The Doctor's Visit: Parent Checklist of Questions
December 14th, 2012
by Dorie Geraci M.S., R.N.
Looking for a child psychiatrist and being prepared for the initial visit can be a daunting task when a parent is also caring for a child who is not yet stabilized. The Medication Safety Team developed a tool to assist parents through this process. This checklist will help parents look for key elements in choosing a physician, organize the most helpful information for the doctor and streamline the visit so that time can be maximized. Members of the Online Support Networks were asked to offer their recommendations. Special thanks to Ann, Mona, Susan, Dee, Shelli and Nanci for their valuable suggestions.
1. What to look for in choosing a pediatric psychiatrist
- Board certification
- Experience with diagnosis and treatment of pediatric bipolar disorder
- Parent references
- How the physician interacts with child, parent and family
- Any published articles
- Openness to questions, new information, second opinions and expert consultations
- Does s/he keep up with education by attendance at professional meetings, courses and reading scientific peer reviewed journals?
2. What to bring to the first appointment
- Pediatrician (or Family Practice) patient history
- Medication list
- behavioral response
- adverse drug events
- medication history to include medications, combinations, dosages, length of time on each and reaction
- Daily mood charts or journal
- Teacher and/or IEP reports including report cards
- Any neuropsych testing
- Social worker or psychologist reports
- Any imaging studies
3. Questions to ask
- What is the diagnosis?
- How is it treated?
- What are the implications for school and home function now and for the future?
- What is the doctor’s general attitude about childhood bipolar disorder and how does it relate to comorbid disorders?
- Is the physician familiar with current treatment guidelines for pediatric bipolar disorder?
- What is the role of mood stabilization?
- How is mania treated?
- What treatments are available for bipolar depression in children?
- How are comorbid diagnoses treated?
- What is purpose of the med, dose, how to give, expected effects, interactions, contraindications?
- What is the office policy about obtaining prescription renewals?
- Are medications able to be prescribed over the phone?
- Are there samples of prescribed medications available for the patient?
- What is a reasonable length of time for trying a course of treatment before considering a medication change?
- What possible adverse reactions should we be alert for?
- Is counseling recommended?
- Is there any specific type of therapy that is recommended?
- At what point in the illness or stabilization should counseling be initiated?
- What type of counseling is available for the other family members (parents, siblings) who are impacted by the patient's disorder?
- Is the physician willing to work in conjunction with the social
- worker, counselor or psychologist who is providing therapy for the family/child?
6. Laboratory blood screening
- What baseline blood work is needed?
- Which medications need blood level monitoring?
- How frequent is blood work needed?
- If the patient is young, or has a strong fear of needles, can the physician prescribe a topical numbing cream such as EMLA?
7. What other palliative measures may be helpful in addition to meds?
8. How to access support/social services needed.
9. Will supportive documentation for insurance, school, social service reasons be provided/needed? Is there an additional charge for this?
10. Can the physician refer you to any medical resources that will help you understand your child’s diagnosis and treatment?
- Does the physician do strictly outpatient work or does he also follow his patients if they are admitted to the hospital?
- If your child is admitted to a hospital and another physician is responsible for directing inpatient care, is there communication and consultation between hospital and outpatient treating physicians?
- What hospital should you take your child to in case of emergency?
- How can the physician be contacted in case of emergency?
- Who provides emergency and backup coverage when the physician is unavailable? What is the clinical experience of the physician (or nurse practitioner or physician’s assistant) providing coverage? Do they have experience treating children with bipolar disorder and comorbid psychiatric disorders?
12. Who can the parent call if clarification or further information is needed?
- Can the physician refer you to any medical resources that will help you understand your child’s diagnosis and treatment?
13. When to make a follow-up appointment
14. How to make the most of the visit
- If bipolar disorder is suspected or there is a family history of bipolar disorder, familiarize yourself with the information and resources on the The Balanced Mind Parent Network Web site at: www.thebalancedmind.org
- Fax or drop off background information to the physician’s office PRIOR to the appointment. (Also bring copies of all information to your visit just in case the information has been lost, misplaced or has not arrived yet.)
- Have a question list ready before your visit and write down answers during your appointment so you have a clear understanding of what is being said.
- Have another family member, close friend or social worker with you at the appointment so that they can help with child care and help you remember information by taking notes.
- Ask for any written information or the psychiatrist’s web site if there is one.