Visiting the Doctor
When children anticipate “going to the doctor,” many become worried and apprehensive about the visit. Whether they are going to see their primary care doctor or a specialist – and whether for a routine exam, illness, or special problem – children are likely to have fears, and some may even feel guilty.
Some fears and guilty feelings surface easily, so that children can talk about them. Others are harbored secretly and remain unspoken. In preparation for a physician’s examination, you can help your child express these fears and overcome them.
Most Common Fears About Medical Exams
Children often fear that their parents may leave them in the examining room and wait in another room. The fear of separation from the parent during mysterious examinations is most common in children under age seven, but it may be frightening to older children through ages 12 or 13.
Children may worry that a part of the examination or a medical procedure will hurt. They especially fear they may need an injection, particularly ages 6 through 12.
Unfortunately, one of a child’s concerns may be the doctor’s manner. A child may misinterpret qualities such as speed, efficiency, or a detached attitude, and read into them sternness, dislike, or rejection.
Apprehensive about the unknown, children also worry that their problem may be much worse than their parent is telling them. Some who have simple problems suspect they may need surgery or hospitalization; some who are ill worry they may die.
As a parent you can help by encouraging your child to express his fears and by addressing them in language that he understands and is not likely to misinterpret.
Do Children Feel Guilty About Their Illnesses?
Children often harbor guilt feelings: they may believe that their illness or condition is punishment for something they have done or neglected to do. Illustrating this point, child psychiatrist Dr. John E. Meeks has described a study of children with orthopedic handicaps. The children were asked what they thought had caused their disabilities. Although all of the children were born with their handicaps, most responded that disobeying some of their parents’ rules was the cause.
Children who feel guilty may also believe that examinations and medical procedures are part of their punishment.
What Can I Do to Help?
Explain the purpose of the visit. If the upcoming visit is for a periodic health assessment, explain that it is a “well-child visit,” in which “the doctor checks on how you are growing and developing. The doctor asks questions and examines you to make sure that your body is healthy, and you will get a chance to ask any questions you want to about your body and your health.” Stress that all healthy children go to the doctor for such visits.
If the visit is to diagnose and treat an illness or other condition, explain in very nonthreatening language that the doctor “needs to examine you in order to find out how to fix this and help you get well.”
Address any guilty feelings your child may have. If your child is going to the doctor because of an illness or other condition, he may have unspoken guilty feelings about it. Discuss the illness or condition in neutral language, and reassure him that it is not his fault: “This is not cause by anything you did or forgot to do; illnesses like this happen to many children”; and “aren’t we lucky to have doctors who can find the causes and know how to help us get well?”
If you, your spouse, other relatives, or friends had (or have) the same condition, share this information. Knowing that you and many others have been through it will help relieve your child.
If your child needs a doctor’s attention because of a condition that resulted in ridicule or rejection by other children (or even by adults), you need to double your efforts to relieve shame and blame. Head lice, embarrassing scratching caused by pinworm, and involuntary daytime wetting are examples of conditions that are often misunderstood by others. Even if you have been very supportive, you need to reassure your child again, before the visit to the doctor, that the condition is not his fault and that many children have had it.
Of course, if your child has suffered and injury after disregarding safety rules, you need to point out (as matter-of-factly as possible) the cause-and-effect relationship between the action and the injury. However, you should still try to relieve guilt. You could say, “You probably did not understand the danger in doing that, but I am sure you understand now, and I know you will not do it that way again.”
If your child repeatedly disobeys rules and becomes injured, speak to your doctor. This sort of worrisome behavior pattern needs a closer look. In any of these cases, be sure to explain, especially to young children, that going to the doctor for an examination is not a punishment. Be sure your child understands that adults go to doctors just as all children do, and that the doctor’s job is to help you stay healthy and fix any problems.
If the examination is a routine one, you can use a doll or teddy bear to show your young child how the nurse will measure height and weight. Show how the doctor will look in his mouth (and will need to hold his tongue down with a special stick for just a few seconds to see his throat), look at his eyes and into his ears, and listen to his chest and back with a stethoscope.
Explain that the doctor may tap or press on his tummy to listen to or feel what’s inside, may look quickly to see that the “private areas” are healthy, may tap on his knee and look at his feet.
Let your child know that what you have taught him about the privacy of his body is still true, but that doctors and nurses, and parents must sometimes examine all parts of the body. These people are the only exceptions.
If your child is going to the doctor because of an illness or medical condition, or is going to visit a specialist, you yourself may not know what to expect during the examination.
Involve your child in the process
Gathering information for the doctor
If the situation is not an emergency, allow your child to contribute to a list of symptoms that you create for the doctor. Include all symptoms you have observed, no matter how unrelated they may seem to the problem at hand. Also, before the visit, prepare a history (in the form of a list) of your child’s previous illnesses and medical conditions, and a history of illnesses and medical conditions among close members of the family (parents, siblings, grandparents, aunts, and uncles).
Writing down questions
Ask your child to think of questions that he would like to ask the doctor. Write them down and give them to the doctor, or, if your child is old enough, let him write them down and ask the questions himself.
If the problem has occurred before, list the things that have worked and the things that haven’t worked in previous treatment. Your child will be reassured by your active role in his medical care and will learn from your example. At the same time, you will be prepared to give the doctor information vital to an informed diagnosis. Doctors report that this information is very helpful in determining diagnoses.