Thinking back to your first days as a pediatric resident or fledgling pediatrician, what surprised you most about caring for children? For many physicians, it’s the fact that their duties as physicians caring for children overlap with caring for caregivers, too. Here are some ways pediatricians support adult caregivers, when not to offer assistance, and why offering a little extra care towards adult caregivers can be essential for the health of your patients and your business, too.
New Parents, The Pediatrician Will See You Now
A study in the American Academy of Pediatrics’ Pediatrics from 2009 states that reassurance and continuity of healthcare were two of the top reasons parents sought primary well care visits. Delivering Mom and Dad the reassurance they ask for is a compassionate choice. Still, for pediatricians, reassurance -- which includes both educational, emotional, and logistical support -- is also a critical factor in healthy families and positive relationships with their physicians that serve kids for their entire lifetimes.
Reassurance is just one reason to fulfill that supportive role. Supporting a patient’s adult family can increase positive health outcomes, improve the understanding of clinical instructions, enable earlier interventions for diagnoses like autism, strengthen family-physician relationships, offer resources for families in need of financial assistance, and much more. As the direct consumers of healthcare, supporting parents can also mean offering alternate hours, payment strategies, and other resources.
In this way, a simple call or visit about a fever, an umbilical cord, or a behavioral health issue can offer many more opportunities for pediatricians to make a caregiver’s job a little easier, improving kids’ overall well-being.
What are a Pediatrician’s Responsibilities to Caregivers?
While supporting your patients’ caregivers is important for the child’s health and wellbeing, what responsibility do pediatricians have to settle some of the issues adults bring to the table, such as custody battles, personal trauma, or distrust in healthcare?
Generally, pediatricians should enact and follow practice policies that protect physicians and enable them to engage with caregivers insofar as it pertains to the child’s healthcare. Here are some situations pediatricians might experience that are not their responsibility.
Communicating health information between parents. Exceptions like healthcare emergencies exist, but in most cases, it’s caregivers’ responsibility to exchange information like diagnoses, care plans, and coordinate appointment dates, no matter the relationship (or lack thereof) between the caregivers.
Offering healthcare to parents. There are exceptions to this too -- situations like lactation consulting or maternal depression screenings can be interpreted as healthcare for the parent. However, they aren’t billed this way. Maternal screens are coded and billed for the infant as the patient.
Pediatricians are physicians licensed to practice medicine, so if Mom, Aunt, Grandpa, or an adult sibling appears in the office and has an injury or illness, a pediatrician can choose to help. Pediatricians can also provide healthcare in emergency situations, and even forego informed consent if the patient is unable to provide it. Pediatricians should be wary of gray areas, such as mental health advice for struggling adults -- while physicians can be an encouraging and supportive presence for the adult as their role as a parent, further treatment should be recommended for serious problems.
According to a course about common pediatric myths during the AAP’s National Conference & Exhibition in 2016, experts warn that pediatricians should be familiar with their liability insurance to ensure that they are protected in these situations.
Mitigating disagreements. A pediatrician is not required to be the mediator between disagreements between caregivers and any other party, whether it’s the other parent, a religion, another physician, or the patient. However, conflict can sometimes result in accusations that it is the pediatricians’ role to investigate, such as neglect or abuse.
Pediatricians can offer medical advice, support positive healthcare choices, provide guidance to protect a child from conflict between adults, and encourage further discussion to ensure that a family can choose the right healthcare decisions for their child. According to a 2016 clinical report by the AAP on supporting families through divorce, “Legal sources suggest that mandated parenting classes, recommended by divorce courts, could improve outcomes for all members of the family”.
So what are pediatricians’ responsibilities to dads, moms, grandparents, and other family? Simply put, to support their healthcare decisions on behalf of the patient. This is more complex than it sounds -- pediatricians should be aware of Mom and Dad as the direct consumers of family healthcare, and also identify key ways to support the joys and challenges of parenting.
Parental Support: from the Day after Birth to Adolescence
Whether they’re familiar with the practice or not, a visit to the pediatrician can feel stressful for some parents. Support for them appears in many ways but is often grouped into several categories. Pediatricians might:
- Offer business services including payment plans, walk in hours, alternate hours or days for working parents, and telehealth.
- Provide adults access to digital and physical resources such as videos, office policy documents, and trusted websites such as the AAP and Healthychildren.org.
- Offer advice based on a child’s developmental milestones, social and emotional health, and physical wellbeing to help parents cope with the challenges of each stage.
- Inquire and provide financial or logistical support to families in need of access to baby clothes, diapers, school supplies, contraception, medications, or transportation to the office.
In addition to these practical services, the well care visit is a wonderful opportunity for pediatricians to engage families in their concerns about parenting and reframe challenges to help adults cope with child behaviors. For example, a Dad struggling with a busy and active toddler doesn’t have a “defiant” or “difficult” child, but a child exploring their own autonomy and independence for the first time. These conversations can have deep impacts on a parents’ confidence, patience, and understanding of their child’s development and healthcare needs.
There are many suggestions as to how to improve the connections between physicians and families. Unsure what the parents want? It’s worth asking, either informally or via a practice survey. For example, the nonprofit Pediatrics Supporting Parents’ mission is to use the pediatric well-care visit as a touch point for improving the social and emotional development of children aged 0 to 3. Parents from the 2009 Pediatrics study indicated they want easier ways to connect with pediatricians, and ideally they want to work one on one with a single clinician rather than many.
The future of an integrated healthcare system is up to families and to pediatricians willing to make changes to support the health of the whole child with collaboration and a little creativity. And don’t forget -- Mom and Dad can get the benefits of your practice’s support outside of the exam room too. Learn how to market your practice to get parents the support they need online and off with our ebook, How to Market Your Pediatric Practice.