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Pediatrician Etiquette

I spent a week at the beach living on pizza, fries, ice cream, cookies, and more fries, and I lost three pounds. Man, I love breastfeeding. That has nothing to do with anything, just felt the need to throw it out there.

Also, since this is my pseudo baby book, Owen got his first "solid" food today. Really it was just breast milk with a few grains of rice cereal mixed in, but still. He ate it, but was less than thrilled when he figured out we weren't going to let him have any pizza.

Now, on to today's topic. I have some questions about pediatrician etiquette (as in how I should behave when dealing with the Hotty Pediatrician, not how pediatricians should behave, which is a whole other can of worms about which I have all sorts of opinions and we can do that one later, if you want), and I figured hey, who better to ask than the internet. Is it wrong that I now go to the internet with all of my personal dilemmas? It really is easier than thinking for myself. Anyway, my questions are thus:

  1. Now that I have two children, what are the guidelines regarding discussing the child that is not the subject of the current appointment? For example, I took Owen in yesterday and found he had hand, foot and mouth disease. Mia was also sick this week with some similar symptoms which made me think she had the same virus but did not get the full set of symptoms since she has had it before. Is it appropriate to mention that Mia was also sick, or am I supposed to make a separate appointment for her? (I didn't consider her sick enough to warrant a trip on her own.)

  2. On a similar topic, when I was there discussing the latest attack on Owen's immune system, would it have been appropriate to ask for a referral to a new gastroenterologist for Mia? I would ordinarily just call for that, but am I supposed to handle it separately?

  3. How much chatting do you do with a pediatrician? Now, keep in mind that I am not a very chatty person and not usually the type to natter away with strangers. But the Hotty Pediatrician has recently generated offspring and during our last few visits has mentioned said offspring in a casual way. Like yesterday when the only time Owen stopped screaming was to flirt with the Hotty Pediatrician I said "fine, you keep him" and the Hotty Pediatrician said "sure, he can play with my kid, they are almost the same size anyway." Am I supposed to pursue that sort of comment with further conversation about his kid? It feels a little strange not to, since we spend so much time discussing my kids, but I don't, you know, make small talk with my OB/GYN about her vagina just because we spend so much time focused on mine. Also, do you think the Hotty Pediatrician keeps mentioning his kid in an effort to prepare me for my future role as stepmother?

  4. I actually have one more question, but I am paranoid enough that I think it has too much potentially identifying information about the Hotty Pediatrician and that someone may read it and figure out who he is, which would blow. So if you want to help me out with my last question and are able to reasonably establish that you live in another part of the country entirely and therefore are highly unlikely to be able to identify the Hotty Pediatrician, let me know and I will email you. And I really need some volunteers for this one because it stresses me out every time I take the kids in.

Come on now, I know you are sitting home on Saturday night just like me, so help me out.

Comments (48)

Oh HOW did you know I'd be home on a Saturday night, just ready to answer questions?

Ok, so as far as pediatrician etiquette:

I think it's perfectly reasonable to mention Mia's symptoms even though the appointment is for Owen and Mia's not even present. It might help the ped to diagnose Owen, but also if it's something that spreads from one kid to another fairly easily, he may want to tell you to look for xyz symptoms to pop up with Mia.

Totally ask for the referral while you're there- multitasking is key. You could even phrase it, "Oh, while I'm thinking of it....or would you rather I just call the office for the referral?"

I do a fair amount of chatting with my pediatrician. But honestly, I'm a really chatty person, and he is as well, and our kids are right around the same age. Usually our chatting has a lot to do with whatever hilarity ensues during the course of our appointment. And also, kids and vaginas are two very different things. Though to be frank, I'm not really looking forward to discussing my boobs and their production, come the arrival of Baby Baby.

What is the issue that stresses you out so much!?

Yep, I live in San Diego (go Padres? Or something? I think they're baseball and also I think we have a football team too) and probably will never meet HP. Fire away with the question.

How can you not be emailing me right now? You know I'm sitting home stuck on the couch nursing :)

My other answers are:
1 Separate appt. unless it's a yes/no answer
2 I think fine, because it is a one word type answer
3 Very little chatting, I think it's mostly to be polite because we're there in a professional capacity. Kind of like a masseuse or a hair stylist. I never think to ask them how they're feeling or what they like about their hair, you know?

