Have you ever left a pediatrician's office frustrated and confused thinking "what did she say" or "that doesn't make sense?" Take comfort in the fact that you are not alone. Physician visits are increasingly complex since many may involve multiple tests, and numerous vaccinations.

Pre-planning can help ensure your questions are answered. Prepare by organizing your thoughts and developing an agenda for the visit. Your pediatrician follows an age-related framework for each visit and will be assessing growth and development, nutrition, immunization status, illnesses, and physical condition. Your pediatrician will also be interested in behavioral and emotional, and school and learning issues, as well as family related problems. For more information about "well child visits" and pediatric objectives go to www.brightfutures.org.

Optimizing the visit to the doctor:

Call early for an appointment, especially when a school or sports physical is due.

When you make your pediatric appointment, ask what information is needed at the time of the visit.

Compile a list of questions in the weeks building up to your appointment and bring two copies of the list to your appointment.

Create an inventory of your child's medications to bring to your pediatrician.

Let the doctor know that you have a number of questions and give her a printed copy of your list to review.

Bring your child's immunization records to the doctor to assure it is correct and to allow for updating.

Remember that you will be better informed if you have a way to take notes during your child's visit.

Let the doctor know before he leaves the examination room if you are confused or need more information.

If additional thoughts or questions come to mind, call the office and speak with staff or ask when the doctor might be able to return your call.

Children may have mixed emotions about a visit to their pediatrician. Many won't remember the visit. Some will recall the relief of learning that they are healthy and developing normally. Others will dwell on time spent in the waiting room, the blood tests, and the shots. Some children can openly discuss their fears and worries while others try to hide their feelings and anxieties. Talking openly and honestly about what will take place during your child's pending visit builds trust and helps to allay anxiety.

Preparing your children for their pediatric visit:

Ask your child if he or she has worries or questions for the doctor and add those to your list.

Reassure them you will be with them for the entire visit. Adolescent visits are a common exception to that rule, but your teenager can request your presence in the examination room.

Let them know that the doctor will talk to everyone in the room and ask lots of questions.

Tell them that the doctor will perform a head-to-toe examination that is not expected to hurt.

Explain that the doctor may look quickly at "private places," which is OK because Mom or Dad are there.

Be honest and tell your child that there may be a blood test or shots, and acknowledge that blood tests and shots do hurt a little, but that the discomfort lasts no more than a few minutes.

Allow your children to express their fears, but let them know these tests are necessary and not subject to negotiation.

Model good personal health care and encourage a positive attitude toward health maintenance for all members of your family.

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Dr. Edward Bailey is chief of pediatrics at NSMC North Shore Children's Hospital, on staff at MassGeneral Hospital for Children and a father of three. You can contact him at ebailey@aap.org.

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