The 24-Hour Pediatrician: Doctors From 80 Leading Children's Hospitals Offer Parents Their Best Tips For Making Kids Feel Better Faster

The 24-Hour Pediatrician: Doctors From 80 Leading Children's Hospitals Offer Parents Their Best Tips For Making Kids Feel Better Faster

by Christina Elston

Paperback(1ST)

$14.95

Overview

Pediatricians at 80 leading children’s hospitals tell you how to make it better—fast!

It’s a physician’s job to make a diagnosis and prescribe treatment for your child’s symptoms. But it’s your job as a parent to comfort your child from the first sniffle or cough until recovery. How can you help when the doctor is out of reach or the medicine is not yet working? Let The 24-Hour Pediatrician be your doctor on call. Equal parts medicine and love, this comprehensive book for parents covers home remedies, tips, and tricks recommended by pediatricians at eighty leading children’s hospitals—including Cedars-Sinai, New York Presbyterian, Children’s National Medical Center, and University of Chicago—for helping your child cope with more than thirty common ailments, from asthma, chicken pox, and colic to earache, fever, sleep problems, and stomach trouble.

Find out how the country’s best pediatricians help their patients and their own children feel better, including these suggestions and many more:
* If your baby has diaper rash, dab a liquid antacid on his bottom, and use a plant sprayer for cleaning to avoid touching the irritated skin.
* If your toddler has a fever and won’t sit still in a tepid bath, lower her temperature gently by wrapping a bag of frozen vegetables in a towel and putting it on the back of her neck.
* If you’re having difficulty teaching your child how to blow his nose, ask him to imagine blowing out a birthday candle with his nose.

Product Details

ISBN-13: 9780812931341
Publisher: Crown Publishing Group
Publication date: 05/28/2002
Edition description: 1ST
Pages: 448
Product dimensions: 5.24(w) x 8.00(h) x 0.95(d)

About the Author

CHRISTINA ELSTON has been writing articles and books for parents for more than ten years, including Safe & Secure: The Loving Parent’s Guide to Child Safety. She has written a monthly children’s health column and served as editor of L.A. Parent magazine and twenty-six other regional parenting magazines across the country. She currently edits education, a website for teachers, parents, and children. She lives with her husband and ten-year-old daughter.

Read an Excerpt

Choosing a Pediatrician

There was a time when one doctor took care of the whole family. He or she treated Mom and Dad's minor illnesses, watched over Mom through her pregnancies, delivered the babies, and took care of the kids as well. But as our knowledge about children's health has changed, so have the doctors.

Pediatricians today must take three or more years of courses after medical school to become trained in pediatrics. Then, to become board-certified, they must pass a detailed test given by the American Board of Pediatrics. This helps qualify them to look after the unique health-care needs of children, including growth and development, behavior and learning issues, nutrition, and immunizations, as well as illnesses and injuries. A good pediatrician should be able to address your child's health needs from infancy through puberty, and know to refer you to a specialist for complex problems.

WHEN TO START LOOKING

Whether you're having your first baby and have never had a pediatrician before, or are moving or changing insurance providers and have to give up your current pediatrician, the time to start looking for a doctor for your child is now. The American Academy of Pediatrics and most doctors advise parents not to wait until their child is ill or needs a checkup before looking for a pediatrician.

Some doctors say that the ideal time to start looking for your very first pediatrician, is before you even get pregnant. Others say that you should start about three months before the baby is expected--keeping in mind that sometimes babies come early. In any case, you should give yourself enough time to interview several doctors.

By the sixth month, if you've had an ultrasound,you might even know about potential problems with the baby. If this is the case, you can look for a pediatrician who has a special interest in this area.

--WILLIAM G. BITHONEY, M.D., ST. JOSEPH'S CHILDREN'S HOSPITAL, NEW JERSEY

WHERE TO LOOK

If you're part of a managed-care program, you'll have to get information on which pediatricians are available through your health-insurance provider. Otherwise, call your nearest university medical school or local children's hospital for referrals, or network with friends and coworkers for their suggestions. Your family physician or obstetrician can be a good source of information.

To get a good referral, call your local academic center and speak with the chief resident. The chief resident will often know which doctors are especially good.

