Keeping PACE: Communicating with Your Child's Doctor

Keeping PACE: Communicating with Your Child’s Doctor University of Kentucky Department of Communication

Dear Parent: This booklet was written as a guide to help parents communicate

with their child’s doctor. We wrote it with common childhood illnesses in mind, like colds, flu, and ear infections. The examples we give

here are related to these illnesses. The booklet on antibiotics is a companion to this booklet.

Although we hope your child never becomes ill with anything more serious than a cold, the principles of the PACE system can be

applied to any medical visit. Remember, as a parent you have the right and responsibility to communicate with your child’s doctor.

For more information about antibiotics, visit this website:

https://www.cdc.gov/antibiotic-use/community/for-patients/index.html Funding to develop and evaluate the effectiveness of PACE for

Parents and Pediatricians was provided by the Centers for Disease Control and Prevention (CDC; Directed Source 02054): Harrington NG, Norling GR, Witte F, Taylor JA, Andrews J. The effects of communication skills training on pediatricians’ and parents’

communication during “sick child” visits. Health Communication 2007;21:105-114.

The University of Kentucky Department of Communication is grateful for the assistance of Dr. Don Cegala of The Ohio State University

and is indebted to his research, upon which this publication is based.

The content in this booklet is solely the responsibility of the authors and does not necessarily represent the official views of the CDC or the University of Kentucky.

Keeping PACE: Communicating with Your Child’s Doctor University of Kentucky Department of Communication

Communicating with Your Child’s Doctor As parents, we know that when our children are sick, all that

matters is getting them well as soon as possible. One way to help

your child get better quickly is to communicate effectively with your child’s doctor.

What can you do to make sure you’re communicating effectively with the doctor? There are four steps to better communication.

You can remember them by keeping PACE: Present, Ask, Check, and Express.

P A C E

Present detailed information about how your child is feeling.

Ask questions about your child’s illness and treatment.

Check your understanding of information you are given.

Express any concerns about the recommended treatment.

These four steps are called the PACE system.

The doctor’s ability to find out what is wrong and how to treat your child depends on what you tell the doctor. Doctors’ appointments are usually no longer than fifteen minutes. This makes it very

important for you to be prepared and organized so that you can make the most of your time and give the doctor the needed information.

By using this booklet as a guide, you will learn about PACE and

how to communicate more effectively with your child’s doctor. You can use the space provided to write down information that will be

useful during your child’s visit, to take notes on information that the

doctor gives you, and to write down concerns you might have about your child’s illness.

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P Present Information When you tell the doctor why you brought your child in for a

visit, you should be as clear and concise as possible. It’s a good idea to think about what you want to say before you come to the doctor’s office. The following questions may help you to describe your child’s condition. Use the space provided to enter the information you want to give to the doctor.

1. Does your child have pain? If so, where? Is the pain constant, or does it come and go? Is it a sharp pain or an ache?

_______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ 2. What other symptoms does your child have? Coughing, sneezing, fever, congestion, sore throat, etc.?

_______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ 3. When did your child start having these symptoms?

_______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________

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4. How often and when does your child have the symptoms? Do

they occur before or after eating, when your child gets up in the morning, only after activity, etc.?

_______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ 5. Have you given your child any prescribed or over-the-counter medications for the problem? If so, which ones? Did these

medications make your child feel better? How much medication did you give and how often? When was the last time your child took an antibiotic?

_______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ No one knows your child better than you do. Chances are, when

your child is sick, you know what’s wrong. You probably just want to tell the doctor what the problem is. However, doctors are trained to look for symptoms so that they can make a diagnosis and set up a treatment plan. If you jump to a diagnosis, you’re leaving out an important step in the process. Plus, you could be leaving out

important information. That’s why it’s better for you to do this:

• Describe symptoms instead of offering a diagnosis.

• Be as specific as possible when describing symptoms.

• Be as thorough as possible when describing symptoms.