Am sitting by computer, very curious about your 4.

If the Hotty is both Mia and Owen's pediatrician, which I'm assuming he is, I see nothing wrong with asking questions about Mia at Owen's appointment. The only problem might be that you couldn't get as much info as you need if Mia is not also THERE. If she is, multi-task away, as someone else suggested.
This goes for the referral too. Reasonably, a referral will take up very little time, so what's the harm in asking.
I know our relationships with our pediatricians are sometimes tricky and very important, if we LOVE the ped and value his/her service, but remember, we are the patients, and thus the customers. We are dependent on and PAY for their services, so the pediatricians should be willing to help us in any capacity.
Now, I don't know where you live (probably because I've only been reading your blog a few months and maybe don't hold onto details so well . . .? Sorry), BUT I live in the deep south in the middle of nowhere, so unless you're as close as Memphis, TN, (my closest metropolis) I'd be glad to give any insight on your more stressing question.
My email's in my info, but it's

Oh, and preparing you to be stepmother, hardy, har, har. Along with that, I think chat should be kept to minimum if you are not BFF. Mostly, I think doctors in general are chatty simply to be polite and give themselves another dimension other than Hotty McHottyson, MD. To follow your own analogy, in no way do I want to discuss my OBGYN's WIFE's vagina (since he is a HE) simply because she and I have the same parts and he may be familiar with both of them. Ewwww. I just skeeved myself out. Now I have to find a female OBGYN.

You know I live all the way in Texas so no chance of me finding him.

I say that it is perfectly alright to ask about Mia at an Owen appointment as long as you aren't asking him to make a diagnosis or to write her a prescription for something without him having seen her. And it's also fine to ask for the referral because he might want to discuss your concerns with the other one. If he doesn't know that some parents have had issues, he may continue to refer to this person.

1. & 2. I hope these are OK, because I do this kind of thing all the time. I suppose it depends on your pediatrician and clinic, and what their policy is. He's a professional; if he thinks something warrants another appointment he should let you know. My doctor (so far) seems not to mind, as long as it's something small.

3. I ask occasionally about our doctor's son -- it helps to pass the time while she's typing notes or whatever. Clearly you have a different kind of relationship with your pediatrician, though, because my pediatrician is a woman and we are currently not allowed to marry in Minnesota.

4. Speaking of Minnesota, I believe you have mailed me one of Chris's excellent CDs. If that is enough proof, and if you are interested in my admittedly worthless opinion, ask away.

I wish breastfeeding did for me what it does for you. (sighs, gulping down another "diet" shake).

I think it's reasonable to discuss Mia's symptoms at Owen's appt. since you're talking about possibly the same illness. Might not be the best time to discuss (hypothetically speaking) Mia's sprained ankle or excessive plaque, but an illness that you are already discussing is relevant.

Dunno about the gastro referral. Since it's such a quick question and not likely to lead to discussion, he probably wouldn't mind you asking at Owen's appt.

I bet the pediatrician is just dying to talk to somebody else about his kids. He spends all day every day hearing and talking about everybody else's kids, he's probably dying for the chance to discuss his own.

I live in Texas and have no stalking skills whatsoever, so feel free to fire away with Question #4

Couldn't you just ask the (Hotty) Pediatrician what his preference is for how you deal with things? I suspect different pediatricians probably have different expectations. I would just ask him. Although I think it would definitely make sense to mention that you suspect your other child may be coming down with the same illness the child being examined is suffering from.

I think the casual mention of the other child being sick or asking for a referral is fine. I'd draw the line there and anything further schedule an appointment. Say, if you bring one child in who is sick and the other one starts exhibiting symptoms, I wouldn't ask the doctor to look in the non-scheduled child's ears. And a little chit chat with Hotty Pediatrician about his kids sounds reasonable. If he's game and you're game to chat about it I think it's a nice doctor/patient relationship exchange. And I live quite a bit away from you so if you're willing to share your last question with me I'd love to know!

