Family Practice

Since we moved to this house almost 3 years ago, I've been thinking about switching doctors' offices. Our line of clinics has a branch much closer to our current home than the office in NeighboringSmallTown where we've been going for the past several years. Although I like our family practice doctor pretty well, there are a few things that are less than ideal about both the doctor and the clinic in general.

So, when I got put on hold once again for what seemed like an excessive amount of time while trying to make Baby E's 2-week appointment, I decided it was time. I called the appropriate number and asked to have myself and all three girls transferred to a doctor at the nearer clinic.

We had our first appointment with the new doctor today. After a 20-minute wait in the waiting room and another 25 minutes waiting in the exam room, the doctor finally came in. She looked a bit perturbed to see the whole family camped out in the room. Without introducing herself or asking our names, she apologized for the delay.

She said she'd been 10 minutes into the exam in another room with the wrong patient before she realized the patient was not Baby E.

Now, even as a lowly former veterinary assistant I know that the very first thing most medical practicioners do is verify that the patient in the room matches the patient whose chart they have in their hand. Plus, Baby E had been the only infant in the waiting room. So it appears it took the doctor 10 minutes to figure out that the 6-year-old girl called in just before us wasn't our infant in for her 2-week check-up. Alrighty then.

So then the doctor came over to look at Baby E. I explained that all three girls and I would be transferring our care to her, and told her all our names. She seemed a bit annoyed that I took the time to introduce us all. She did not make eye contact with any of the 5 of us. She vaguely acknowledged the introductions and started asking routine questions.

First she asked if we had any questions or concerns, and I named three: Baby E's stuffy nose and erratic breathing, and sometimes choking and gagging. The little white bumps (they look like tiny blisters) on her scalp and forehead. And her stomach pain/fussiness. I had to ask again later in the appointment about all three.

The doctor read off a chart several questions about breastfeeding and then proceeded to tell me to do what I had just finished telling her I'm already doing. She seemed to be reading from a script rather than interacting with us as an individual case.

The doctor seemed quite disturbed that we wanted to discuss varying the vaccination schedule a bit. I told her that we wanted to delay the Hep B shot until at least age 2 and she said that was fine, but then kept saying the baby needs the Hep B at 2 months, 4 months etc. I don't know if she forgot in that 5-minute time span or what.

I asked about spreading out the vaccinations to a bit farther apart so we could give the baby fewer shots at a time, and she didn't seem to understand the question. She went into this big long explanation about how you can't really do that because the state provides the vaccinations and they only provide single vaccines instead of the combination shots. That the combination shots allow for fewer needle sticks to give all 5 vaccinations at once, but aren't really an option because they're too expensive.

I tried to explain, but gave up.

My concern wasn't the amount of needle sticks--it's the basic idea of giving 5 or more shots all at the same time. I've seen too many vaccine reactions and I prefer giving just one or two vaccinations at a time rather than 5 at once because of the load on the immune system. Plus, we are going to want to skip some of the vaccinations like the Chicken Pox (Varicella) one, which is rather controversial and possibly unecessary anyway. This doctor just didn't even seem to want to interact with those ideas. (Our old doctor had no problem with it; even told us that she wouldn't give the Varicella shot to her own kids and didn't think it was necessary.)

They weighed Baby E fully dressed, which I thought was odd. The doctor didn't remove any of her clothing except her socks during the appointment. She lifted E's shirt to listen to her heart and look at her spine, and she checked the baby for what seemed like 2 minutes and said she looked great and healthy.

Baby E weighed 8 lbs 13 oz. at birth and 9 lbs. 1 oz at her 4-day appointment. At both of these they weighed her without even a diaper to be sure to get an accurate weight. Fully clothed and with a wet diaper, she weighed 9 lbs 1.8 oz today. I am sure that means she's lost weight. Neither of my other two babies lost weight in the first two weeks--they both gained about an ounce a day the first week or two. But the doctor didn't even compare Baby E's weight to her earlier weights. She didn't address the fact that she hadn't gained weight and whether that was normal or a matter for concern. She just looked her current weight up on a chart and said she was 90th percentile in both height and weight, and that was good. So now I don't know whether to try to get Baby E to nurse more, or if she's doing fine.

We asked about Baby E's fussy spells and abdominal discomfort, but the doctor didn't make any suggestions or even answer the question--just said ok and looked back at the chart. The same when I asked about the little white bumps on her scalp--she didn't even really look at them. When I said I'd had exczema on my scalp as an infant and was wondering if this was something like that or just bumpy skin, she just kind of said mmm-hmmm and moved on to the next question.

I asked about Baby E's chronically stuffy nose and the way she gasps and gags frequently, and she said she'd look in her nose but then forgot. I had to remind her at the end of the appointment. (She said it looked clear and just to try using the bulb syringe, which we've already been doing but hasn't been helping much, and try some saline solution.) Side note: I just realized that the reason the snoring/stuffy nose thing bothers me so much is that our 3-month-old nephew who died in November had the same kind of thing.

We also told the pediatrician that we'd had two SIDS deaths in the family and were concerned about it. She said "oh," but didn't really interact with us about that either.

The doctor never once smiled. She didn't seem to enjoy the baby or any part of the appointment. She didn't talk to the baby. She barely acknowledged the existence of anyone in the room other than me and the baby. We were just the next item on her assembly line. She didn't seem to really care or register what we were saying, even in answer to questions she asked. As DH said, "She was on autopilot."

As we were leaving, DH looked at me and said, "Suddenly, driving to NeighboringSmallTown doesn't seem so bad."

I'll be calling on Monday to see if we can go back to our other doctor.