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    Improve your practice: Patient visits

    In this consumer-driven age, pediatricians must provide good medical care during office visits while creating a pleasant experience for children and parents.

     

    A bit of magic

    If you are not rushed, patients appreciate some quality time with their pediatrician. You can tell jokes, play with puppets, engage in a game of tic-tac-toe, or show them a magic trick. I find my teenaged patients almost always have headsets attached to their smartphones that they listen to while texting. It just takes a moment to ask about their music preference and perhaps have a listen to gain their confidence before asking them medicine-related questions.

    Immunizations and pain reduction

    As you know, many patients are needle phobic. Some parents are needle phobic as well, so it is not a bad idea to have nurses given simultaneous injections to young infants if you have the staff to accomplish this. For the older child, consider using the Buzzy system or DistrACTION Cards for shots from buzzyhelps.com or the Bionix ShotBlocker (bionix.com), or hand them a Fidget Cube (fidgetcubeshop.co) to play with during injections.

    Some patients insist on the application of EMLA cream (lidocaine/prilocaine) at home so their immunizations are pain free. Until needle-free injection systems are in widespread use, do whatever is necessary to reduce your patient’s discomfort. Children also quickly forget their injections if you cover the evidence with a colorful adhesive bandage. As these are very inexpensive, send 1 or 2 home for the child to use when the ones you apply fall off.

    The best part

    When patients are checking out, you have your last opportunity to keep your patients happy, or if they are tearful, to brighten their day. Traditionally, pediatric practices give parting tokens of appreciation to the child (their parent gets the bill, of course). Some older pediatricians, myself included, use to hand out lollypops but no longer do so because these are not “politically correct” and conflict with today’s messages about making good food choices. The most popular and cost-effective handouts are stickers that you can display on the checkout window and allow children to choose their favorite. Virtually every pediatrician is familiar with smilemakers.com and medibadge.com where you can get stickers galore. Medibadge.com also has cool sticker-based games.

    Next: Use medical websites to improve your practice

    I have also given out toothbrushes (politically correct), or even plastic toys that do not have small plastic parts and are of sufficient size that they can’t be swallowed or placed in body orifices (very embarrassing). My patients’ favorite items in the past have been small containers of bubbles with wands (popular among girls) and plastic cars (top boys’ item). Older kids often choose pencils topped with colorful erasers. All these latter items can be had from orientaltrading.com.

    Parting thoughts

    The reason most of us became pediatricians is that we get to care for a very special kind of patient. We help parents raise their offspring in health and in illness and play an invaluable role in their upbringing. Although pediatrics is not the most lucrative of medical specialties, it has its own unique rewards. By making every effort to provide quality care, and being kind and considerate to parents and children, we can end every day assured that we did a great job!


    Andrew J Schuman, MD, FAAP
    Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, ...

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      How do you deal with parents who threaten the misbehaving patient with a shot by the doctor, while in your presence???

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