Worst, perhaps, are those doctors whose own prejudices get in the way of providing good care. Thato, originally from Botswana but now living in New England, said her sons’ first pediatrician wasn’t her choice. “He was the only one accepting patients,” she said – a common reason we end up with the doctors we do – “and he was young, geekish and awkward. I don’t think he had ever been around people of color. He was just weird and always uncomfortable around us and he never made my son feel comfortable.” The doctor’s lack of cultural intelligence went even further, according to Thato. “He once said that some kids have more mental capabilities than others and some have more physical capabilities . . . and he explained that my older son just happens to be more physical than mental.” To assign any child one particular trait – he’s just athletic, she’s just verbal – is bad enough, but to blithely judge a young black boy as ‘more physical than mental’ can do as much damage as a botched prescription.
Pediatricians have a delicate role to play, of course, and there are surely as many difficult parents as there are awful doctors. Among medical specialties, pediatrics confronts doctors with uniquely complicated demands – there are the tiny, often nonverbal, irrational patients to be examined and treated, and with each one comes these large, terribly verbal, also irrational parents. Parents of small children call too often, worry too much, and are quick to blame the doctor for anything that goes wrong. And because of the way the profession has developed over the past century, pediatricians find themselves called on for not only physiological expertise, but also information and advice on developmental and behavioral issues – some of which are so controversial they divide families. Navigating these waters has got to be hard.
“. . . telling her that I was leaving seemed harder than staying.” So how do you know when it’s time to quit? A doctor-patient-parent relationship only works when all three feel comfortable. A lack of trust, unfixable failures of communication, and any hint of medical error should be enough to send a parent off in search of a new doctor. Yet many stay years longer when their initial instincts tell them to flee. “I kept going to her for years because I was afraid of her,” said Amy, the St. Louis mom, “and telling her that I was leaving seemed harder than staying.”
Breaking up is hard to do. But once it’s over, these mothers report, they wonder why it took so long to make the move. Happily cared for by doctors they trust and like, they feel they’ve crossed an important parenting milestone. Are these families’ second pediatricians objectively better than the first? In most cases they are, but the parents have changed, too, have grown into themselves as veterans, no longer the scared rookies they were in those early days and weeks.
Amy, the St. Louis mom, provides a clue about the different relationship one has with the second pediatrician. Her kids’ new doctor doesn’t ask many probing questions, she said, “but then, the kids are five and ten. Evidence suggests that I’m able to keep them alive and well.”