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Pediatricians around the world!

We just recently took all three kids, ages four and under, to our pediatrician here in the United States. It’s difficult to even describe the level of chaos generated by managing, bribing and comforting three tiny humans at a doctor’s office. Oh, my. And yet, I couldn’t help but notice how well organized these practices seem to be. It’s like they saw us coming!?

The kids happily played with toys in the bright, carpeted waiting area designated for non sick children, while parents frantically filled out pages and pages of forms.

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We’re asked about insurance information, health history and things we may have noticed about our children’s development. Little samples of creams and coupons fill baskets at the front desk, next to a large hand sanitizer.

On that day, friendly nurses welcomed the kids by name and invited them into a second area to take vitals. It was like a factory line of weighing and measuring before focusing on each child in the private room. We were invited to take seat in one of the 10 or so consultation rooms and wait for the doctor, who isn’t ever the one to give vaccines or measure head circumferences. We know we like our pediatrician because we have interviewed her and chose her based on her expertise and online biography.

Dr. Liz entered the room with her laptop and a gift for each kid: age-appropriate bilingual Spanish-English books to promote early literacy. She interacted with the kids and asked us questions about their development. At the end of the visit, kids got to pick out a sticker and my treat was a 10 page paper for each kid, comparing their weight and height and head sizes with averages of kids their age. These mini booklets contain basic parenting tips, nutrition and development advice, warnings about marijuana consumption near baby, a hotline in case you might want to shake your infuriating toddler and what to look out for in the next few months. What we really look out for in the next months though, is the bill. Without Obamacare, not sure we’d be taking healthy kids to be seen!

Our visit made me so curious about what it must be like to take kids to the doctor around the world. So, here are some fantastic insights from some friends and bloggers on what it looks like in their countries.

It goes without saying that bedside manners and procedures will vary from practice to practice. Getting seen in the city will obviously look different to life in a more rural setting. In fact, in our city, we have seen anything from pediatricians serenading kids with their guitar and essential oils, to your standard khaki clad frumpy doc pushing pharmaceuticals for gut relief.

I hope you enjoy the journey as much as I did!

 

Brazil

“We go to our pediatrician every 2 months or so. He has his own small private practice in a tower block just outside the city centre. There is a small waiting room with chairs for 5 people. We always try to get the first appointment after lunch so there is no wait. There are very few toys, just a few building blocks and a few tatty comics and magazines. There is a small bathroom with a place for nappy changing. The doctor’s room is quite spacious and he has more toys inside. Everything is done by the doctor. The secretary is the doctor’s wife. We’ve been going since before my son was born and we all get long very well. There is a nice, friendly atmosphere. He has paid as much attention to us, the parents, as he has to our son from the start. My son now calls him ‘tio, Marcelo’ or ‘uncle Marcelo’. The only people I have ever met here who even question vaccines are Americans and one Kiwi. Brazilians don’t think twice about it. If the doctor says take this medicine, they take it. If the doctor doesn’t say anything about taking some medicine, they’ll probably take it just in case.” – Stephen of Head of the Heard

 

China

“Our visits are always in a hospital, not at a doctor’s office. The wait time is always long except when it is your turn. No weight or height or temp or blood pressure measurement. The doctor sees you and goes right to business. We are given vaccines, always on the arm not on the legs. Normally we get medicine or IVs right away, instead of getting meds by prescription from a pharmacy. The pharmacy is in the same building as hospital. When I was little, my mother tended to request CTM (Chinese traditional medicine) instead of Western medication as it was more natural and had fewer side effects. Dr tried to push Western meds. I heard they can get some kick backs at that time.” – Helen

 

Ecuador

“Growing up, I went to a family doctor at a local hospital, maybe every two years for a physical. We would get vaccines at big public health drives. At the doctor’s, we’d sit in a hot waiting room with everyone hacking. Then weight and vitals are taken in front of everyone. Doctor sees you in a private room. But you saw whoever was available so not much of a rapport was built. Doctor is God. Healthcare isn’t very proactive in Ecuador, since it is still the developing world. More people tend to go when they are sick rather than healthy. Only wealthier families can afford well visits. One funny thing is that every time we went, we had to drop off a stool sample to treat whatever worm or parasite you had. This is standard practice since most everyone had something. I grew up in the bush! Saw more snake bites than broken arms. Looking back now at how I take my own kids to the pediatrician, it seems so surreal. No mamas in Ecuador are calling a pediatrician over a rash, that’s for sure!” – Eileen

 

