This post is likely to be a little lengthy and a little personal, but I really encourage you to read to the end. Sad as it may be, I truly think I need to do this for 2 reasons. I first decided to write this post as a segue into an upcoming post I want to write about a controversial issue (yes, that means vaccines). Secondly, I am finding more and more that patients hear my advice and then file it away somewhere between advice from the woman in playgroup and Google. I know that parents want to get as much information as possible in order to make the best decisions they can for their children, but some of that information is outright inaccurate and most can be hard to interpret without knowledge and experience. Furthermore, every patient is different and care and treatment plans don’t always work for everyone. Plus, not everything you find on the internet is true or accurate. I know, shocking! My intent is not to be a paternalistic doctor, insisting that my patients only listen to me, but for patients to understand that my advice comes with a certain level of expertise based upon my background, experience and education. So, without further ado, my life story…
School
I knew I wanted to become a doctor sometime in middle school. By 11th grade I was looking at colleges strictly based on their science/pre-med program. I attended the University of Rochester and suffered through classes like biochemistry, genetics and organic chemistry. In order to apply for medical school, I had to take an extensive exam called the MCATs. I can’t remember for the life of me what was on it, but it took months to prepare and an entire day to complete. The point was to have a solid background in science and critical thinking. I went on to the University of Maryland School of Medicine and, like all doctors, studied anatomy and physiology, pathology, histology, pharmacology, microbiology and immunology. Just to name a few. These classes were taught by doctors and scientists who have extensive backgrounds in these areas, and the material and textbooks used were all evidence based and rooted in scientific research. I’ll tell you these professors were smarter than I will ever be! After 2nd year I sat for my first US licensing exam and had to regurgitate everything that I learned the previous 2 years. By third year, I was ready to hit the hospital ward and apply what I knew to patient care. I learned the art of taking a history, performing an exam, coming up with a diagnosis and forming a treatment plan. Most importantly, I learned that being a doctor didn’t mean just memorizing everything from my classes, but using it as a base to build upon. Frequently doctors have to think outside of the box and dig deep into all of their knowledge to come up with an answer. During this time I assisted in multiple surgeries, examined psychotic patients in the ER, lectured heart attack patients about the dangers of smoking, delivered babies, gave devastating diagnoses and learned that my goal in life was to be a pediatrician.
Residency
This is when the fun began! 80-100 hour work weeks learning everything there is to know about every possible disease or injury that can happen to a child. I was performing procedures on the tiniest babies, watching injured and sick kids have amazing recoveries and coping with the loss of beloved patients. On top of that, I was learning about development, behavior and preventative care. That’s a lot to take in during 3 years! I think one of my biggest take-away messages was learning the difference between “sick” and “not sick”. This means knowing which patient is acutely ill (has something life threatening) and needs immediate care vs the patient that has something mild or can be observed during an ongoing work up. It is this experience that drives my instinct and is constantly in the back of my head every time I am in a room with a patient. When your child comes in with a simple cold, I am already looking at him/her thinking of all of the possibilities. This is why I tell parents when I am worried and when I am not. Let me do the worrying.
Current Practice
My first job out of residency was working ER/Urgent Care for Rady Children’s Hospital. Nothing gets you up to speed in the real world like the fast paced, intense nature of the Emergency Room. Once I had my first child, I knew I was ready to settle down into primary care. I have been with my group since 2004 and I still love it. I love watching the patients and their families grow. I love listening to the silly things kids say. I love seeing the success of breastfeeding. I love hearing the gratitude of exhausted parents who need me when they are most vulnerable. The list goes on and on.
Working full-time in primary care pediatrics AND raising my own family, leaves very little time for me to read every study and every article that comes out. This is why I trust the very smart people who read these studies, form opinions and develop practice guidelines for front line doctors like myself. I fully trust the American Academy of Pediatrics, the specialists at my own hospital and those around me that I consult with. I take their advice and add to that my own experience that I’ve described. On top of that, I add my own instincts and ability to critically think and draw conclusions based on everything I’ve been taught. So far this path has not led me astray.
Therefore, when I give advice, know that it has been many hours of study and many years of work in the making and I don’t take it lightly. I will always treat your child as my own and would not make a recommendation that I wouldn’t make for my own family. Because of this, I want you to trust me. I would love for my advice to move to the top of your opinion list, even if you want to question me or get more information. We are a team and our ultimate goal is the health and safety of your child.