--WILLIAM G. BITHONEY, M.D., ST. JOSEPH'S CHILDREN'S HOSPITAL, NEW JERSEY

The best and most objective measure of a pediatrician, according to many doctors, is board certification by the American Academy of Pediatrics. Board-certified doctors append F.A.A.P. (Fellow, American Academy of Pediatrics) to their titles and have to renew their training every seven years, so they keep up on new information and techniques. Otherwise, doctors don't often change their practice techniques.

If you're getting a referral from a friend or coworker, find out if the doctor and office staff are good at handling questions, and whether telephone calls and emergencies are managed well. How long is the wait in the office for a scheduled appointment? Ask if the children seem to like the doctor, and whether she seems to relate well to children as well as parents. You might also want to ask if there is anything about the pediatrician or office that has ever bothered your friend.

Once you've compiled a list of potential candidates, you'll need to contact their offices to ask a few questions, and to set up in-person interviews with any who seem promising. This way you can check out the office environment and make sure the chemistry is right. Doctors say that it's not a good idea to bring children on this visit. You and the doctor will both be better able to concentrate, and to speak freely, if you aren't distracted by children.

WHAT TO ASK

The main reason to sit down and talk with doctors you are considering, rather than doing interviews over the phone, is to make sure that the "chemistry" is right--especially with the parent who will have the primary responsibility for bringing the child to the doctor. Ideally, you'll find a pediatrician whose personality is compatible with yours, someone you would be happy to work with.

More important than the doctor's views on issues that might cause controversy (such as circumcision, breast-feeding, or use of antibiotics) is the doctor's attitude. You want a doctor who exhibits a certain degree of flexibility and doesn't mind explaining his views.

--EDWARD R. B. MCCABE, M.D., PH.D., MATTEL CHILDREN'S HOSPITAL AT UCLA

Prepare a list of questions in advance, bring them with you, and be ready to take notes. Doctors recommend discussing topics like an interest in alternative medicine, or religious objections, with any physician you are considering. Find out how long the doctor has been in practice. How long has the staff been with him or her? A doctor who has long-term relationships with staff probably has a better-run operation than one with constant turnover.

This is someone who is going to be a partner with you in keeping your child healthy. It's important that you trust your pediatrician, because then you are more likely to follow his or her instructions.

--LINDA MCCABE, PH.D., UCLA

OFFICE LOCATION AND HOURS

Find out if the doctor is convenient for you. The doctor's office should be close enough to home that you can take your child in for checkups and get there quickly if your child is ill. If it's difficult for you to get your child to the doctor during business hours, you'll want to find someone who takes evening or weekend appointments at least occasionally. Ask how long it generally takes to get an appointment with the doctor. Many pediatricians don't keep their own schedules, so you'll need to ask the office staff about this.

If you have a special interest, such as holistic medicine, find out how any doctor you're considering feels about it. Also, find out about any special areas of interest the doctor might have. Sometimes even a doctor who isn't a subspecialist knows a lot about a particular area, such as allergy and immunology. If you know your child has a particular health problem, it's a good idea to find a doctor who has taken a special interest in that area.

--RACHELLE TYLER, M.D., M.P.H., MATTEL CHILDREN'S HOSPITAL AT UCLA

It's also important to know what will happen when the doctor is on vacation or otherwise unavailable. Is it a group practice, with more than one physician? Who will you see if you can't see your doctor? All doctors need some sort of cross-coverage arrangement so that they have time to lead personal lives and to renew their training when they need to.

OFFICE ENVIRONMENT

The pediatrician's office should be both child-friendly and child-safe. The colors and artwork on the wall should be appealing to children. There should be games and toys for them to play with and/or videos for them to watch. Look for a warm, welcoming, well-lit environment and a responsive and friendly office staff.

When you visit the office, keep in mind that most pediatricians' offices will be a bit hectic. Some will have times of the day when the doctor sees sick children as opposed to well children. Others might have a separate alcove in the waiting room for sick children, or make it a practice to take sick children straight into an examining room. They should have some system for keeping them separated, though this can be challenging.

--EDWARD R. B. MCCABE, M.D., PH.D., MATTEL CHILDREN'S HOSPITAL AT UCLA

The exam room itself should be friendly, and it's a nice idea if there are gowns readily accessible for older children who need to undress. Each exam room should have a sink for washing hands, and the tables should be safe and well padded, with paper that is easy to change.

There should be a place in each exam room for you to sit if the doctor needs to talk with you. It's also a good idea for the pediatrician to have a separate consultation room, so there's a comfortable place to have a longer discussion if necessary.

Check out the bathrooms. Are they clean and kid-friendly?