I think it totally makes sense to bring up Mia's stuff in Owen's appointment, because it's not like you stop being Mia's mom all of a sudden when you walk in there. That's just silly ;-) Referrals, yeah, I'd probably ask the doc's preferences. And if he's initiating small talk, go with it, but keep it light and chatty :-) And ask me the last one - not only do I live on the other side of the continent, it's a whole other country ;-)

I would definately bring up that you have another kid with some similar symptoms. When I had some freaky rash and went, I mentioned that my daughters had a touch of the same, and my doc wrote me a prescription for a tube of cream large enough to use on them, as well. He had zero problem with that. Besides, more information is better, and you never know when the combination of info about both kids may help with a diagnoses.

The referral, I'd ask if he can do it, or would prefer you call. He'll probably do it, but it shows that you know his time is valuable.

Re: the chattiness, I'd make sure to talk up your own kids a bit, you know, so he knows he's getting the three of you are a real catch. I'd make a polite comment in return, unless you're rushed, but probably not get too deep. I always feel stalkerish if I delve too deep.

And if you still need more opinions, I'm in the Dallas areaand my boy is asleep, so I can even type a reply with both hands.

I agree with all of the above. I'm pretty chatty with our pedi nurse practitioner, but we're in the same field and just click. I want a hotty pediatrician! Maybe he is secretly grooming you to be a step-mom ;) I really want to know question #4. I'm in Texas and at an all-girl pedi practice so there's no chance I know hotty pediatrician seeing as I'm not taking my kids to him.

I have no idea about issues of pediatrician etiquette. But I do live in Ottawa, far, far, far away from you and any possibility to ID the pediatrician, if you really need an opinion.

I think chit chat about his kid is okay, as would be mentioning Mia's similar symptoms.

I think since you have an established relationship with the Dr it would be ok to mention things about the other kids and to ask questions. I dont think they mind unless you drag on with questions. Im pretty interested in whatever your last question could possibly be and since I live in Kansas I dont think I will be running into your Dr anytime soon.

I think since you have an established relationship with the Dr it would be ok to mention things about the other kids and to ask questions. I dont think they mind unless you drag on with questions. Im pretty interested in whatever your last question could possibly be and since I live in Kansas I dont think I will be running into your Dr anytime soon.

I think since you have an established relationship with the Dr it would be ok to mention things about the other kids and to ask questions. I dont think they mind unless you drag on with questions. Im pretty interested in whatever your last question could possibly be and since I live in Kansas I dont think I will be running into your Dr anytime soon.

Not sure why my comment posted so many times but sorry for the people that have to keep reading it!

I TOTALLY live in Seattle, so feel free to email away - my experiences with my two kiddos (5 and 3) should be helpful to someone...

Since I live in the midwest (read my blog regarding all the flooding we've experienced, with pictures I took to prove it), I'd be safe...

Plus, since I have the same dang disease as your son, I truly have nothing better to do with my weekend. ;-)

Ooh, I love doctor's office questions, because I worked at a family practice for about 5 years so I feel like I KNOW EVERYTHING! Ready for a long comment? Here goes:

1. Schedule separate appointments. You know how you have to wait FOREVER for your doc to come see you? That's because some other parent only told the scheduler there would be one sick kid coming in and then she brought in all eight of them to piggyback on that appointment. Offices schedule a certain amount of time depending on what the reason for the visit is. Also, chances are they will think you are trying to get free care even though will be doing an exam and all that, just no chart or bill sheet.

2. Chances are the nurse handles referrals, so you could tell them at check in that you need to speak with her to get a new referral. Nurses generally don't require appointments (although some do, which is ridiculous, IMO)

3. I'm no help here as when I go to the doctor he HUGS me. Granted, I worked with the guy for five years, but STILL. Hugs. Weird. If your doc is bringing up small talk though, then go for it. After all, he's probably just trying to get to know you so he can be sure you really are Mrs. Right.

Whee! That was fun! I feel so USEFUL. If you wanna email about number 4 go for it. Or if I was too know-it-all-ish then don't. Whatever. :)

Our pediatrician brings the medical records for the other kid into the room during the exam (at least the well baby ones), so she must expect questions about siblings. I think that means it's okay. Ditto on #2. Chat if you feel like it. I doubt you'll offend your doctor either way. Oh, and email me about 4, even thought I'm local.

