Choosing a GP for your family
Dr Andrew Leech, GP (FRACGP, MBBS, BSc, DCH)
We now live in a world where knowledge is everywhere, where many parenting or health questions can be answered within a few seconds online. Up to 40% of us use Google as our only source of health information.
It is not unusual for a parent to come in and open their consult saying ‘now you’re going to think I’m silly but’, as I wait in anticipation for the ‘silly problem’ they may have just researched on Google to find a really tricky, unusual diagnosis or treatment. My answer to that is ‘there is nothing I haven’t seen’! (Well this isn’t exactly true but it is a good line to help relax parents). Of course in reality there is nothing too silly either. GP’s love the ‘silly consults’ because they are often quick and easy and enable us to catch up. We all go through periods where we think ‘gosh, my child’s problem could be really serious’ or second guessing ourselves and our judgement. This is natural. We are surrounded by information from a wide range of sources including Mum’s and Dad’s Facebook chat groups.
Finding a GP can be a bit of a challenge. There’s the basics such as looking for one close by, finding a kids friendly clinic, considering fees, availability before and after school and the look and feel of the clinic. Simple things like do the receptionists give you a friendly smile? Is there space for breastfeeding?
There’s even more important aspects than this, and I have compiled a list of some things to consider below.
# 1 Find a kids friendly GP!
GP’s need to talk to your child (regardless of age). They may ask a few simple opening, welcoming questions to help them feel comfortable. No child really wants to be at the doctors, a quick survey of my paediatric patients revealed that most of them fear they are coming for an injection! Injection or not, the doctor has an important role in engaging your child. They are the patient after all. Some doctors are clever in the humour they use, or go one step further to include magic, toys, lollies, and phrases in their consultations such as ‘I saw some elephants in your ears today!’. Engagement occurs on many levels in a consultation. My simplest method of doing this is being at their height level especially when them.
Also, using kids friendly language, having an understanding of their world, what helps them tick (sports, computer games, friends) and what age appropriate language might help them to open up. Finding a GP who also has children may be of use. A GP’s background is often accessible on the medical clinic’s website.
# 2 Do they listen and understand you?
Little did I realise the importance of a good family GP until I actually became one. I always thought that my local family doctor would help me if I sprained my knee or give me antibiotics for a sore throat. I now know this is far from what is reality. GP’s are equipped and trained to deal with a wide range of problems related to family health. It is important to know that they expect to hear from you when you are struggling, that there is no passing of judgment (in fact I usually have forgotten the situation by the time I’ve moved onto the next patient), and that they provide a confidential space for you to discuss things over.
Who would’ve thought a GP would provide parenting support? Well I now know they do! In fact, baby sleep and settling advice has become my forte!
Finding a GP who will listen and take things seriously is a key to forming what could become a long lasting therapeutic relationship. Equally important is finding someone who understands where you are coming from and who can offer up to date, evidence backed advice and treatment.
# 3 Knowledge of childhood problems
An average week for me might include a range of the following areas:
Preventative health – as important as treatment is I prefer the idea of prevention. Is there any way we can intervene earlier to prevent a nasty illness or a developmental problem for example. What role does diet or exercise have in a child’s health? Typically with kids health a GP will consider immunisations and monitoring of growth parameters and development.
Acute illnesses – All the snotty noses, coughs and colds, tummy bugs and ear aches. Also injuries at sport or school. Even worms! When your child is not feeling right, and you are concerned, the GP is your go to support person for advice.
Chronic (more persistent or prolonged) illnesses – Conditions like eczema, asthma and allergies, mental illness such as anxiety, OCD, depression, developmental delays including cerebral palsy and autism, epilepsy, gut disorders like coeliac disease, joint syndromes, the list goes on.
I believe one of your most important allies when managing a child with a chronic condition is going to be your GP. They need to be part of your journey, to navigate between allied health professionals such as physiotherapists and specialists. We ensure everything has been checked and everyone is talking to each other. The best approach to a lot of these is a team approach in order to achieve the best outcomes. Most importantly, does your GP understand your child’s condition? Now it is impossible for us to know everything in detail. We usually have a fairly good idea of where to look things up or who to call about it. If you are finding your GP just isn’t ‘clicking’ with an understanding on what to do next or managing your child then it might be good to find someone who does.
# 4 Being thorough and reassured
When I see children presenting with a problem, I now realise that there are multiple factors playing a part in that problem. For example, a child who comes in with separation anxiety is more often than not anxious secondary to a wide range of influences. This includes their genetic makeup, but also their family setup, their school situation and peer relationships, their overall perception of themselves. It is far more complex and important than just a child who does not want to go to school. GP’s are good at approaching anxiety from these angles and considering ‘the whole person”.
The one key benefit of establishing a long lasting relationship with your GP is that they can get to know you and your children. This is so useful when assessing children and following their development. This also enables a quicker response to problems as we know when these areas are skewing off track. A weight problem in a baby is often due to difficulties with breastfeeding. But it can go undetected. Regular review of weights at the GP during immunisations enables this to be treated earlier.
On learning more about our paediatric patients over time, we can often get a feeling about when things are not right. When they are stressed or anxious. GP’s can read body language and observe for changes right from the moment the child enters the waiting room. I often get a sense when a child is being bullied at school for example because of their minimal responses and avoidant eye contact when we discuss peer relationships.
Your GP often needs to be thinking broadly before narrowing down the most likely. This often leads to reassurance in many consultations. I would expect your GP will examine your child for almost everything. It could include a weight check or even a blood pressure check, but also physical examinations such as abdominal check, chest review, ear nose and throat review depending on the problem. This is ingrained in us during our early stages of training. If there is any doubt, it is worth a follow up or review and this can be arranged through the reception. For the more tricky cases it might also involve blood tests, XRAY or ultrasound or a trip to the local hospital for further workup. My point here is if in doubt, follow up. If still in doubt, get a second opinion or go to hospital.
# 5 Trust your GP!
Trust that your GP knows their stuff and will look after you. They might not have all the answers but they should know where to find them and when to ask for help.
GP’s have a lot of competition online these days. They may not be as up to date as Dr Google but they offer a very unique perspective – being able to assess your child face to face, be considerate of their world and to put the pieces of the puzzle together unlike any computer can. So as much as it can be comforting to see on Google that fevers are usually viral infections and 95% of kids rash’s are harmless, if in doubt, trust your instinct, and get an opinion to gain this objective approach.
Does your GP involve you in the decision making? This can further help you feel reassured because together you are deciding what is best for your child. Keep in mind that you know your child better than anyone!
Your family health and wellbeing is one of the most important aspects of life. This is why investing time to find a local GP who you are happy to turn to in times of need is worth the energy. As a GP, the service provided to you and the unique perspective on your families life is a great privilege.