular practice because of insurance issues, I would consider moving to a new office where your requests are respected. There have been too many cases of doctor's assuming control over a situation with which they didn't approve. ( Justina Pelletier and the recent case of the home birthing mom who was hounded by social services because of her home birth!!!  The doctor's actually did a battery of tests to find something wrong in what appeared to be a healthy infant.)

[Joanne]

Really? Barring homelessness, which homes in a city don't have indoor plumbing?

 

Guess I live under a rock!

I have 2 bathrooms, but one of them has been nonoperational for over a year. The landlord won't fix it (one of the reasons I am moving) and I can't afford to.

 

I have had my water, electric and gas turned off (never at the same time, fortunately) it is really awful and embarassing but really not terribly uncommon in middle to lower middle class neighborhoods.

[goldberry]

I sort of understand questions about car seats, smoking and trampolines, etc.  They want to make sure parents know about the risks and basic safety precautions.  I wouldn't consider that "telling me how to parent" but more "making sure I was informed of accurate information."  That, in itself, would not bother me.  I could see how a pediatrician might feel they were fulfilling their obligations by making that information known, because those are related to health and safety.

 

If I refused to answer, however, that should be respected. 

 

 

[Wheres Toto]

I've had the same pediatrician for 20 years.  I'm not longer asked questions like that but I can't swear that it isn't asked of new patients.  If I go to one of the doctors I don't usually see (I have my favorites in the practice), the kids might get a quick - "You're sitting in a booster/wearing a helmet when riding/eating good foods/getting exercise" comment.

 

I guess if it's a new doctor/new practice, they wouldn't know whether they have a parent/patient who knows about the safety guidelines or not.  I think a conversation would do better than a form.

[jenn-]

I would look for a family practitioner unless your daughter has some special stuff going on that you think a pedi would be better suited for.  I've yet to find a GP that asks all those questions.

 

Really?  Barring homelessness, which homes in a city don't have indoor plumbing?

 

Guess I live under a rock!

 

I can tell you that in the late 90's I was on a mission trip in the hills of Kentucky.  One of the tasks we performed that week was digging a hole and constructing an outhouse for a lady that only had 1 small water line into the house.  Her kids (grown and living next door) were hoping to stop her from using a chamber pot and emptying it into the field behind the house. 

[Alicia64]

I totally agree with you. And that whole, "but we have to do this for the bad parent" argument will allow "them" to chip away at our rights. In this case, our right to privacy.

 

Providing medical care does not mean they get to ask a bunch of personal questions. Period.

 

I was in a similar position as you and I voted with my feet: we found a new ped.

 

I have a social worker background too -- I'm not proud of this, but I walked out quietly because I know these people can call CPS at the drop of a hat. You're brave for standing up to this garbage.

 

And I mean that.

 

Alley

[ktgrok]

They did ask me all that stuff in the hospital.  Everything including whether or not I had running water and indoor plumbing.  I was like what the heck, there are people who don't?!

 

Yes. Yes there are. 

 

It amazes me that people don't realize the depths of poverty we have around us. 

[Word Nerd]

I totally agree and think it's ludicrous how little time is spent actually doing an examination.

[SKL]

There's a way to approach things, too.  The doctor could ask if the parent wants information on xyz.  It's a client-vendor relationship and doctors should remember that.

 

I too used to go to a GP to avoid all the BS of pediatricians.  Then my insurance changed and I have no choice unless I want to pay 100% out of pocket.  :/  So we go to the chiropractor first, where possible.

[fairfarmhand]

I wonder if this is related to being a pediatrician.

 

I've never gotten any questions except County or Well water, lead paint, etc.  type questions that the health dept requires.

 

We use a family doctor.

 

And then there are those parents who dont. have. a . clue.

 

But I would assume that she'd get that you aren't one of those parents and drop it.

[In The Great White North]

 

 

Well I'm thinking so long as someone is living in a home it was not legal where I lived to shut water and electric off with kids in the house.  

 

I don't think this is true if they own the home.  There are a lot of places around here that are totally off the grid.

[SKL]

So what if there are parents who don't have a clue?  I'm getting tired of all parents losing their rights because there are some parents who don't have a clue.  Especially since even those clueless parents' kids usually come out just fine.

[zoobie]

The questionnaire sounds a bit reaching. However, we (making an assumption as a parent on a classical education board) are not the norm as parents. The pediatrician is the child's doctor, not the parent's. Maybe for the children of less educated (not in an elite sense) parents, having someone in "authority" tell them it's important to lock up guns and give them info on where to get free bike helmets and car seats and etcetera is helpful.

[Catwoman]

Catwoman and VaKim, what do you do?

I'm no help -- our family has used the same doctor for so many years that he was my doctor when I was a kid.

 

I dread the day when he finally retires.

[SKL]

I understand that some people don't have running water etc., but wouldn't it make more sense to ask those questions IF they are relevant?  Unless the patient has symptoms of a disease related to sanitation, how is it relevant in that context?  I don't want my doctor to be a sanitation counselor or gun safety counselor etc. etc.  I do not want to pay that person for those services.  When I do decide I want to pay for those services, I will go find an expert in that field, or better yet, look it up on the internet.

[Alicia64]

So what if there are parents who don't have a clue?  I'm getting tired of all parents losing their rights because there are some parents who don't have a clue.  Especially since even those clueless parents' kids usually come out just fine.

 

BRAVO!!! Well said!!

