“Because I said so,” doesn’t work in healthcare anymore.

“Because I said so.”

“Because I’m the doctor.”

“Because that’s the way I’ve always done it.”

Silence.

These can be common responses when a parent is inquiring further in regard to a medical decision that has been made for their child or asking for an explanation as to why an intervention or procedure is being done. Now this isn’t to say every provider responds this way, but lately that does seem to be the atmosphere that has been created within our healthcare system. Whether the request for the “why” is met with frequent glances at a watch, a roll of the eyes, or my least favorite, silence, it can be create a difficult situation impossible as a parent.

A lack of response can be just as deafening. I remember an incident where we were simply performing a sterile procedure on a child in the Neonatal Intensive Care Unit and when we finally let the father come to the bedside, he was on the verge of tears. I’ll never forget him looking at me and saying, “I thought he was dead, no one told me why I couldn’t come back here yet.” My heart broke as he stood at his sons bedside wiping tears off of his cheek. This father had been sitting in the waiting room believing that he was just waiting to say goodbye to his son when we were only practicing sterile technique in setting up his child’s IV lines. Would it have been so difficult for someone to have taken the time to provide a brief explanation? Those were my thoughts as I profusely apologized and reassured this father this his son was by all accounts alive and stable. Fast forward a few years when I was undergoing an emergency c-section and my son did not cry and continued not to cry as I asked about half a dozen times, “Is he okay?” I was met with silence. While my son made it safely home and continues to be the best mischievous little piece of my heart, that was a time that still haunts me to this day and I am sure the same goes for that father.

So why am I telling you all of this?

The pandemic of 2020 did many things, but one of the them (that I predicted) was widen the spectrum in how the general public views healthcare workers. You have one end where no matter what is being said, if someone in the healthcare field makes a statement, it is taken as gospel and there is no ifs, ands, or buts about it. Then you have the opposite end of the spectrum where there is no trust; no matter how good your intentions, if you are a provider in the healthcare field, you are thought to be bought and paid for so your goals are not for the health and safety of the child you are caring for. In early 2020, the Journal of the American Medical Association reported approximately 70% of the United States trusted our healthcare system. In 2024, that number had plummeted to 40%.

Could this shift have occurred due to the constant back and forth of recommendations and updates we received throughout that tumultuous time? Perhaps. I can remember the hospital where I was employed would send an institutional-wide policy update in the morning and by that afternoon, it was rescinded and a different one would take it’s place. I was not surprised that this was being seen on a nationwide level.

This may be a cheesy line, but communication truly is the key to creating a stronger and more efficient healthcare system. Simply informing a parent that a decision was made because of who we are as healthcare workers is not going to cut it anymore. With only a third of the nation’s general population reporting a general trust in the system that we have in place, a change is in order.

Options should include:

·       Offering longer appointment times for at-risk patients and their families, particularly when it comes to mental health concerns.

·       Teaching patients and parents when to call their provider versus going to an urgent care or the Emergency Department.

·       Utilizing HIPAA compliant apps where patients can be triaged for after-hours concerns when on-call is not available

·        Providing telehealth options for patients, especially mental health care, to ensure consistency of care  

Keeping the lines of communication open is ultimately the best thing that we can do for our kids. One of the reasons I opened this practice was to offer families the opportunity to choose the type of follow up that best suits their family’s needs. I also wanted to be able to practice with the incentive of taking my time with patient’s rather than being told to roll through an assembly line to meet a quota. Everyone involved in the care of a child should be working together, not against one another in ensuring a child is safe and healthy and it all starts with a conversation.