Mom-meeee!

02.23.14

Doctor to Dads: You’re Doing It Wrong

At least some of you, and at least when you come into the doctor’s office, clueless about your kid’s health.

Dads: you’re doing it wrong. At least some of you, and at least when you come into the doctor’s office.

Let me back up and explain. I’m a pediatrician. Which means I start almost every visit by talking to people. For all the advances of medical technology and treatment, it’s hard to know which test to order or consultation to arrange if you don’t know which question you’re trying to answer. Increasingly detailed scans and penetrating lab tests are wonderful tools, but all good care starts with information gathered by speaking with people and examining them directly.

As a pediatrician, more often than not the questions I ask are directed at people other than my patients. After all, many of them are still learning to talk. Even those who have mastered verbal skills can lack the ability to communicate exactly what it is they’re feeling. And so most of the information I gather comes from the grown-ups in their lives, typically their parents.

How long has he been fussy? What does her cough sound like? Are there other things going on that you’re concerned about?

As you can imagine, there is little that I find more professionally frustrating than when patients are brought to appointments by people who have no idea what’s going on with them. I’m sorry to say that by far the most consistent culprits are dads.

Please don’t get me wrong. I think it’s great when patients are brought in for visits by their fathers. I am a dad, after all. And the vast majority of fathers who accompany their children to my office are perfectly informed about the concerns that led to the visit in the first place. But if I’m faced with a parent who hasn’t a clue about why they’re there, it is almost invariably a dad.

In my experience, these fathers fall into two broad categories.

The first is the annoyed dad. It’s clear from his affect and demeanor that he’s been dragooned into bringing the kid in, usually with a sense that he has been inconvenienced in the process. An added element commonly communicated in these situations is that he doesn’t think the appointment was necessary in the first place, and has only a rudimentary understanding (at best) of why the patient’s mother has foisted the duty on him.

It’s endlessly frustrating when patients are brought to appointments by people who have no idea what’s going on with them. By far the most consistent culprits are dads.

“I dunno. His mom says he’s sick” is a medical history of limited clinical value.

Under these circumstances, I have to rely entirely on my physical exam and trust I’ll detect anything abnormal. Then I put whatever plan in place as seems warranted, with the hope that the information makes its way back to the mother in halfway reliable form.

The other kind of clueless father I encounter on a semi-regular basis is the sheepish variety. They at least seem to acknowledge that it would be helpful if they knew something, and appear vaguely apologetic that they don’t. But shucks, they’re just dads! Knowing stuff about the kids is apparently the sort of thing that only moms are expected to do.

What can be doubly frustrating is when this species of father brings a child for a well visit—checks meant to help medical providers ensure that our patients are thriving across the board. We want to make sure development is going normally, that they’re eating healthy diets and learning to make new friends. We want to know how much time they spend watching TV and if they’ve seen a dentist yet and if the house is childproofed.

For patients with any kind of complexity to their care, dealing with a father who has little information can make my job as their primary care provider all the more difficult. Ideally, I can assure that everything that needs to be coordinated and overseen is going smoothly, and nothing is falling between the cracks. If subspecialists are involved, it’s important to know that follow-up appointments are being made and kept.

“I’m not sure. My wife usually handles those details” is a response I get far more often than I should. To be fair, I’ve certainly encountered my fair share of mothers who have lost track of some aspect of their children’s healthcare or another, and it bears repeating that most dads are on top of things. But insofar as the task of shepherding the children through the medical system has been assumed by only one parent, the clear majority of the time it is the mother.

Every family has to divide tasks and chores to get things done. Frankly, if most families’ division of labor makes medical management a maternal domain, who am I to say that there’s anything innately wrong with that? Though I am broadly in favor of parents viewing childrearing as an equally-shared responsibility, I would never go so far as to draw broad conclusions about a father’s involvement in raising his kids just because he’s bewildered during their doctor’s visits.

But if the dad the designated parent for said visits, at very least he needs to be thoroughly briefed prior to arrival. Adults at children’s medical appointments need to be more than warm bodies, and I can’t do my best for the patient without all the information I need. There isn’t a blood test I can order or a scan I can arrange that will take the place of solid answers about what’s going on from a good source. Anything less can result in suboptimal care.

Fathers should know what’s going on with their kids. Being involved means knowing about their health, and it’s not just the mom’s job to be a good grasp of the details. “I’m just the dad” is no excuse for cluelessness.