What’s Wrong with the World

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No Pediatricians

If I had the graphics ability, I'd make the header for this entry one of those circular signs with the word "pediatrician" and a slash across it. Read this story if you have minor children. Read it all the way through. And then if you'll take my advice, don't, repeat, don't, send your child to a pediatrician. (Technical note: There's something strange about the way the first page of this Boston Herald article comes up when you click on the link. The first time it comes up page 1 is very short, and you miss some of the information to which I refer in what follows. If you click the number 2 to go to page 2, then go back to page 1 by clicking on the number 1, you should get the complete page 1 with the story about the author's thirteen-year-old daughter and her recent pediatrician visit.)

Here's the deal: The American Academy of Pediatricians has become a wacko advocacy group and has issued "guidelines" to its doctors suggesting that they ask scary-crazy questions of children during routine checkups. And in the case of teenagers, these questions are to be asked if possible without parents present. The questions include how much the parents drink, whether they have a gun in the house, and (this is the worst of all) whether teenage girls' fathers "make them feel uncomfortable." Let me emphasize: These are not cases where there is probable cause of abuse. The doctor is supposed to ask these questions routinely of girls who come to him for, say, a sports checkup for school.

Think of it: You have a beautiful daughter or daughters, a wonderful family, a loving relationship with them. And some doctor gets her alone in a room and insinuates to her without the slightest reason to do so that you are a sex pervert. He believes that it is "standard of care" for him to insinuate this, because the question, "Does your dad make you feel uncomfortable?" is in a list contained in a set of guidelines he's received from his professional organization.

Such behavior ought to be litigable in itself, at a minimum. (Proto-anarchist that I am, I would have some sympathy for a father who punched the pediatrician in the nose.) But it isn't even litigable. Instead, the doctor is probably worried about somehow, somewhere, in some indirect way, being subject to litigation if he doesn't go on such a perverse fishing expedition.

I recommend family practices. Big ones may be the best, because they are usually fairly busy. They are therefore less likely to push pointless yearly checkups just for the sake of having yearly checkups. You take your child to the doctor when your child is sick. Doctors and physicians' assistants in family practices are less likely (especially if you are taking your child in for some specific ailment) to go down a list of intrusive and sicko questions. After all, they aren't directly paying dues to the AAP and receiving crazy question lists from them. And have your wife go into the appointments with your daughters, all the way into their teen years. Insist on it. Get a new doctor if the doctor objects. It's just one way to make sure that what's wrong wiht the world doesn't come straight into the heart of your family.

Comments (25)

Disgusting. It's just bizarre that the usual suspects want us to be, on the one hand, endlessly tolerant of the sexualization of children in the media, and, on the other hand, endlessly suspicious of familial relationships.

When it comes to the representation of young girls in, say, hip-hop, they see no evil. But when it comes to fathers and their daughters, they see nothing *but* evil.

I don't know for sure what the doctors or social workers asking these questions think about the sexualization of children in the media. They may throw up their hands about it with a mild "cluck-cluck." But I think perhaps if they brush it off it is because of this weird myth that there is a bright, sharp line between what children are entering into voluntarily and what is forced upon them and that somehow their sexualization in the media and in clothing styles and the like fall into the former category. This is, of course, nonsense, as anyone can testify who has seen a four-year-old in the store fretfully pulling at her jeans because they are so low they feel uncomfortable!

The insanity of this voluntary/involuntary dichotomy goes farther. I thought of including this in the main post, but what is now happening in Britain (and to some extent in the U.S.) is that doctors are being told to hide from parents the sexual activity *and diseases* of minors. One doctor (in the U.S.) even has said that some doctors' offices will try to induce insurance companies not to send bills to the parents' home that include diagnoses of STDs!

So if a girl is sexually active with a boyfriend, this is treated as if she is an adult making consensual choices, and it is hidden from her parents in every way possible. But if she isn't sexually active at all, the doctor may yet insinuate to her that her father is sexually abusing her!

Nor does this craziness stop with a girl whose boyfriend is her own age. Probably everyone has by now seen the several documented stories in which Planned Parenthood has covered up for statutory rape, even though medical personnel are supposed to be "mandatory reporters" of any criminal activity like this that comes to their notice. Presumed consent trumps, and full consent between a minor girl and an unrelated man of 25 or so is presumed (no questions asked).