I want to know about number 4.

Also, I really want to talk about pediatrician etiquette, so work on that. :)

I think if it was a similar disease and could have affected the dx or something, absolutely. And I would say that if you aren't sure you could sort of say so. Like "I'm not sure if this is the time to bring this up, but I need a new referral for Mia. Should I talk to you about this now or should I make a new appointment?" That way he knows you at least care. But if he doesn't really care, you arent' out two copays...

1. I think it's appropraite to mention Mia was sick also. It night have a bearing on his assessment of what is wrong with Owen. A Dr can never have too much information. Now to get her treated would require a seperate appointment.

2. It would have been appropriate to ask for a referral to a new gastroenterologist for Mia. I mean you're right there talking to the Dr that would be making the referral. No need to make a seperate telephone call. That's just more work for everyone.

3. Since he bought up his own kid, a little back and forth would certainly be ok. Somehow discussing one's children doesn't seem to be on quite the same personal level as things with your OB/GYN. And yes, you'll need to know about his kids when you become their stepmother.

4. While technically I live live down the street from you (figuratively speaking), we been out of the peditrician business for quite some time so I doubt that I would ever come across him or take the time to try and research it. Your decision though obviously.

I am envious that you got to go to the beach and eat all that tasty beach food.

1. I say ok to do at the same appt.

2. Not sure...have only been a mom for 8 mos...still figuring that out....

3. I say heis prepping you for step mom glory..

4...I live in send your query!

1) When making an appointment, ask them to pull both files if you even think you might ask a question about the other. If you explain that one of your children is sick and they spend all their time together, they should be more than willing to do that. Then the Dr sees both files, you're all clear.

2) See above.

3) I'm very chatty. My last physician and I always said we were going for margaritas together and I pointed out that she'd be the only one of my friends who'd ever looked up my hoo-ha. I think he sounds like a proud new father who is probably dying to whip out a series of pictures.

4) I'm in Atlanta. Ask away.

1) I mention related stuff on the spot. Like, "Oh! Edward has X?? Elizabeth had the exact same symptoms last week!" Then I let the pediatrician take the lead: he can say, "Oh! Then we should see her too!" or he can say, "Oh! Let me write you a prescription for her, too!"

2) For other stuff, I call separately. Because once I asked the nurse for a vitamin prescription for another child, and she went OVERBOARD with the fake confusion: "Oh! Now...we didn't see him today, right? *riffling through files*" So I took that as a hint, but maybe she was just easily confused.

3) I do extremely mild chatting, if the pediatrician seems to want to. So, like, if he brings up how his boys fought, too, I might say, "How old are your boys now?" but then I am coiled with fear: have I asked too much? have I PRIED? (I LOVE the gyn analogy.)

I AM INDEED here on a Saturday night. Our neighbors are having a party, and their music is too loud for me to sleep.

I live in Seattle. There is no possible way I could ever figure out who HP is. If you need me to prove it, I will do my best. I will be more than happy to answer your #4. As for the other questions:
1. My ped always, always asks how the other kid is doing and if the other kid has symptoms of what ever is going on. So I have never had to bring it up. But I think it is totally appropriate to bring it up.

2. Ask for the referral. Multi-tasking. I am sure that he won't mind.

3. I am guessing he is preparing you for step-motherhood. :) I would say chat as much as you are comfortable with.

Looking forward to your #4 question.

I believe my surgery does have a 'one person/problem per appointment' policy, but my GP and I have known each other since I was a child. He's known all my kids since they were bumps and I guess knows I'm concise and have a reason for all my questions, so is happy to discuss other children etc.

He does have a holistic view I think - has a family himself so knows that viruses go round etc so questions about other members etc are very relevent!

I live in the UK, fire away re #4!

I believe my surgery does have a 'one person/problem per appointment' policy, but my GP and I have known each other since I was a child. He's known all my kids since they were bumps and I guess knows I'm concise and have a reason for all my questions, so is happy to discuss other children etc.

He does have a holistic view I think - has a family himself so knows that viruses go round etc so questions about other members etc are very relevent!

Oh, and I often ask after his kids :)

I live in the UK, fire away re #4!