France

“One of the funniest and yet stressful times was the monthly visit to the pediatrician ( yes, we used to have visits every month!). We had a wonderful pediatrician in France that was the same one at the hospital when I gave birth. But, he was always on the go, and unlike the US, France doesn’t have the check-in/check-out part before you meet with the doctor. So we had to do pretty much everything at the same time: paperwork, remove clothes, answer the doc’s questions, dress kids, wipe tears and pay (I learned later on to have everything on hand and ready before going , like writing the check before leaving the house). It was a real marathon and you can be sure we were both tired after each visit – let alone when I was going all by myself!
I remember my daughter’s expression when she would see the doctor at his office. She knew he was the one giving shots. She would almost try to run off because of that and it did strain the rapport between doctor and child. Also, no separate waiting area exists for sick and healthy kids.” – Hélène

 

Germany

“Here, in Germany, children are seen by a pediatrician on a regular basis. The waiting rooms are amazingly child-friendly, full of toys and bright and colorful. Our pediatrician also has toys and books in the consultation rooms. Regular check-ups are carried out by nurses and doctors (nurses do the cognitive/developmental part). My kids love going there because of the toys and the pretzel they get at the end of each visit. Schools check that kids have been vaccinated before entering school at 6.” – Annabelle from The Piri Piri Lexicon


Ghana

“Once-a-month visits are handled by community health nurses, where the child is weighed and given any necessary age-appropriate vaccine. Where none are needed, weighing alone is done. It’s a bit funny seeing the bewildered kid dangling from the scale in his pouch as his weight is recorded. It’s not at all surprising to see one mother comforting her just-injected child, while another child is receiving Vitamin A drops all within earshot.

The good thing is that most schools require these weighing and vaccination records before admission. A book also contains tips on childcare: simple enough for the barely educated to understand, and comprehensive enough for more middle-class mothers.
Nurses also offer advice on feeding. It’s easy to build a rapport with them, especially if mother and child visit the same health facility on each occasion.

Normally, doctor visits aren’t scheduled unless it’s something more serious. GPs handle most cases, though pediatric care is also readily available. While some mothers have particular doctors they go to, some just wing it with whichever doctor is available.” – Kwaku from The Daily Commute

 

Jordan

“Pediatricians in Jordan are friendly and facilities are clean and modern. Most do not go to pediatricians though, because of cost, and if they are sick, would rather show up at government clinics. Government clinics are not clean and modern. Antibiotics are prescribed immediately for many symptoms. Visits are paid in cash, no insurance. Prices are reasonable, pharmaceuticals also reasonable, but the poor still visit government clinics. Polio still occurs in villages without immunizations, it is even more prevalent in Syria. I remember getting a polio vaccine by my landlord (who was a doctor) in his home when there was a polio outbreak. He brought home a bunch of doses for the neighborhood!” – Elisa

 

Nigeria

“I was pregnant with my third daughter when I was living in Lagos, Nigeria. We paid privately to have a foreign-educated doctor/ obstetrician to be my doctor while I was pregnant. The experience was positive but I did get the feeling they were much more relaxed about the hygiene side of things (and this post-ebola crisis). While having my blood tested, the lab technician seemed to be more interested in the fact that I was a foreigner living in Nigeria and married to one of his countrymen that he didn’t seem to be paying attention to what he was doing. He put on the glove to take my blood and handle the needle only to pick up his mobile phone when it rang. He even tried to continue put the needle in. It was so absurd it was almost comical.” – Fariba from Mixed up Mama

 

Slovenia

“There are almost no private practice pediatricians, so you need to wait in line for someone you like or settle with someone else. It helps if you know someone that can help jump ahead the wait list. Connections are everything in our country! Everything is payed for by our national health insurance that you pay for with your taxes.

After mama gives birth she’s assigned a baby nurse (similar to a postpartum doula but this nurse is a certified nurse that works at your hospital or doctors office). She’s comes in weekly for six weeks to check on mom, baby and breastfeeding. After that you start seeing your chosen pedi. All siblings born after your firstborn go automatically to the same pedi. Fewer vaccines are obligatory than in the US but no exemptions are available for the mandatory ones.

An interesting thing is that babies with improper posture get referred free of charge to a specialized developmental clinic where they teach parents proper baby handling to support better posture.

In Slovenia, both parents get 15 sick days paid by the country for every child they have. In order to use it you need to call your pedi and let them know you child is ill and they will give a note that you bring to your employer’s HR manager.” – Tamara / Zenja

 

Taiwan

“Since all children are covered under the National Health System, vaccinations are scheduled and parents are charged a minimal fee, whether they go to a local clinic (they are ubiquitous in Taiwan) or a larger hospital.  Take my son’s case, he still goes to the same hospital to get his check ups and shots where he was born. You can choose to stick with the same pediatrician by scheduling during their appointment hours, but it is not mandatory.  They have about six on staff.

