Why does a person become a medical professional? For many reasons, of course, but the most important reason for us was to be able to help people. The next question is: why do we choose pediatrics? We did it because we love children and families. We turned our backs on more technical specialties because, for us, nothing matches the satisfaction of becoming friends with a young family, and helping them to grow up as healthy and happy as possible. We think that we can help you in two different ways, one way when your child is well, and another when he or she is sick. Preventive Medicine When your child is well, we think in terms of preventive medicine. One type of preventive medicine is health promotion: how to live in a healthy way, what to expect for development, nutrition, discipline, temperament, and so on. A second type of prevention is avoiding disease: for instance, advice on how and when to baby-proof the house, and also giving the child immunizations. A third type of prevention is early detection: looking for early signs of disease, so treatment can be started early. In our practice, we try to emphasize prevention a great deal. We try to schedule frequent preventive visits to check on growth and development, to answer your questions, and to give you some handouts for health education. In many ways we feel that these are our most important services. In order to prevent illness and to promote good health, we need to see you regularly. For the first year we will see you a great deal, because so much is happening with child growth and development and with the formation of new family dynamics; after that the intervals grow longer, but it is important to keep coming regularly. We don’t know exactly why, but those patients who keep up their well child visits seem to do better, to have fewer problems than those who don’t. Even if your life is going smoothly (and long may that be the case), it can give a sense of security to your child to know clearly who his or her doctor or nurse practitioner is, and that we are there to help if needed. Especially in the sometimes troublesome teenage years, it will be good to know that there is a friend to rely on, someone there who cares and who shoots straight. Regular visits through many years can help to ensure that. When you come in for these well-child visits, it is a good idea to bring a list of questions. If both parents talk about what their questions might be before the visit, you might bring up issues that have been lurking below the surface and discuss them, and so the “visit” can actually become only one part of a longer focused discussion. If you think of it, bring us some pictures of your children to put into the chart – subsequent visits then become visits to the photo album as well! Most any issue is fair game to discuss at the well visits. Diet and nutrition in our fast-food age is always a concern. Exercise. Weaning from the bottle. Toilet training. Working parents. Childcare. Schoolwork – if a child is failing in school, his or her future is in danger. On the other hand, bring in your successes – let us celebrate with you! Discipline – when to cuddle, when to correct, when to have a time out. Accident prevention. Teenage issues. Family life – is everyone fairly happy, or are you parents becoming martyrs, and do you need to do more for yourselves? All these issues and more are appropriate at our regular visits. Through it all, we hope to become people you trust for advice and direction. Diagnostic and Therapeutic Medicine Prevention is important, but when your child is sick, there is nothing more important than diagnosing and treating that illness. The great majority of our pediatric training was focused on this aspect of pediatrics, and if your child is sick, nothing is more important to us. Don’t let anybody kid you, modern medicine is great! Just a few generations ago, very little could be done to help kids when they were sick. Today we can do so much. Still, with our ever more powerful medicines, we feel there is great room for restraint. Viruses don’t respond to antibiotics, so we are not going to throw antibiotics at them, we are going to wait to let the body cure itself. We are also going to try not to overuse lab tests and x-rays – there is still room for our clinical judgment. Our philosophy on referring our patients to specialists is this: when we are confident that we are doing everything that should be done, we will leave it at that. Anytime that we feel that our opinion is not the best and we need someone else’s, we will refer you to that person. If you ever feel that you need a second opinion, let us know. We will not be offended – we know how precious your children are to you, and none of us thinks that we are God. How We Do It A generation ago pediatricians “helped” patients by ordering them to do things. “Give him carrots for three days, then try squash.” Since that time, however, society has become less authoritarian, and so have we. Most of the time we will really prefer to discuss things with you. It isn’t that we don’t have our opinions – we do. And in some cases we will be quite forceful – if your child is seriously ill we will insist on the proper treatment. But for most decisions, there are choices to be made, and we feel that as parents, you will make the best choices. So, we will be there with you and try to help to steer you in a general area, but we will not try to take away your freedom. You are the parents, they are your kids, and you know them better than we do. Our advice is just that, advice. And remember: we are here to help you, not to judge you. So try to be open and honest with us, and we will try to be sensitive to your feelings, and worthy of your trust. We do take our responsibility to be good, well-informed practitioners very seriously. We all worked hard in medical school, we have been well trained, and we keep up our continuing medical education religiously. Several of us have occupied leadership positions in the local pediatric community, and we try to serve you as a responsible, well-functioning team. We each have our areas where we are particularly knowledgeable, and so we often consult with one another on cases. It is satisfying for us to practice this way, and it is better medicine for you. The medical team, by the way, includes you. While we are trying the best we can to be good doctors, we ask you to be good patients. Work with us and talk with us as teammates. While we are seeing your ill child, one of our objectives will be to educate you on evaluating and treating childhood illnesses. We will teach you to look for what’s right as well as what’s wrong with your child. And of course the well child visits emphasize education as well. We welcome your contributions. If you think you know what the matter is with your child, tell us! If we are prescribing a medicine that you think your child might be allergic to, speak up! If we are failing you in any way, rudeness in the office, difficulty in making appointments, whatever, let us know! Call us, your practitioners directly – we are not a bureaucracy, we want to serve you well. We can’t fix it if we don’t know it’s broke. And then, don’t forget, that part of being a responsible patient is helping us out by following the policies of the office. (Also, it doesn’t hurt to praise us when we do well!)