What surprised me pediatricians in the United States: the experience of mom
'04.03.2021'
After a year and a half of intercourse with American pediatricians in Chicago, where my daughter was born, and in New York, where we later moved, I brought out for myself the main rule of American medicine: do not scare.
No, this does not mean that doctors in the States hide diagnoses or diminish their seriousness - everything is exactly the opposite: at every reception the doctor pronounces every step, even if he does basic things. This approach gives parents an important sense of confidence and maximum awareness. At this interesting features of American medicine does not end there.
American pediatricians take children not in hospitals
The classic medical institution in America is called practice. Pediatric practice is most often located in an ordinary office building - as a rule, it can be distinguished from any other working space by the presence of a play area at the reception desk and children's drawings on the walls.
Doctors are available around the clock.
No, this does not mean that the pediatrician sits at the practice office all the time and is waiting for someone to come to him. At the workplace, doctors are available for a rather limited time (each pediatrician has his own schedule). However, in any good practice there is a doctor on duty “on the phone” who communicates with all anxious parents all day and night and either makes recommendations himself or connects with your pediatrician. In some practices, after hours calls are charged (approximately $ 20-40 per call).
Ambulance is too expensive
911, the American version of the ambulance, can cost a pretty penny - from $ 400-600 or up to a couple of thousand dollars - even with good insurance. The fact is that the local ambulances are equipped with the most modern means of resuscitation. This is really an emergency service, designed not to give an antipyretic child with 39,5 ° C (and at the same time a sedative to parents) or act as a taxi that will take him to the hospital. This is why it is customary to dial 911 only when it is really a matter of life and death.
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In America, it is not customary to churn the temperature
Even 39,5ºС in a child, in the opinion of most American doctors, is not a reason for receiving a febrifuge. A weighty reason is the obvious discomfort that gives the child a fever: atypical weakness, reluctance to eat, inability to fall asleep. Each case is individual, and doctors recommend first of all to focus on the behavior and condition of the baby, and not on the numbers on the thermometer. In case of misunderstanding on the part of parents, pediatricians remind: temperature is a sign that the body is actively fighting the virus, no need to interfere with it.
The doctor does not come to examine a sick child and does not visit a healthy newborn.
If you need to see a doctor, you do not call him at home, and you go to him yourself even with a high temperature - these are the rules of communication with doctors in the States. A sick baby will be taken into special “sick hours” in his practice without a recording or around the clock in a children's hospital. Healthy babies are also invited to practice on regular “healthy visits” on 3-6 day of life, on 2 weeks, on 1 a month, on 3 a month, on half a year, on a year, and so on.
By the way, about newborns: they do not know what is a clinical examination
If there are no obvious problems, the baby communicates only with his doctor. Clinical examination as a phenomenon in America is absent for both pregnant women and children. It is believed that the pediatrician is able to see the problems, if any (and in this case, the doctor will, of course, redirect the patient to a specialist), and parents can complain about unobvious deviations if they are worried about them. If the baby is healthy, why stress him once more and carry him around the tests?
Vaccinations are a personal matter for parents, but ...
Where your freedom of choice begins, the freedom of choice of others should not end, some American doctors believe. Not all pediatric practices establish such strict rules, but in the one that we have chosen, they approach the issue of vaccinations categorically: with parents who do not vaccinate a baby up to 6 months according to the standard calendar for no obvious medical reason, they have a serious conversation, and if she does not which does not lead, the administration of the practice proposes to find other doctors for the unvaccinated child.
Unvaccinated children may face similar difficulties in kindergartens and schools - again, each school sets its own rules, and for those who sabotage vaccinations, the range of accessible gardens and schools is narrowed.
The most common doctor response is “relax.”
Maybe we were just lucky (although someone will say the opposite), but the favorite phrase of our pediatrician is "leave the child alone, do not strain." The baby does not go to the toilet for a couple of days, she develops infant acne (in Russia it is called diathesis), the temperature suddenly rises, she sleeps all night without a break for food - just leave her alone. At first and out of habit, such medical tactics can seriously bother young parents, but over time it demonstrates its efficiency - and you admit that such an approach not only has the right to exist, but also saves tons of valuable parental nerves.
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It is difficult to self-medicate in America
Almost all drugs in the States are sold by prescription. You cannot nominate your child the pills recommended by the Internet - only the simplest means such as antipyretic, cough sweets and antiallergic drugs are available for sale, everything else is required prescription. This creates certain inconveniences and makes you do “extra” movements (that is, go to the doctor “extra” times). But such a system also has a nice bonus: the insurance often pays for medicines prescribed by doctors.
Sick without insurance in the United States - ruin
American medicine is a very expensive and confusing system. Without insurance, it's actually a robbery in broad daylight. It seems that no patient is able to make sense of the numbers that he sees on the bill after a visit to the doctor. A person who is not used to such a leapfrog, mad zeros for a reception can lead to a state of panic. But often it is worth taking a closer look - and you realize that your insurance company received a discount of $ 1000 to the cost of $ 950 for the examination, paid $ 40 itself and offers to pay you $ 10. Both life and health are getting better!
