T he physician-patient relationship has been referred to as a therapeutic alliance.
The caregiver and the patient communicate and come up with a plan for the latter’s healthcare.
The pediatrician-patient relationship is different. Most of the time the patient is a minor and is legally incapable of making healthcare decisions.
This is why the relationship between pediatrician and parent (or guardian) is so important.
Virtually all infant and toddler health information is provided by a parent.
The patient in this regard either cannot answer for himself or will make little sense if he does.
Preschoolers and elementary-school-aged children can start to communicate their concerns but may change them to avoid unpleasant tests or other consequences.
Adolescents may be embarrassed to speak in front of their parents (even if parents would not be embarrassed by hearing them).
State laws require, in some cases, that health information be kept strictly confidential between a pediatrician and adolescents of a certain age when it comes to issues such as pregnancy (and a few others).
Those patients 18 years old and above can legally make decisions with their pediatricians concerning their care.
I have found that many still want the input of their parents when it comes to more serious health issues.
The American Academy of Pediatrics advocates for the concept of a medical home.
This is an ongoing medical relationship between the child, the parents and the pediatrician.
In the vast majority of cases, nobody knows a child better than his caregiving parents.
Going to the same pediatricians allows for the doctors to get to know the child and the rest of the family.
This helps the pediatrician and the parent (and later on the child) make better treatment decisions.
Acute illnesses are only one example of what pediatricians treat. Some children have chronic illnesses.
Some have behaviors or signs of illness that gradually worsen over time.
It helps to have parents and pediatricians reassess these children and decide when and what interventions should be made.
The pediatrician-parent relationship under the medical home concept will grow stronger and more effective over time.
As the child ages, this relationship will serve as a model for him as an adult about the importance of maintaining a therapeutic alliance with a physician.