To Whom It May Concern

So here you are, about to give birth to a little human and suddenly you realize…

I need to pick a pediatrician!

You do a quick scroll through Google, find a doctor within reasonable driving distance, check a couple reviews and then make a phone call. You set up a meet and greet, take a tour of the clinic and scan the rooms with your mommy vision.

It’s so clean in here! Must be a nice place.

Everyone is smiling and friendly, and commenting on how adorable your big belly is. The receptionist gets your info, hands you a stack full of pamphlets and you glide out the doorway feeling assured and excited.

We have a pediatrician. All set!

This is exactly how I chose my firstborn’s pediatric clinic and I’m sure it’s pretty similar to how you chose yours. Some of you may have done a little more research on medical backgrounds or called your friends to get recommendations for the best of the best. But the reality is, we really have no idea what we just signed up for. We are going in blind. And do recommendations really matter anyway? One person may have a great experience with a physician and another person may have a miserable experience with that same physician. Everyone is different and every patient has different needs.

Case in point… we had no issues with the pediatricians who cared for our oldest son Mason. They were by the book as far as well-child exams go and they got us in whenever we needed. We floated around from one physician to the next (about 5 of them) and it was great because we were getting to know everyone. And my favorite part was that when we called the office to make an appointment, a nurse ALWAYS answered the phone. This is almost unheard of. It was an awesome place to go for Mason who didn’t have any serious medical issues. But for my second son Carter, who was eventually diagnosed with Eosinophilic Esophagitis and food allergies, not so much.

Here’s why we had to let them go:

They band-aided his symptoms.

Carter suffered from reflux-like symptoms basically from birth. The pediatricians treated it with medications and diet changes. But as his symptoms persisted for months and months, all they did was prescribe more medications and recommend new diet changes. Not ONE of them stopped to question why this line of treatment wasn’t working or sought to find out the cause.

They refused to refer us out.

I asked our pediatricians for a referral to see an allergist twice. Both times we were denied. There are two reasons I can think of why a doctor would not give a child with blatant health issues a referral to see a specialist: either his ego was so huge that he refused to believe his diagnosis was wrong OR he saw dollar signs. I assume it was probably a little of both.

They listened, but they didn’t hear me.

I kept describing to the pediatricians the difficulty Carter had when he was eating and they would all look at me like I was nuts. Here was this chunky, happy baby in the 85% percentile for weight. How could he possibly have eating issues? Then when he started screaming at night, they kept telling me it was “behavioral”. At one point I sobbed my eyes out in the exam room and told the doctor I knew in my heart that something was wrong with him. She told me to try sleep training. She didn’t hear me. None of them did.

They missed all the red flags.

For most of Carter’s first year of life, we were in and out of the doctor’s office on a regular basis and we were seen by every doctor in the practice. With each new physician I had to repeat his life story over and over again, trying to remember every detail (which was a lot). They just weren’t familiar with us or his history. Because of this, none of them comprehended the severity of Carter’s symptoms. Had we been treated by one physician, I believe someone would have noticed that the reflux medications hadn’t been working for months, that maybe we were dealing with something greater than a little heartburn. They also would have noticed the crazy number of ear infections Carter had and would have (I hope) referred us to an ENT. But they didn’t. They missed it all.

So what’s the best way to let your pediatrician go?

Well, that depends on how mad you are.

If your experience was anything like ours, your initial reaction may be to bust through the doors, arms flailing and telling all of them to go to you know where. But that won’t get you anywhere; it will only solidify any assumptions they already have about you being a crazy person. You’re better off staying calm and getting your point across.

After Carter’s diagnosis, I was furious. To the point that I couldn’t even be in the same room with these people for fear that I might strangle one of them. I was also so overwhelmed with hurt and emotion there was no way I would make it through a sentence without turning into a blubbering mess. And I needed these doctors to hear me this time. So instead of trying to have an in-person discussion, I decided to write them a letter and sent it in the mail. I suppose an e-mail would have sufficed, but there’s just something about signing a letter by hand and sealing the envelope that says “I mean business.”

Here’s what it said:

To Whom It May Concern,

I would like to begin this letter by expressing my gratitude to the entire staff of [clinic]. Since 2012, your physicians, nurses and receptionists have exemplified professionalism and courteousness, and have exceed my expectations in availability. The care you have provided to both of my children for their basic medical needs has been wonderful. And so for that I thank you.

