Sunday, January 9, 2011


The time has come for the hallmark rant about the pediatrician. Don't get me wrong, I like Leila's doc. I think this is a reflection of the larger issue that is U.S. healthcare. I'd also like to preface this with the fact that I work with a lot of physicians and understand that their position is crammed right between the rock and the hard place. The rock: patient well-being and leaving no stone left unturned (wow, what's with all my geological references?). The hard place: making money and satisfying insurance companies.

At our last visit, I had what felt like a proverbial finger waving in my face about Leila's growth stats. For those who are interested, Leila has dropped from the 90th+ percentile to the 5th in a matter of a few months. Hubby and I were prepared by the docs at Children's for the steroid-induced stunting and have since embraced the notion of raising a wild, little smurf until the treatment is completed (at which point her growth will rebound to where it should be). Back to our 8-month checkup. I felt a reaction of disbelief and quiet judgment coming from the pediatrician that we haven't been feeding Leila solids at least twice a day, if not three. I'm immediately feeling embarrassed and a whole lot guilty. Is that something everyone knows? How could I NOT know that? Shit. (I know, I know, you're sitting there thinking, "duh." Whatever, smarty pants.) Anyway, I then got internally defensive. At our last visit, it was recommended that we introduce solids at one meal a day to see how she does. If we wanted to, we could go ahead and give her more, but the message I heard was that the goal is to get her interested and to get her practicing. Ok, now I take some responsibility for not scouring the internet for a feeding schedule for my baby. But, I also expected that the pediatrician would help us out with this one - and, no, not a sheet printed from the internet with general milestones. I'm talking about one that is specific to Leila, who has been on a steroid regimen (which affects her appetite) for the past 5 months and who consistently deals with reflux and bouts of constipation. Did I mention the milk protein allergy? With all that is going on in life, that pinto brain of mine has been sputtering along just trying to stay within the lines - it doesn't have time to be proactive, much less common sensical about something. Plus, if you've read my earlier blogs, you know that I've tossed the kooky baby books. There's such a thing as an oblivious first time parent! ::hand raised high in the air:: How was I to know? Communication gets faulty. Misunderstandings happen. I get that. But I think this touched a nerve and is a sign of what things have come to with managed care. I would prefer to receive guidance and support throughout this daunting process, not a boatload of judgment followed by a request for a copay. Appointments have to be shorter, patient questions need to be succint, and responses are rapid-fire. You would be scratching your head feeling as though you've missed something, but you can't because you have an appointment card in one hand and a heavy, cumbersome car seat drooping in the other as you're quickly shuffled out the door. Again, I can't fully blame the pediatrician - I'm perfectly capable of researching things and, bottom line, I dropped the ball. But, given that I have the memory of a 90-year-old Alzheimer's patient, remind me of what I'm paying the pediatrician for? All snarkiness aside, I guess we learn from our mistakes. I just wish I didn't have to feel so inept in the process. We'll chalk this up to Mommy of the Year Moment #37.