1. I think you should ask if you can ask about the second child while you are there for the first child.

2. Again, can't hurt to ask...

3. I'm so not a chatty person, with anyone, and especially not doctors.

4. I'm in Illinois, I have no proof but I would love to give you advice on question 4.

First of all, it looks like you may have enough volunteers for the last question. But I'm in Michigan and you need a tiebreaker, let me know.

For the rest, I usually ask the nurse when I go in to the exam room with the appt kid if I have a question about the second kid. She's usually able to tell me if I need another appt, or can let the doc know I have another question - she has the schedule and can guage if the doc is running behind or has time for a second question.

The referral I'd ask about no problem since the doc would probably have the front desk do it anyway.

The blah blah blah about social life? I don't know - when we have our regular doc, we get pretty chatty (she's really a great doc)... there's another doc in her practice who is very odd and socially stupid - and if he starts chatting, I gather up my stuff and say, "Well, look at that, gotta go!"

Oooh, I am dying to know the other question. not that i will be much help as I am totally retarded when it comes to dealing with peadiatricians and the like. And i am in another country, hell, a whole other continent, so your secret is relatively safe.

Yes mention that Mia was/is sick. If they have the same thing, even though her symptoms are lighter she may need some medication as well.

Yes ask for the referral, you are already there and he's her doctor too.

Ask a couple questions abut his kid if he brought it up. If he is vague, you can tell he doesn't really want to talk.

I'm in another part of the country, so shoot me an email if you want.

As a doctor, I say:

1. feel free to mention someone else is sick (other siblings, kids at school) because that can help with the dx. If I have time, I'll look at a sibling, but usually will not prescribe meds unless I can see her/him. I'm happy to see the sibs if I have time, but if I'm behind that day, I will ask that the parents schedule another appointment. (Please don't get angry at your doctors for that - schedulers anticipate how long they think we need and schedule for the appropriate time and though a few minutes here don't seem like much, if every parent asks about a second child, those minutes add up)

2. If the referral is quick and I've already seen the child, no prob. If writing a referral means that I have to examine the child, then please schedule another appointment. Sometimes when we refer patients, we have to do exams and send our findings with the referral.

3. Chatting is nice, but again be aware that doctors have to stay on schedule too.

Thank you for asking though - so many patients don't even think about these issues and get really angry when we can't see their other child.

Hi Beth - I'm a doctor, but not pediatrics. I still did pediatrics in medical school and spent several months in various outpatient clinics working along side them. Anyhoo - it was always fine to bring both along to one appointment if it was something quick like "name that rash." The doctor would often ask about the sibling anyway for something very infectious, and it was like doing double good for the price of one.

If it was an entirely different question, such as "Oh, by the way, can we do our well-baby visit for Owen while I have Mia here for her sore throat?" then that was uncool. It's not just the question or the prescription that takes the time - the doctor also has to write up a full note for each kid, which takes more time than you would think. With computer records it is a little easier, but with paper charts you have to hunt down the second chart and.. there's no time for that nowadays, especially in primary care.

Follow the doc's lead on the small talk. It is not uncommon for doctors who deal with children to talk about their kids to make the kids in the room more comfortable - "Oh, my son loves so-in-so famous baseball player..." If you have a doctor who relates to you as a social human, so much the better. Except avoid doctors who share their "issues" with you. That's creepy. And lord knows I've heard of enough cases of that.

Well, these are all questions I've asked before and always get a lot of variety in the answers. Though I'm dying to know what 4 is, lol.

So here goes, question 1. It seems like no matter when we go in, be it for the boy or the girl, we always talk about the boy. He has had major medical issues and our hotty pediatrician (we have one too, lol) always asks about him. I remember one occasion where we went in for the girl and spent 15 minutes talking about the boy. But I follow his lead on this. I would not have ever done this with our old ped cause she was NOT into discussing anything, even about the one we were there to discuss (she sucked).

2. I would ask for the referral. But that kinda goes back to question 1. But I would still probably ask for it.

3. We chat but I follow his lead. There was a stint were we saw him at least twice a month so we got pretty friendly so I know about his family a bit. He has a son that has similar issues to my son so we chat about that or about vacations, etc. If he brings it up I ask conversational questions. Some days he's too busy and I respect that. And yeah, sure, he's telling you about them because your status could eventually be stepmom. ;)

4. I live in the midwest, is that far enough away?

Hey Beth,

I live in Canada. As well, I don't know any pediatricians. This may put me out of the running for advice. I don't know what you need advice for!

