Pediatrician Gripe: Squeezing in Parent Exams

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The Offending Statement

"Oh, can you just listen to my lungs quickly?"

More often than one may think, I get asked for a quick "parent checkup" after the kids are through. Although it may seem like a quick and convenient way to maintain your health, asking your child's pediatrician to treat you is a bad idea.

Why We Don't Want to Hear It

When a parent asks me to take a look at his rash or check his blood pressure or listen to his lungs, it makes me a little crazy. Why? Well, an adult asking personal medical advice from a pediatrician presents multiple problems. For example:

• I haven't studied adult medicine since medical school—and that was a while ago. Current treatments for adult diseases like hypertension and congestive heart failure are a mystery to me now, so if you're in need of medical attention you should see a clinician who specializes in treating grownups.

• Also, what if I did the exam and found a problem? I don't know your detailed medical history, which means that I can't make an accurate assessment, but if something seems irregular my responsibility at this point is vague. How can I make sure you follow up? How can I communicate that I'm worried to your regular clinician? If it turns out you do need medication or more tests, it's very unlikely your insurance will cover further treatment from your child's doctor.

• Another reason this is a bad idea is that a "quick listen" to your lungs implies a superficial evaluation. Superficial evaluations lead to incorrect diagnoses. If an evaluation is done correctly, it's never a "quick listen."

What You Should Say

I would rather hear a parent say something like, "I have the same symptoms as my daughter, should I call my doctor?" Or you could try, "I'm worried about my health. Can you recommend a physician for me?" You may get a few follow-up questions, and some advice on how your child's specific illness is spread and how to best protect you and the rest of your family.

Helping Parents Deal

I wonder why I hear this question so often. It's likely that parents think of this as a small favor and a minimal inconvenience to the doctor, someone with whom they may have bonded over the years. Parents could just be trying to save some time, and they often trust their pediatrician's opinion, and have sought advice over the years and learned to depend on the counsel they were given. After all, if your pediatrician has diagnosed your son with asthma and it made a difference in his life, then why not have that clinician listen to your lungs?

Unfortunately, good medicine is just not as simple as it looks, so when you're at the pediatrician's office, keep the focus on your kids. And everyone will be better off!