For example, instead of saying, “I think she has a sinus infection,” say, “She has a hard time breathing through her nose, and she says her face hurts.” This will give your doctor the information

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needed so that your child gets the best care.

Medications and Allergies Tell the doctor what medications your child is taking. Include medications prescribed by other doctors, and also mention

over-the-counter medications and nonprescription vitamins,

minerals, and herbs. Your child’s doctor may not remember all the medications the child is taking, even if he or she prescribed them.

Either bring all of your child’s medications with you to the

appointment or bring a list of them. Write down the name, the

dosage, and how your child takes each one. For example: Tylenol, two teaspoons, three times a day. Also remember to tell the doctor if your child is allergic to any medications. Please list current

medications below with the dosages, and also list any allergies your child has.

Medications My Child Takes ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________

Allergies My Child Has ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________

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A Ask Questions Ask questions during your appointment so you will understand your child’s condition and medications.

As a parent, you have the right to ask your child’s doctor questions.

It’s also your responsibility to ask questions to make sure your child gets the very best care. Think about questions to ask your child’s doctor before you come to the appointment, so that you will be prepared. Here are some sample questions you might ask the doctor about your child’s diagnosis or medications: 1. What is wrong with my child?

2. Is it contagious?

3. How serious is it?

4. Will it get worse before it gets better? How long will it be before my child feels better?

5. Will it affect my child’s normal activities? If so, how?

6. Does my child need medication for this condition? What is the name of the medication?

7. What does the medication do? Is there any other treatment besides this medication?

8. Does the medication have any side effects?

9. How will I recognize negative reactions to the medication? What should I do if my child has any of these reactions?

10. What if my child throws up right after taking the medication?

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C Check Understanding When your child isn’t feeling well, and if the doctor is in a hurry or gives you a lot of information, it’s easy to lose track of what was

said. So it’s always good to check your understanding of what the doctor tells you. Here are some good ways to do this.

1. Ask your child’s doctor to repeat or clarify information that is

unclear or confusing to you. For example, the doctor tells you to give your child an over-the-counter cold medication three times

a day. You could ask her to clarify: “Does that mean once every eight hours, or three times each day while my child is awake?”

2. Repeat out loud what the doctor just said, using your own

words. For example, the doctor says, “You can rotate Ibuprofen and Tylenol every two hours.” You could say, “Okay, so I can

give Tylenol at, say, 12:00, and then Ibuprofen at 2:00, and then

Tylenol again at 4:00. Is that right?”

3. Check your understanding of the treatment at the end of your

child’s visit. Summarizing will help to make sure the information is fresh in your mind. Plus, you can always double-check your notes.

4. Make sure to get the phone number for your doctor’s office so that you can call back later if you have any questions.

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E Express Concerns Sometimes, parents anticipate problems with following the

treatment plan the doctor recommends for their child. When these problems come up later after they get home, parents often either change the recommended treatment or stop it altogether.

Unfortunately, even if there are good reasons for changing or

stopping the treatment, a parent can unknowingly harm the child by doing so. The solution is to express any concerns you have about

the treatment to your child’s doctor before the end of the visit. Being honest with your child’s doctor about your concerns is extremely important. Don’t hesitate to do the following:

• Let the doctor know what problems you think you might have with the treatment (for example, your child has a hard time swallowing pills, or you’re worried about taking medication at day care).

• Express your willingness to work with your child’s doctor to find a more agreeable treatment or to change the treatment to better meet your child’s needs.

Finally, it is important for you to think about what you really want from your child’s medical visit. What is it that you are expecting from the doctor? Do you hope to receive…

• Reassurance (that your child’s illness is “normal” and will run its course or that it is not something more serious)

• Medication (cough syrup, antibiotics, pain medication, ointment) • Self-care suggestions (what you can do to help your child feel better)

Think about what your concerns and expectations are, and be ready to tell the doctor about them.

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Notes

__________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________

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