Straight from the Doctor: Interview with Dr. Tobi (pediatrician)

"I recently had the pleasure of talking to Dr. Tobie a wife, mother, daughter and pediatrician. I was very excited about this interview because I know as parents there are so many things that we want to ask a pediatrician. See the full interview below."

Danielle

Hello Dr. Tobi (aka, DrBabyMamaDrama) I would like to thank you so much for taking the time to talk to us today and answer some questions. What inspired you to become a pediatrician (please give a little bio)?

I wanted to be a physician since high school and was involved in health and science related activities since then. I wanted to be a pediatrician because, quite frankly, I prefer children to adults most of the time. I love kids' honesty and resilience. I also love being able to help instill good health habits now that will positively impact my patients' health in the future. I went to Vanderbilt University for undergrad and did my medical and residency training at Children's Hospital of Pittsburgh.

I am sure that as a pediatrician you come in contact with many different types of people with many different beliefs. Have you ever had a parents beliefs interfere with what you thought was best for their child? If so how do you handle situations such as these?

I ascribe by the fundamental tenet of medicine which is to "first do no harm". As long as that is at the center of my decision making process, I usually can come to some sort of happy medium with parents. There are certain things that I will not budge on, like childhood obesity and dental hygiene and bike helmets. There are other gray zones, like sleep issues and parenting styles that I will often agree to disagree. I often have patients who have differing beliefs from my own. I usually try to put myself in the parents' situation as often as possible and keep in mind that we both generally have the child's best health interests at heart. As long as I am certain that the child is not being harmed, I am willing (within reason) to do things to accommodate personal preferences.

Winter is approaching and cold and flu season will soon be knocking at our door. What are some things that we can do as parents to ensure that we protect our children this cold and flu season?

Wash hands, wash hands, wash hands! Did I say wash hands? I encourage hand washing after coughing, sneezing and touching your face. Getting the flu vaccine (particularly for those with chronic conditions like asthma, congenital heart disease and suppressed immune systems) is also helpful. Other things to encourage a healthy immune system include getting plenty of sleep, exercise and eating a healthy diet, which can often be challenging in the cold winter months.

Many parents have differing experiences with their children’s doctors. Sometimes parents want more answers and the doctors don’t seem to be listening. How can parent’s best approach their child’s doctor to ensure that their child is getting the proper testing?

I think the best way is to understand that every doctor is different. Some will tend to wait while others will want to run a many tests at once. Some will prescribe antibiotics for everything and others will call everything a virus. I am generally relatively conservative and with most things. However, I believe in asking for a referral. I will do referrals sooner rather than later to get to the bottom of chronic conditions that don't seem to be getting better with standard treatments. The best way to approach is to be as non-confrontational as possible. A nasty or abusive attitude to the nursing and office staff is only going to do a disservice to your child. And a second opinion is never a bad thing! I have had patients do so and I encourage parents who are questioning a diagnosis to seek one from another qualified doctor. A parent is (usually) their own child's best advocate, but a pleasant attitude goes a long way.

There are a lot of differing views on the topic of immunizations being connected with autism. As a doctor should parents be concerned? My child’s pediatrician had to warn me that some believed that there was a connection before she administered my sons immunization. Is this required?

I have given my own child every single recommended vaccine on the recommended schedule and had ZERO hesitation doing so. I would never give my child anything that I believed would do her any harm. This is a very heated topic of debate and while there has not been a single study that is accepted in the medical community showing a link (the Lancet study that had suggested a link was retracted last year), there are always parents who are afraid to give the vaccines. That is the parents prerogative, but I personally will not care for patients who will not adhere to at least a delayed schedule (I have no problem spreading out the shots if the parents want to). My patients' parents who refuse vaccines except for religious reasons I encourage to either sign a waiver for release of liability should their child become seriously ill or to find a practitioner who will agree to forgo vaccines. By law, any time you give shots, the patient is required to receive the VIS (Vaccine Information Sheet). The VIS has all of the information that you are required to tell the patient.

I know that when it comes to parents and their children’s health things can get very serious. How do you handle the overly concerned parent?

I know which of my parents will tend to be more nervous and "overly concerned" than others. This can be frustrating as a pediatrician but I also remember that most parents haven't had the benefit of years of training to learn which kids are "just a little sick" or "uh-oh, I should be worried sick". I try to be patient and sometimes take a few extra minutes to reassure them that their child is doing normal kid things (if that is the case). I also keep in mind that no one knows the child better than the mom. A mom's instinct is a very powerful thing and should not be underestimated.