The yearly check-up: it’s the time when your child gets a total look-over. As a pediatrician, I’m often struck by just how much I need to cover in that appointment. I need to find out about eating, sleeping, exercise, school, behavior, even about peeing and pooping. I need to ask about the dentist, about screen time, about changes in the family’s health or situation. I need to do a full physical examination and check on growth and development. I need to talk about and give immunizations — and make sure parents have the health information they need and want. And of course, I need to address any chronic health problems the child might have, and any concerns the parents have.
In our practice, the longest I have to do this is 30 minutes. Usually I have 15 minutes.
After 25 years of being a pediatrician and doing thousands of check-ups, I’ve learned about what can help parents get the most out of whatever time they have. Here are some tips:
Think about what you want to talk about before the visit. This sounds really obvious, but too often parents don’t do it. They get caught up in scheduling and getting to the visit, or in the forms they need, and don’t take the time to think about what they want to ask the doctor. Keep a list somewhere (like on your phone, so you don’t leave it at home); jot things down. As you go along, prioritize the concerns: what is most important to cover at the visit? Which leads me to…
Don’t leave it all for the visit. This happens all the time. Parents store up all their worries— and have a list that is so long and complicated I can’t possibly tackle it all and still do what I need to do medically. While sometimes we schedule a follow-up visit to finish up (more on that below), another alternative is to find ways to get some of your questions answered ahead of the visit.
Most practices have nurses that can answer common health questions and otherwise help families. You may be able to leave a message for your doctor and have them call you back; this can be particularly helpful when there are concerns, such as behavioral problems or bullying, that might be best discussed without the child present.
Use portals or other forms of communication. More and more, practices are devising ways for families and doctors to communicate. You can use these to get a question answered or get advice. I’ve also had parents send me written information about their child ahead of a checkup exactly to save time at the visit — and allow us to be more efficient and focused when we are together.
Consider making an appointment before the checkup. This sounds odd, but it can be really helpful, especially when there is something complicated going on — like asthma acting up, school problems, worries about behavior, or a family crisis. That way, I can fully focus on the problem, instead of having to ask about sleep or poop or daily servings of vegetables. Plus, it gives us a chance to try something — and then at the checkup, see if it helped or not.
Ask your doctor which health and parenting websites they recommend. There’s a lot of great information out there.
Have any forms or papers ready — and have your child undressed before the doctor comes in. Little stuff, but it really helps things move smoothly. If you have to fill out something for the visit, get it done. Have the argument with your modest child about the gown before the visit starts. If you have forms you need for school or sports, let the nurse or clinical assistant know; sometimes they can help.
Work with your doctor to set an agenda for the visit. Too often, we docs come in with our own agenda. Or, parents start in with their first concern — and then time runs out before they get to the second or third. As soon as the doctor comes in, say something along the lines of, “I have three things I want to be sure we talk about today, and I know you have things you need to ask. How can we best make this work?” Planning it out together can make all the difference.
Be brief whenever you can. I’m not saying you shouldn’t say everything you need or want to say. But if all is going fine in a particular area, say it’s fine rather than giving lots of details. Or if all isn’t going fine, just say it’s not, rather than defending or giving excuses. Save the time for questions and conversations that can help you and your child.
Let your doctor know if your needs aren’t met. Sometimes we just can’t pull it off in that one visit, but that doesn’t mean that you can’t get all of your needs met. As I said before, sometimes a follow-up visit makes sense. Maybe there is a nurse who can spend some time helping you before you leave or a social worker who can give you a call. Maybe you can get a handout about a topic you are interested in or a recommendation for good online information. Never just leave saying, “Oh well, maybe next year.” That’s not how primary care works; it’s an ongoing relationship. We are here to support you, every step of the way.