CHILDREN & YOUR DOCTOR’S VISIT

Your Doctor’s Visit

Should children be allowed in the consulting room?

Should children be allowed in the consulting room? This question is fraught with political correctness, implications and difficulty for the consulting doctor AND the patient. The following scenarios are examples of children accompanying their parent during a consultation.

CONSIDER A MOTHER WITH AN ACTIVE AND ENERGETIC TODDLER.

• a hyperactive two-year-old

• accompanying her already anxious mother, Carol (the patient)

• who is displaying multiple symptoms arising from complex health issues.

The above scenario was our first meeting and we had a 30-minute window of opportunity. Here was a mother in obvious need of medical assistance who could not find a babysitter for our appointment. Life happens. However, the result was that the child was entertained for 15 minutes while the mother received little help.

THE IMPLICATIONS.

I love children (my own included). However, any medical consultation has serious implications for the patient. Among the considerations are:

• the connection between the patient and the doctor

• limited time

• the need for focused concentration

• the detailed conversation around

• symptoms

• prognosis

• medications & treatment strategies.

A MOTHER WITH A YOUNG SLEEPING CHILD.

Lindsay came to see me after there had been a sudden cardiac death in her family. She came with a three-month-old baby who slept throughout the consultation. I was able to engage with Lindsay, sharing very complex ideas in relation to her family history, her health and that of her child.

WHEN CHILDREN CAN HELP.

When Bruce came to see me, he was 85 years old and he brought his son, Tony, who was just over 50. Bruce had complicated health issues and he was a little confused. Having Tony accompany him was an absolute bonus. Tony was able to:

• clarify what drugs Bruce was taking

• understand the treatment strategies I wanted to instigate for his father

• in the time ahead, was able to follow through to ensure the plans were followed.

A HAPPY ENDING.

Carol’s story has a happy ending. I was able to see her again not long after the first consultation and, on that occasion, she had a babysitter for the child. We were able to have a far more meaningful discussion. Carol’s health has improved. Occasionally, she still brings her child when the babysitter is not available. Over

time, we have covered a lot of ground and are now in a much better position to cope with the active and energetic toddler along with the consultation. Also, the child is now old enough to be immersed in iPad activities as the adults’ converse. While this is not ideal, it is certainly an improvement.

In raising this issue, I am not saying that children should be excluded. However, the patient must be aware that the presence of a child, especially a young child, can impact on the excellence of care being provided in that consultation. Discussions around prognosis, medication and ongoing treatment strategies can be complicated and, at times, distressing enough without the added distraction of young children. Some personal issues may also need to be dealt with and this may be difficult or not appropriate with an older child present. There are times, however, when their presence cannot be avoided and, under those circumstances, we do the best we can.

SUMMARY.

So, although children can be a hindrance or a help, they can be welcomed into any consultation, keeping in mind that:

• If the child is active throughout the consultation, there is no question his/ her presence will detract from the visit. If you have a child who will sleep throughout the consultation, fantastic. If you have a child who can participate in the consultation and assist with ongoing treatment, brilliant.

• In the end, it is your health and future that are at stake.

Dr Warrick Bishop is a cardiologist with special interest in cardiovascular disease prevention incorporating imaging, lipids and lifestyle. He is author of the book ‘Have You Planned Your Heart Attack?’, written for patients and doctors about how to live intentionally to reduce cardiovascular risk and save lives! Dr Bishop can be contacted via his website.