I think in terms of patient-doctor (child/parent-ped) relationship, it is very doctor-specific in Taiwan. From what I have observed, most parents treat clinics/hospitals as places to get subscription medicine for colds or checkups for other more serious illnesses and less as a place to get questions on child-raising. Unless there is a specific clinic that you have a personal relationship with. I don’t see regular personal relationships with parents and pediatricians.  But of course there are the exceptions as well, especially in other cities where less options for pediatric clinics are available, there is more of a personal touch.” – Jenny

 

Uganda

“In Uganda, I never took my kids to milestone checkups (like the 18 month visit, etc.) and that’s been a challenging transition for me now here in America. I actually laughed out loud when the pediatrician asked me if I wanted to have my daughter see a physical therapist when she wasn’t walking by her year check up (which didn’t happen until she was 14 months). Because in Uganda, there was zero emphasis on comparing kids to “normal standards.”

Ugandan offices, even the most “high end,” are stark. Ugandan children are used to sitting and waiting (waiting is a huge part of their lives!!!) without being entertained. And there are no stickers or treats after seeing a doctor in Uganda! There are very few pediatricians. In fact, we never saw a pediatrician! We would ask around for “good doctors,” and that’s where we would go.

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The doctors we saw were all friendly and knowledgeable–the care we received was wonderful. Except that Ugandan doctors/nurses (because most of the time you just see nurses) give out antibiotics for everything, even viral infections.  Nurses in Uganda can be very rough, rude and demeaning. Bedside manner isn’t considered when selecting a doctor in Uganda.” – Courtney from Carryingwonder Photography

 

United Kingdom

“In the UK, there are no pediatricians in private practices. People go to see a generalist when kids are sick. Regular developmental check-ups are carried out by a health visitor (NOT a doctor or a nurse). And that really got to me. I knew a lot more than mine did on many topics!! This person usually comes to your house for the first few months. Immunisation is done at the generalist’s practice. No toys, no special rooms. Depressing in my opinion.” – Annabelle from The Piri Piri Lexicon

 

 

Featured image and Uganda image courtesy of Carryingwonder Photography
Germany photo courtesy of Annabelle of The Piri-Piri Lexicon

4 thoughts on “Pediatricians around the world!

  1. Very interesting subject, and before I read the whole article, I’d like to comment in the humblest way. Ten years ago, as I was living in the States, I thought the Americans were very organized in this area. Needdless to say they were very kind and patient with me when I showed up to the doctor appointment, the blood test, the x-ray and the ultrasound. And the hand sanitizer was available too. ? Even though I love that country so much and love that they provide services which can help children to get ready for the situation (toys, for example), I believe french doctors are doing a great job maintaining a proximity with their patient. For old people for instance the doctor is like an old friend to talk to, probably the only person they’ll talk to and specially when they live in a secluded area. And that’s probably why the doctors are always late for their next appointment, right? Also, seeing your doctor in a specific location where there’s only one or a couple of doctors or specialists doesn’t make you feel like you’re going to a factory. On the contrary, it’s a nice, cozy place where you’ll be listened to and where they’ll take the time to do it properly (maybe too much?). Of course, it’s not true ewerywhere in France but this is something that surprised me right away in the States. Makes sense? ?

    1. Lots of great insight here. I like your comment and appreciate your approach not to just make blanket statements based on your experience but to see good in each. I hope you get the chance to read the whole article and see that my aim isn’t to say which system around the world is better than the rest. This light-hearted article should be read like a grouping of testimonials containing variations on each place. I often edited out the comparisons so they wouldn’t be a stumbling block to readers, who rightly so, have their own opinions. If I wanted to compare hard facts, I would have asked each person questions to be able to compare apples to apples. Rather, it should make you smile because often, each country’s values come through even in these stories. Shhh…that’s my favorite part! You’re right, it’s a well oiled, painless BUSINESS in the US (not talking about the healthcare mess!) aimed at excelling in CUSTOMER SERVICE..and you’re right, the French value fostering RELATIONSHIPS, taking the TIME that is needed and we have always received outstanding care there. 🙂 PS: For our purposes, the article focuses on taking kids to doctors, not on the elderly, who absolutely benefit from the humanity of doctors who take the time to listen. You’re totally right on.

  2. This post is amazingly engaging and thought-provoking. There are numerous pediatricians and doctors worldwide who work very hard to have an amicable and personal relationship with the patients they care for. I think, although, our healthcare system in America brings in a variety of opinions, many doctors (Dr. Liz! Me!) desire a close relationship with that one on one connection. We want to provide good care and establish trust.

    We can learn so much from world culture. And the world can learn from us. Thank you for posting this wonderful array of family experiences!

    1. I think that you go into these caring professions because you love to help people and ultimately see them well and thriving. The latest (interestingly enough American) research for community births shows that developing a strong patient-midwife rapport drastically reduces chances of hospital transfers and other complications just because of the relationship of trust established. The research doesn’t stem from pediatrics, but there’s still plenty to learn bilaterally. Our own experience is that of excellent client-care provider relationships across the board, with a huge exception for dentistry for some reason :-).
      Thanks for stopping by, Lisa, and for being willing to read a non medical article on pediatrics in different part of the globe. 🙂

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