By Rod Moser, PA, PhD
Most of my 40-year career has been in primary care, mostly family medicine. Even when I was in medical training, I loved working with children. My undergraduate thesis involved reducing a child’s fear of having surgery. For the last 13 years, I decided to practice pediatrics full-time. Why not end your clinical career doing something that you love?
I had a dozen years of full or part-time academic medicine and found that graduate medical students whine more than little children. Don’t get me wrong. I like adults as well, but I find that children give me more happiness in joy in my stressful clinical day. I still deal with parents and grand-parents, so in a way, I am still heavily immersed in family medicine.
My days are long (12-13 hour shifts with only one lunch break). I choose to do some of the more technical aspects of our practice, like suturing bleeding kids, removing their ingrown toenails, or managing their broken bones (Thank you, monkey bars). If teenagers are worried about an ugly mole, I take it off for them. About half of my patients are teenagers; the other half starts at age two days old.
I am often the first one who gets to deal with new parents, seeing the pride (and fear) in their faces as they enter the dreaded “4th trimester” (the first three months). I can discuss breast-feeding issues, the pros and cons of circumcision, why belly-buttons stink, and why baby poop looks like mustard. Every day, I address concerns about immunizations, and deal with picky eaters, ear-pullers, snotty noses, coughs, boo-boos, thumb-suckers, and bed-wetters. I perform routine physical exams for scout camp, sports, and Mormon missions. I address the under-weight, the overweight, and the ones that hate to wait.
I have five grandchildren, but I sort of have about 5,000 grand-patients as well. Some of the parents were actually patients of mine when they were children. If I stay working long enough, I may have a few great-grand-patients. Compared to adult medicine, kids are fun, or at least I try to make a stressful medical visit, less-stressful for them.
It doesn’t hurt that I look like Santa. Just yesterday, a little boy kept teasing me about my Santa-like appearance, until I threatened to put his name on the Naughty List. Lately, the discussion of the Easter Bunny has come up, as well as the beloved Tooth Fairy. Of course, I have added a few “fairies” to the team. I have a Stitch Fairy and a Toenail Fairy. I am conversant about superheroes, the most recent kid movies, and know just about every character in the sticker box. I watch the high school. We give out thousands of sugar-free (and kosher) lollipops. I get lots of giggles when I tell them that we only have the following four flavors: onion, kitty litter, stinky feet, and broccoli.
I search for little birds that live in their ears, boogers in their noses, and cookies in their tummies. I count lots of toes (I can trick the little ones into thinking they have six toes on each foot).
Children can be frightened when they come into a medical office. Their biggest fear? Shots. When I know in advance that there will be no need for any immunizations, I mention this up front. You can often see the relief in their face. Doctors in white coats can scare children, too, so I don’t wear one. As much as I can, I first let them get used to me. Then, I involve them in their own care, from just holding a tongue depressor for me, or turning on the otoscope to look in their ears. Children are much more cooperative when they think they have a little control, like deciding which ear that I examine first.
One boy said that I was a silly doctor, so I told him that I could be any kind that he wanted. I could be a serious, mean doctor or a funny, silly one. His choice?
He picked “silly”.