Communication Guide

Communication Guide: Sharing Information About Your Child

Learning to communicate effectively with your child's health care providers will help you become an active partner in important care decisions and ultimately benefit your child's health. This involves much more than listening to what the doctor has to say. It also involves learning as much as you can about your child's condition, and asking the doctor to explain anything you don't understand. Your child's doctor may be an expert in his/her field, but remember that you are the expert on your child. You are your child's voice, or advocate and you can help the doctor understand your child and develop the best treatment plan for him or her.
Many parents feel uncomfortable talking with doctors, afraid of asking stupid questions, or of seeming impolite by questioning something the doctor has suggested. The following are some examples of positive ways to voice your concerns. Most parents find that speaking up gets easier with practice.

1) The child's doctor writes a prescription for chewable antibiotics:

Avoid this=> "Not the chewables again! He hates those."
Try this instead=> "He's had problems with the chewables in the past. Are there any alternatives?"
You may also ask the doctor to document in your child's record that chewables are not an option. That way, anyone looking at your child's record in the future will also be alerted.

2) You have received a third letter from your health insurance denying payment again for services you know should be covered:

Avoid this=> "Why do you insurance people keep denying this bill? It should have been paid months ago!"
Try this instead=> "I have a bill and a denial in front of me. Can you help me figure out exactly where the problem is?"
By appealing to the person on the other end of the phone, rather than getting angry, you have a better chance of getting to the root of the problem. Ask your doctor's office staff for help, too - they may even call the insurance company on your behalf. Sometimes the problem is the doctor's use of an incorrect procedure code or a diagnosis code not recognized by the insurance company.

3) Your child has just been scheduled to have blood drawn for the second time in one week:

Avoid this=> "More tests? This poor child is being treated like a pincushion!"
Try this instead=> "Did you know he already had some tests done this week? Can we get any of the information you need from previous tests? Or can we combine them with the tests her other doctor has just requested?"
Talk with your doctor's office about scheduling appointments and tests together to save travel time. Often the nurse or the administrative staff can be very helpful. And ask your doctor to try to communicate with other involved doctors. It may be possible to coordinate lab tests in order to avoid duplication and to reduce your time spent traveling.

4) The doctor has quickly written a prescription for a medicine you know is extremely expensive:

Avoid this=> "Why do you doctors prescribe such expensive medicine?"
Try this instead=> "I know this is really expensive. Is there a generic brand you could prescribe instead? Or do you have any samples we could take home?"
You can also call your pharmacist for help - sometimes there isn't a less expensive option, but often there are alternatives. There are also financial assistance plans for certain situations. Don't be afraid to ask for help.

Making the most of each doctor's appointment

Plan ahead - Before you go, think about specific questions you have for the doctor. Writing your questions down may help you stick to the important issues and avoid distractions during the visit. Bring medication records and any other records of your child's health, especially those from other doctors your child has seen. Care Notebook log sheets may help you keep track of the information. Offer your records to the nurse or physician - that way it easy to confirm that they have accurate information on their chart.
Ask questions - Ask for handouts or clarification on anything you don't understand. Ask about options for treatment, including the expected benefits and possible side effects.
Be honest - Make sure the doctor has all the important information about your child, like "He complains of a stomach ache after taking this medicine," or "We can't afford this medicine." There may be alternatives for your child.
Test results - Ask how and when you will be notified about test results: by phone, by mail? Will you be notified only in the case of positive results?
Know the next step - Do you need to make a follow-up appointment to assess how your child is doing? Do you know the warning signs to watch for if your child's condition worsens?
Keep records - Record important information from each appointment in your child's health log or Care Notebook. Whether you keep these in a notebook or toss them in a box, keeping your child's information at hand will help you stay on top of things. If your child sees different doctors, a health log will help you keep track of medications and treatments, and will also help you work with each doctor to coordinate medication and avoid duplicate tests.

Become Part of the Team

Becoming an active part of your child's health care team is the best way to help your child. Keeping good records and keeping the communications lines open will help everyone help your child.


Information & Support

For Professionals

Building your Medical Home: An Introduction to Pediatric Primary Care Transformation (AAP)
A guide to building a medical home in practice, aimed at achieving recognition by the NCQA, from the American Academy of Pediatrics.

For Parents and Patients

Center for Parent Information and Resources (DOE)
Parent centers in every state provide training to parents of children with disabilities and provide information about special education, transition to adulthood, health care, support groups, local conferences and other federal, state, and local services. This link has a search tool to help you find the parent center in your state; Department of Education, Office of Special Education.

Authors & Reviewers

Last update/revision: July 2008; initial publication: June 2008
Current Authors and Reviewers:
Authors: Gina Pola-Money
Chuck Norlin, MD
Robin Pratt
Reviewer: Alfred N. Romeo, RN, PhD