To think the US paediatrician system is weird

[shaniahoo]

I'm on a few parenting groups that are American and the way they talk about their pediatrician is so alien to me. The ped seems to have a lot of power. Like, the hard line of these groups is that you always follow your ped's advice and nobody is allowed to question what a poster's pediatrician told them. But a lot of it seems like non-medical parenting advice? Everyone has their ped tell them when to start solids and they follow that - so they might tell you to start at 4 months so you do that or if they tell you to start at 6 months you do that. And everyone has to have their paediatrician "clear" their baby to start solids before they start. And the ped "clears" you to start sleep training or tells you you must do it or must not do it, and you do what they say. I suppose the equivalent here is the HV but you don't see them nearly so much and there's no sense among parents that you must do whatever your HV says.
AIBU to think this takes autonomy away from parents? Or is it great that they have so much advice and support?

@RosaBonheur Of course not, but that is an issue with a shortage of staff. Staff and fathers should be fetching food for those women who can't walk to get their food.

@Randomizer

Can I suggest that it's possible the people frequenting the parenting forums are a self-selecting demographic, possibly not representative of an entire system, and that you might possibly, therefore, be making somewhat ignorant judgments?

and sign off for school. Uni entrance had a sheet to sign off at the doctors and vaccination check to make sure they were up to date too

OMG seriously, you have to get signed off by a doctor to go to school and uni?

I find it hard to reconcile the small state philosophy of the USA with what I see as a very invasive medical system.

I honestly don't know anyone who treats their doctor as some kind of god. Parenting forums aren't real life.

yes, there are rules requiring vaccinations and physicals for school entry. quite honestly I am in favour of it. It's not about an "invasive" medical system, it's a stick to get people to vaccinate their children. In most states, schools also have nurses on staff.

The regular check ups can pick up on things before they get so bad they cause issues enough for parents to notice or might not be noticed for years but cause damage in the meantime. For instance genital checks will discover undescended testicles which might otherwise go unnoticed until puberty by which point damage to fertility might have already occurred. Or hearing tests picking up slight hearing problems that would explain difficulties in school or with behaviour. They're also a good time to bring up stuff that's too small to bother making an appointment for like my son's cradle cap not going away.

With no other major surgery would a patient be expected to get up and walk to every meal straight away but c-section patients are.

And that's exactly how it is in practice as well. Like the OP of this thread, you seem to believe that US pediatricians have a huge amount of control. In reality, they offer advice when asked and parents are free to accept or reject it.

I usually avoid any thread on MN that is about the US. They are invariably full of misinformation, insults, and sneering. This thread is no exception to that, alas. However, I am pleased to see many US-based posters who have pushed back against the false information and offensive statements.

As PPs have said, there are many aspects of US medicine that are troubling and in dire need of reform. But the system of pediatric care is not one of them.

Oh this is pretty typical in France too.

I needed to get a certificate from the paediatrician as part of the paperwork for my son starting crèche, they took a copy of his health record to make sure he'd had all his compulsory vaccinations, and you even have to get a certificate from your doctor if you want to enter a running race.

I had a C-section in France and all meals were brought to me. Actually, all meals were brought to me after my VBAC too.

After the C-section the nurses came round with painkillers every 6 hours and I had daily visits from midwives and from my obstetrician to see how I was doing. Someone came in the morning after I gave birth to remove my catheter and help me get up to walk to the toilet. After that I was encouraged to get up and walk around, but they just asked me whether I was managing to do it OK, and whether I had been able to have a bowel movement etc.

Framing forcing post C-section mothers to walk down the corridor to get their own meals if they want to eat as encouraging them to be mobile is some next level bullshit.

You are expected to get up and walk after major surgery. Those saying that have clearly never had major surgery. And if you physically can not get out of bed you will usually have a bar over your bed and be encouraged to do light exercises.
Even with elderly frail people a physio will come to the bedside and help you get out of bed after major surgery.
So you have your food brought to you but are encouraged first to sit in the chair, and then walk to the toilet and shower.