IN AN EMERGENCY

Ask about how the office handles emergencies. Some doctors use a telephone triage service, where parents can call at any time and talk to a nurse or other health-care professional about their child. The triage worker will ask questions to help determine whether the child needs to come into the office or go to a hospital or urgent-care center. Doctors say that some of these services can be quite helpful, and of good quality, giving parents a twenty-four-hour resource. If the doctor doesn't use telephone triage, ask whether she or a colleague is available to speak with you in an emergency. In either case, a good pediatrician should have some way to answer emergency calls, even at night. If the doctor uses an answering service, how quickly will your calls be returned?

Does the doctor use an urgent-care center that might take care of emergency visits? These centers are generally set up to handle emergencies or evening and weekend visits without exposing your child to a hospital's emergency room. Knowing the protocol beforehand might save you from being kept on hold if you call the doctor's office.

If your child has to be hospitalized, you'll want to know if your pediatrician will meet you in the emergency room. Doctors say that if the pediatrician uses a community hospital rather than a children's hospital, he or she should be prepared to meet you in the emergency room, because community hospitals aren't as experienced at treating children. However, if your doctor uses a children's hospital, a visit from him or her isn't really necessary.

HOSPITAL PRIVILEGES

Most doctors have "privileges"--the right to practice--at one or more hospitals in their area. Find out where the doctors you are considering have privileges, especially if you're pregnant. If your pediatrician doesn't have privileges at the hospital where you will deliver your baby, he or she won't be able to come and examine your baby before you leave the hospital. The pediatrician also won't be able to care for your infant in the well-baby nursery.

Find out if the doctor does in-patient coverage in the hospital, or whether he or she has a hospitalist (a doctor who handles patient loads at that particular hospital) do that. This is controversial. Hospitalists at a children's hospital give very good care, and there are advantages to having someone who is located on the hospital premises all the time. However, some doctors are concerned that the continuity of care might be interrupted if the child is handed off to a hospitalist. If your doctor doesn't do his or her own in-patient care, decide whether you are comfortable with this.

Ideally, it's best to have a pediatrician who is affiliated with a children's hospital, because children's hospitals are better prepared to treat children than community hospitals. However, if you've got a good board-certified pediatrician who will know if your child needs to be transferred to a children's hospital, you'll be fine.

--WILLIAM G. BITHONEY, M.D., ST. JOSEPH'S CHILDREN'S HOSPITAL, NEW JERSEY

WORKING TOGETHER

Once you've found a pediatrician with whom both you and your child are comfortable, you can focus on working together to keep your child healthy. Your part of the bargain, according to doctors, is to be well prepared when making calls or coming in for office visits, and to help prepare your child as well.

If your child is old enough, talk with him about visits to the doctor. Let your child know that the doctor is there to keep him healthy, or to help him feel better if he's sick; don't ever threaten that a doctor will give your child a shot if he isn't good. If you know what's going to happen at the visit (such as whether he's going to get an immunization), prepare him for that as well. Read related books and play with toys to help your child get ready for upcoming visits.

While in the office, be supportive and involved in helping your child through the experience. Also, support decisions and treatment even if your child resists. Don't argue with the doctor in front of your child about whether a certain procedure is necessary.

--RACHELLE TYLER, M.D., M.P.H., MATTEL CHILDREN'S HOSPITAL AT UCLA

If your child is ill, you might sometimes have an idea about what might be wrong or how your child should be treated. Maybe you're convinced that antibiotics are necessary or that your child needs a prescription cough syrup. Doctors advise that you hear what your pediatrician has to say before bringing up your own ideas. Of course you should feel free to ask questions and discuss your child's treatment, but in the end you need to trust your doctor.

Try to prioritize your list of questions. Some pediatricians are only able to spend an average of about six minutes per office visit, so you might not get them all answered. Identify the four to six that are most important to you.

--EDWARD R. B. MCCABE, M.D., PH.D., MATTEL CHILDREN'S HOSPITAL AT UCLA

Some pediatricians are now answering patients' questions via e-mail. Ask whether your doctor does this. There may also be a child health associate or pediatric nurse practitioner in the doctor's office who can help.

If you ever become frustrated with your pediatrician, try to determine whether there's a pattern of unsatisfactory behavior or whether the doctor might be focusing on a very ill child in the next room whose case he is trying to figure out. If you have ongoing concerns that the doctor doesn't address, it might be time to find a new pediatrician.

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