Health Care

The Pediatrician’s Most Awkward Task

June 24, 2019  • Sarah Zhang

This article originally appeared on The Atlantic. 

When Carrie Quinn was training to be a pediatrician, she dutifully memorized the list of symptoms for meningitis. She learned the right antibiotics for pneumonia. But when she got into the clinic, she found herself unprepared for what actually concerned parents.

“What I was actually faced with wasn’t seriously sick children,” Quinn, who’s now the executive director of the Mount Sinai Parenting Center, said on a panel at Aspen Ideas: Health, which is co-hosted by the Aspen Institute and The Atlantic. More often, it was parents anxious over what to do about their kids’ behavior issues or language delays.

Ben Danielson, another panelist and the medical director of the Odessa Brown Children’s Clinic in Seattle, jumped in: “You made the joke the other day that, so often, a [doctor] who finishes pediatric residency would way rather intubate a baby than talk about breastfeeding.” Talking about how to parent might be one of hardest parts of being a pediatrician.

And yet, what parents do in the privacy of their own homes has an enormous impact on their babies’ health, especially when it comes to the developing brain. Research has tallied the benefits of talking directly and repeatedly to babies. The idea has gotten so popular that even playgrounds have put up panels encouraging caregivers to talk to kids.

Pediatricians like Quinn are getting involved, too. The Mount Sinai Parenting Center created a free online curriculum for residents—who are trainees recently graduated from medical school—to learn how to integrate lessons for parents about brain development into routine pediatric exams.

In a video Quinn played as an example, a doctor models a rich, interactive conversation with a baby during her exam. “This is my stethoscope. It helps me hear. I’m going to put it on your chest now!” the doctor says in a sing-song voice. “I’m going to tell you everything that I’m doing, not just so mommy knows. So that you can learn about the world, too.” (The sing-song voice people often used with babies isn’t just about being cutesy. There’s evidence babies actually prefer it because it may help them learn to talk.) The curriculum was piloted at eight residency programs last July.

A traditional checkup, in contrast, is much less involved. “You have 15 minutes. They might be totally dominated by the doctor running through checklist, asking how many times your baby’s peeing and how many words do they say, uh huh, uh huh, uh huh—now it’s time for the vaccines,” says Danielson. He believes in slowing down the pediatrician visit, so there is time to build a real foundation of trust with patients.

For pediatricians to have an impact in the home, he argued, they need to be actually interested in what’s going on in the home.

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