I think that you could ask about Mia's stuff, and just follow the questions by asking if he minds. And say thanks.

I seem to have mastered talking about other people's offspring quite nicely. Sometimes it's a little fake. So just ask a general question about the offspring. You know, to get an idea of what it will be like to be his step mom.


Hmmm, I suppose I would probably ask simple questions regarding the opposite child while at appointments. If it's a simple answer, then what's the problem? Is the Seattle area far enough away?

I live in Seattle which is about as far away from you as I can get, probably.
SO if you want my opinion you can email me.
Also, I have a question for you too *if* you feel like discussing your VBAC. If not, nevermind. But don't hate me!

Okay. First, you crack my ass up! Second, I have two as well and I sometimes feel/want/need to ask questions about the other child even though it's not "their" appointment...I mean, seriously, I'm already there...but have actually been charged an extra co-pay for doing so. Third, I am in Seattle as well...I'm sure you've already emailed all your q's, but if not, feel free. I also have the hubs with the concrete pee on concrete, how to clean...ring a bell? ;)

I agree with everyone (mostly) above! If its a simple question that doesn't require an examination and tests, then no biggie! I have mentioned before on the phone when making the appointment that while I was there, I had a few questions about the other child. They gave my time block an extra 15 minutes and did not charge me a different co-pay. So sometimes its just all about scheduling :) Small talk with Dr. Hotty is fine, especially if he is grooming you to be the step-mother. You need to know all you can about this kid when you are taking care of him Wednesdays and every other weekend! haha! :) Okay - mow I will email you for the last question!

i know i'm a little late but i'm dying to know what question #4 is. i'm in nyc, by the way.

I've brought up issues about the "not present at appointment child" before and our pediatrician didn't seem to mind at all. I'd take ques from the hotty and see how it goes. When I make appointments for both children to see him, I let them know both need to be seen. Somethings they make back to back appointments where I get to pay 2 co-pays and other times they squeeze them both into the same appointment. I suspect the latter happens when there aren't back to back appointments available, but I always remember to thank them for seeing both at the same time... which they do whether there are seperate appointments or not.

I'm not a big chatter either, but I do engage in conversation that has nothing to do with the appointment, when it comes up. Even if its just a quick comment or question that shows I'm paying attention. heh

Not sure if I'd be at all helpful with the 4th issue, but I do live way down here in Texas. I can't think of a single person I know in your neck of the woods! I certainly don't know him, but read your husband's blog. Does that count? lol

I think it's perfectly fine to bring up Mia in the context of the questions above. I know I do so for my kids all the time. If the conversation leads to something more involved, you can always make an appt.
I can be reserved as well, but I think it's completely fine to chat up the Hotty Pediatrician. Firstly, he's hott. But also, I like to have a somewhat personal relationship with my Dr's so that they'll remember me and my kids and want to take that phone call from that lunatic who has an emergency, instead of sloughing it off on the on call person.

I live in Chattanooga, TN. I will likely never live in DC. let me know if I can help you with your other secret questions!

Well, I'm not going to look at the other answers because I might possibly be doing something wrong here...but...I always ask quick little questions about the other child who the appointment is not for. At youngest daughters last appointment I asked for a refill of allergy meds for my oldest daughter. Heh, why pay $20 extra for a quick quesiton? I'm cheap that way.

Now, I LOVE my pediatrician so we discuss her kids and grandchild. I ask how her vacation/holiday or whatever it was just then went and she's does the same. So, I think it would be okay to have brought that into a conversation.

Also, live in Antarctica so you can ask me any question although I will be visiting my Mom in Northern VA next week so maybe I don't count anymore!?

I really just want to know what the fourth question was :)

If you still need help with number 4, I would love to help you!

I would discuss both kids, if needed. If he's short in time, he can always ask you to schedule a new appt.

I live waaaaaaaaaaaaaaay over in Europe AND I'm very curious to find out #4! :)

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