Some checks happen at childrens regular checks at school. All my children had a hearing test and pretty sure my boy had a check of testicles at puberty and at about five? Hard to remember but fairly young. It was part of the regular checks.

I've had abdominal surgery twice, neither time was I expected to get up to walk to meals, instead I was first encouraged to get up to sit on a chair, then encouraged to walk a short distance, slowly building up my strength, but all meals were brought to my bed.

After my 2nd birth I had a haemorrhage and wasn't even allowed to get up to go to the loo without a nurse to help me because of the risk of passing out. Can't imagine what I would have done if I had to walk to get my breakfast.

In surgical wards all meals are brought to people's bed even if they could walk unaided down to the canteen alone. But people are expected to get up and moving.

What regular checks do they have at school these days? I can only remember one hearing check and two vision checks when I was in school, certainly no physical exams. Well, except for nit checks! And the beep test in secondary school which checked fitness levels, can't remember if there was anything more than the beep test (the fitness tests here do the beep test, flexibility, ball throwing, some kind of jumping thing, and push ups and sit ups)

Yet surgical patients on the post-natal wards are treated differently to other surgical patients. That's not right. And not just those with c-sections that struggle to get about after giving birth, plus have to look after a newborn who might be on and off the breast constantly, leaving very little opportunity to get up and go somewhere.

@Natsku I was simply responding to the false claim that people who have major surgery are not expected to get out of bed. They are. It is unsafe not to.

My claim was that they are not expected to get out of bed to get their meals. That's not a false claim.

@Randomizer perhaps you are seeing what you want to see, or perhaps those forums show selection bias.

The people you cite sound, if anything, rather uneducated and in need of support. Nothing wrong with offering support to unsure, possibly young, parents. Maybe these parents are in turn bragging a bit about being able to access such support but isn’t that really rather harmless? The UK is now so full of braggarts we’ve lost the ability to call out Americans for that quality.

My sister lives in Virginia. She has annual 'mot' from her Dr (equivalent to GP), annual colonoscopy because her medical insurance (provided by work) insists on it, annual smears for the same reason and for those she sees her gynaecologist (specialist Dr always the same one not regular gp). Interestingly she doesn't have to have an annual mammogram but goes to the (the same) obgyn for them every 3 years.

She pays something for each visit even though she has full insurance.

They check you’ve been vaccinated and if you’re going to do sports they may ask a few questions about health history.

Have to say I much prefer the US system where kids with serious health conditions know that the other kids at school have been vaccinated, and they don’t have to worry about chickenpox or measles like you do in the UK.

When we lived in the UK I do remember getting a random letter from our UK school nurse telling me that DD was 'too tall' but with no suggestions for further steps to take, and no questions about the heights of her parents.

Good to see them focusing on the stuff that matters.

There has to be some kind of miscommunication here. Insurance companies cannot "insist" that you have any medical treatment. It just doesn't work that way.

As stated many, many times before in this thread yearly colonoscopies are a figment of somebody's fevered imagination, LOL. Unless your sister has a genetic syndrome that places her at very high risk of colon cancer no insurance company would pay for a yearly colonoscopy.

Think of it logically. Insurance companies are in the business of turning a profit. So their goal is to collect more in premiums than they pay out in healthcare costs. Colonoscopies are costly procedures in the US with extra fees for anesthesiologists. Why on earth would an insurance company want to pay for this yearly? They wouldn't.

This is actually funny. In the US everyone complains that the meanie insurance company refuses to pay for procedures and in the UK people think they can't wait to throw money at every diagnostic test under the sun.

@GulfCoastBeachGirl 🤷🏼‍♀️ I only know what she tells me

This is actually funny. In the US everyone complains that the meanie insurance company refuses to pay for procedures and in the UK people think they can't wait to throw money at every diagnostic test under the sun.

Schrödinger's Insurance.

This is correct. I have a GI disease puts me at an elevated risk of colorectal cancer. I get scoped every other year. My doctor gets prior authorization from the insurance company, which is routinely granted. All in, it costs about $1400. My gastroenterologist has to start the process every time. My insurance wouldn't give a rat's ass if I skipped it.