 

:hurray: :hurray: :hurray:

[SKL]

The questionnaire sounds a bit reaching. However, we (making an assumption as a parent on a classical education board) are not the norm as parents. The pediatrician is the child's doctor, not the parent's. Maybe for the children of less educated (not in an elite sense) parents, having someone in "authority" tell them it's important to lock up guns and give them info on where to get free bike helmets and car seats and etcetera is helpful.

 

My mother, who quit school on her 16th birthday, would tell that doctor to stick it where the sun don't shine.  LOL.

 

My dad, who quit school before his 16th birthday, knows how to lock up his guns.  Probably better than any doctor who sees my kids.

[TeenagerMom]

This Doctor was new to you?  We've been seeing our Ped for a few years now.  The first several checkups, we had the same questions and answered them.  There was no pressure to vaccinate, etc., just informing me of what was available & I nicely refused each time.  Now, after 4-5 check ups, we don't get those questions anymore because the Ped knows us and what our answers will be.  DD's check up was last week & vaccinations were not even mentioned even though Vaccine guidelines have changed for the next school year.

 

Given the general population of this clinic, I absolutely understand the questions.  We have a very LARGE Immigrant population.  Many of which are not familiar with general carseat safety, helmet safety, etc.  Asking those questions may potentially be SAVING those children's lives because the opportunity to educate the parents is there if something is amiss.  We have a lot of people in our area that go without water, electric, etc.  Clinics can refer the families to organizations that can help them get their utilities restored if they are aware of the need.

 

Not everything is about invading your privacy.  There really ARE a lot of crappy parents out there. 

[SKL]

I'm no help -- our family has used the same doctor for so many years that he was my doctor when I was a kid.

 

I dread the day when he finally retires.

 

For my kids' first doctor visit, I went to the guy who had been my pediatrician.

 

Unfortunately, by that time, he done drunk the kook-aid.

 

I found a much better family practice after doing a lilttle research.

 

Blah, this topic makes me long for the day my kids are done with all this crap and can speak for themselves 100%.

 

[Joanne]

So what if there are parents who don't have a clue? I'm getting tired of all parents losing their rights because there are some parents who don't have a clue. Especially since even those clueless parents' kids usually come out just fine.

 

Personally, I don't believe that lots of parents qualify as not having a clue. I think most - the overwhelming majority - do.

[Tess in the Burbs]

I noticed it last well check visit. Very little medical questions/looking at the body.

 

We aren't going back until they need a dr!

[zoobie]

Ifeel for you, op, one hundred percent.

 

As an aside. Why on earth do we have to enter all our info on a piece of paper, only to tell it all to a nurse or aid again in the room, and then again to the dr? The nurse or aid puts it into the computer, so what is the purpose of the paper, or visa versa?

Because many times, slightly different/additional information is gleaned each time. We do this at our law firm (questionnaire, an assistant goes over it, then an attorney) and almost always something new comes out with each layer. Sometimes people are trying to hide things, but most of the time it's just something that slipped their mind or gets asked in a slightly different way and elicits a different response. Or the person is illiterate. Or has a hearing problem or vision problem or memory problem... I'd want to ask questions at least that many times as a doctor when their well being is in my hands!

[Seasider]

I wonder if this is related to being a pediatrician.

 

I've never gotten any questions except County or Well water, lead paint, etc. type questions that the health dept requires.

 

We use a family doctor.

.

I think this was discussed in an older thread. My older kids see a family practitioner. The youngest still sees a pediatrician. I do see a difference in the way conversations flow (between the offices in general, as we've seen different doctors within each set of offices). I am thankful for our current very kind and home schooling friendly pediatrician.

 

When we first moved to this town, all the kids were together at a different office. One of the physicians there was very much like the one the OP describes. After about two years, we decided it was too overbearing, my kids picked up on the authoritarian vibe and no one enjoyed seeing that one doctor in particular.

 

Sahamamama, I hope you feel free to choose a different practitioner.

[momacacia]

Thank you for standing up for yourself (and therefore the rest of us!). I had the computer-care experience with baby's first doc. He spent way more time talking into his computer mic (which worked way worse than Siri) and talking and talking and talking at me about vaxing, than he did the 2 minutes he looked at and touched my 6-month-old.

 

I had some of these questions with oldest's first pediatrician, but it was much more of a discussion. She gave us a nice folder with brochures in it about car seat safety, trampolines, other AAP brochures, etc. on safety and basic child/baby care. All stuff most of us would know, and she checked things off on her computer (like carseat, non-smoking, etc.) as we talked. A lot of it was tone. She had a good tone that was actual care and concern for my individuals kid's safety.

 

Fortunately, I found someone good to talks with, listens to (voices and body parts that should be listened to), peeks in ears, mouths and noses of my kids. But it's not like we're in their an hour either.  

 

And, I'm really, truly, honestly, not trying to be political, but I vaguely recall reading (on here, I believe) that some of these extended questions were part of the ACA. So we're likely to see more of it, if that is the case, and need to be prepared to "just say no." ;)

[Laurel-in-CA]

I remember asking the dr. if it was a parental IQ test, since all the "correct" / desired answers were in just one column, whether they were yes or no. Nor do I think it's their business about guns or helmets...these things are already legally mandated. 

[PinkyandtheBrains.]

Those questions come up when we go in for sports physicals/annual well check visits. So I assume it might be part of an intake appointment with a new doctor. I just answer honestly and move on.