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Monday Jun 06, 2016

Paging Dr. Mom: Becoming a Parent Made Me a Better Physician

When my daughter recently turned 1, we celebrated her birthday and I paused to reflect on all the things I'd learned as a new parent that helped me become a better family physician.

The journey hasn't been easy. But she survived, and so did I, through my first year of juggling the responsibility of nurturing a new life with all of the other tasks I have been trying to do well. Breastfeeding was much harder than I expected. And my baby's well visits weren't the straightforward encounters of just shots and anticipatory guidance that make family docs smile during an otherwise busy workday.  

It changed my counseling. I have developed more confidence and empathy, now counseling based on experience and a developing intuition instead of relying solely on my training. I have gained more insight as part of a community of parents where I have witnessed variation in child development, experiences and parental response.  

I am more supportive of those who are anxious about the things that run through a parent's mind at 3 a.m. Despite all of my medical knowledge and experience caring for sick children, I have watched over my baby's chest at night to make sure she is still breathing. And I have agonized after accidentally clipping skin instead of nails.   

Up until this past year, I didn't fully comprehend the emotion behind the vaccines debate because "science ruled." But after having a child, I understand that any controversy raises red flags for new parents, and I respect a parent's decision to make a choice -- even when I disagree. My job as a doctor is to help parents make the healthiest decision for their child by being supportive and providing evidence-based information.

I have also learned how much influence family and friends have on new parents, as the volume of their day-to-day advice about parenthood can overshadow what I say at well visits. This dominant force in a young parent's life shouldn't be ignored. Knowing what is being said to new parents and helping to provide a different perspective is fundamental to the concept of anticipatory guidance(pediatrics.aappublications.org).

I have learned to listen. I fired my child's first physician because she didn't. Her assumption that I was "worried well" made her deaf to my complaints and unsympathetic to my concerns. The doctor was fixated on my daughter's diagnosis being nothing, so she looked for nothing. Meanwhile, I was observing exactly what was going on with my child.

It's important that we listen to families. The parent in me saw that my child had difficulty latching, seemed to have developed an aversion to my breast, was smaller than other children her age, frequently seemed uncomfortable with bowel movements, had dry skin and vomited every time I gave her formula to help supplement.

Still, I was shocked when the doctor told me during the 2-month visit that my baby was only at the second percentile for weight and she recommended starting formula -- even though I had previously mentioned we had already started formula out of necessity.

Reassurance is not always reassuring. The doctor offered no other solutions. In fact, I was told to be patient. Thankfully, the doctor in me woke up after observing another emaciated child in the waiting room, and the reality of a failure-to-thrive diagnosis set in. My 2-month old infant was showing many signs of a milk allergy, everything except the tell-tale sign of bloody stools.  

This led to my next big realization: Emotions really do get in the way of objectivity, which is why as a parent it is impossible to be your child's physician. However, you can be your child's biggest advocate. It is important to surround your family with those who listen and whom you trust. After all, we are all human. Parenthood often exposes the vulnerability of all people, including physicians.  

I belong to a strong community of knowledge. Besides joining the Physician Moms in Family Medicine Facebook group(www.facebook.com), which has been extremely helpful, I also have been tapping more into the resources I already have. In regard to my daughter's health, I organized a teleconference with an FP colleague who works as a lactation consultant, a college friend who works as a med-peds doctor, and two of my friends from medical school (one is a pediatrician and the other has two young children and had gone through something similar).  

As a family physician, there is so much to know and even more to learn. Tapping into the collective knowledge of those who have practiced for decades, those who practice in different specialties, and those who are parents helped me to organize and develop a plan to put my daughter on the road to better health. Similarly, I have been called on more frequently by my friends, family and community to offer advice and second opinions for virtually all things kid- and family-related. As a new physician, I notice even my patients, especially the older ones, trust and respect me more now that I am a parent.

The transition hasn't been easy, but it has taught me much in this first year. I look forward to future lessons, and I hope it will make me more humble, resourceful and knowledgeable for the benefit of those I wish to help and serve.

Venis Wilder, M.D., is a board-certified family physician who practices at a federally qualified health center in Harlem, N.Y. She also considers herself a community health practitioner working at the intersection of primary care and public health.

Posted at 11:20AM Jun 06, 2016 by Venis Wilder, M.D.

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