I am writing, however, to address an issue regarding my youngest son, Carter, who has been a patient at your office since his birth in November of 2014. For over a year he has been suffering from various medical conditions including eating issues, recurring ear infections and the like, so much so that he has been seen at your office 15 times in addition to his well-child exams. He has also been seen at [urgent care] on a few occasions. Having been treated by all 5 of your physicians at one point or another, I believe it has been difficult for your team to truly grasp the complexity of Carter’s medical issues.

At 3 months old, Carter began having difficulty with feedings and was screaming during and after his bottles. Over a 2-month period he was treated with medication for acid reflux. When his symptoms worsened at 5 months, he was diagnosed with lactose intolerance and began a soy formula diet. It seemed to resolve the issue until 7 months when Carter began gagging and vomiting with solid foods. By 10 months Carter was refusing food and started feeding therapy at [hospital] where they determined he had severe food and oral aversion. Fortunately, this was resolved after a few weeks of therapy.

At 1 year we were told to introduce cow’s milk to Carter, hoping he had outgrown the lactose intolerance. This resulted in diarrhea, irritability and a trip to [urgent care]. The physician who treated him there believed he was having an allergic reaction to the cow’s milk (causing otitis media) and recommended having him tested at an allergist. At a followup appointment in your office I was told for the second time that because Carter did not have common symptoms of a dairy allergy (rash, vomiting, etc.), allergy testing was not necessary and I was not given a referral I requested. 

From the beginning of December until recently, Carter was waking in the night screaming inconsolably (up to 11 times per night). During this time he suffered from colds, otitis media, sinus infections, gastroenteritis, croup and teething pain, all of which I am aware can cause night wakings. However, in between illnesses the night waking continued and I was told on two occasions it was most likely behavioral. At Carter’s last appointment (15-month well-child exam), I strongly urged that something else was going on but it was recommended that we try sleep training. After a full week of sleep training with very little improvement, I began reviewing Carter’s lifelong symptoms and did my own research. What I found led me to believe that Carter may be suffering from a food allergy with less-common symptoms. Having new insurance that did not require referrals, we decided to take him to [allergist] where I have been a patient for 7 years.

We discussed Carter’s symptoms in detail and [allergist] quickly came to a conclusion: difficulty with feedings, painful burps / acid reflux, irritability and night waking can all be symptoms of food allergy. More specifically, [allergist] believes that Carter has been suffering from Eosinophilic Esophagitis. He also believes that Carter’s recurrent otitis media may be related. With skin testing it was confirmed that Carter does in fact have an allergy to dairy.

I hope that after reviewing all of this information you can understand my frustration. It’s possible that Carter has never had lactose intolerance or acid reflux, and the culprit may have been food allergies all along. Our child has been dealing with discomfort for most of his life, and has been screaming in pain for the last few months, all of which may have been avoided had we done allergy testing on the two occasions I requested it. I am also confused as to why our inability to discontinue Carter’s Prilosec medication has not raised any red flags. Furthermore, I cannot comprehend why we have never been referred to an ENT given that Carter has had 6 cases of otitis media in a 9-month time period, which I reminded you of several times.

I feel as though I have repeatedly expressed my concerns in these words I have said countless times: there is something wrong with my child. Overall my concerns have been disregarded and not taken seriously. It is for this reason that we will no longer be requiring your services and have decided to seek medical care elsewhere for both of our children. We will be in contact with you soon to begin the transfer of medical records.

Best regards,

Brianne Geetings

I was taught that when you receive poor service at a restaurant, you shouldn’t forgo leaving a tip; rather, leave a small one. Make a statement and just maybe it will help to prevent someone else from receiving the same terrible service. This was exactly my intent behind this letter: I laid out the facts, pointed out their mistakes and let them know it was unacceptable. And it worked. A few days later I received a phone call from a very apologetic office manager, begging us to stay with their practice (most likely to keep us from sharing our terrible experiences with the world). But it was too late; the damage was already done and we had moved on.

So I guess the moral of the story is… follow your heart. There is nothing more important than the health of your little one and if your pediatricians aren’t doing what they are supposed to (no matter how friendly or available they may be), it’s time to let them go. Speak up. Let your voice be heard. And maybe what you say will stay with them a while.

 

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