We've had tangential experience with this sort of thing: when taking our toddlers in for vaccinations (yes, I know, a whole other subject), we were questioned as to whether we smoked or drank in the presence of the children, or drank at all, and had guns in the house. I don't believe that the questions concerning alcohol and firearms are any legitimate concern of any physician, and so dissimulation is the rule in those cases. The question concerning tobacco use is one of those irritating, left-puritan things, as well, but could be pertinent if a child presents with symptoms of asthma or respiratory distress. Otherwise, not so much. What's next, questions concerning the nutritional balance of their meals, with a demand to produce charts, graphs, and menus? Receipts from local markets?

I have not the slightest doubt that this metastasizes as the children mature, into the grotesque combination of intrusiveness and concealment, born of a perverted doctrine of autonomy, that is the primary concern here. Then again, I argued, both on my own blog and the old EM, that liberalism has a problem with minors and sexual consent; Paul brought to my attention the fact that some lefty blogs had a field day with my argument. Damned if they didn't go and start proving my point.

Radio-host Michael Medved's 15-year-old son had this experience when he went to a doctor for a sports injury. Medved had him on his show discussing it. He was asked things like "do you like boys or girls", "are you sexually active", etc. Our pediatrician attends our parish and has pictures of the saints in her office, so we're blest.

If you don't mind my asking, Maximos, did those experiences with your toddlers take place with a pediatrician or with some more generic sort of GP or family physician's office? (Collecting anecdotal data, here.)

I knew about the AAP recommendation on asking about guns in the house before I read this article. It was in place several years ago. I also know that some four or five years ago a friend took her 10-year-old in for a yearly checkup at a pediatrician, and the doctor began without parental consent talking to the girl about menstruation. (I pointed out to my friend that the onset of menstruation in small, white girls at the age of 10 would be unusual, so this made it all the more pointlessly intrusive.)

So for years I have been glad that we never got started with a pediatrician in the first place, though it was largely a serendipitous thing at the outset that we ended up with a family practice instead. This Boston Herald article (for which I forgot to give a hat tip to Wesley J. Smith's blog) was the first I had heard of the really incredibly intrusive sexual questions.

Pediatrician. A large, hospital-affiliated practice.

I was also aware of the sex quizzing, and not only because so many doctors, in pediatric practices advertise the HPV vaccine for girls.

I suppose they probably try to run the HPV vaccine in such a way that no one really talks about the sexual connection, though. But I could be wrong about that. It would just seem to me to be a) the canny thing to do, so as not to offend parents or get them wondering why they are doing this and b) the pattern that has been followed with the Hep B vaccine, where Hep B is also an STD. (Unless your child is going to be sharing a dirty needle with an infected person.)

Lydia - insanity is the word.

Doctors are told to withhold from parents information that they genuinely need to know. Meanwhile, they're asked to treat parents like prime suspects *before* there's any reason to believe that any crime has been committed.

It's a puzzle to me.

Parenthood represents a traditional form of authority. Traditional forms of authority are automatically suspect and are presumed to be exercised by people who at best don't know what they are doing, and more commonly who out of ignorance or malice abuse their authority for illegitimate ends. Authority resting on technical expertise and certified by modern technocratic institutions is legitimate authority, particularly to the extent it calls into question traditional forms of authority which do not rest on technical expertise.

The AAP is simply carrying out the implications of this understanding of legitimate authority consistently by indiscriminately asking these kinds of questions of all young patients. Parenthood -qua- parenthood is evidence in itself, not perhaps of a specific crime commited, but of illegitimate authority exercised by the ignorant or malicious.

I think you're on to something very central, there, Zippy, esp. w.r.t. authority. What's resented isn't lack of "trained expertise" but the absence of such in a person who presumes to have and exercise authority. They don't seem to mind nearly so much children having sexual intercourse with each other or even with older boyfriends, and making all manner of other highly dangerous decisions for themselves, even though they have no special expertise! But those foolish and inexpert children are regarded benignly as subjects (as in, those who are ruled). The parents are resented because they aren't subjects but rulers in their own right.

This goes for areas other than sexuality, too. Education, of course, is an obvious one. Religion as well: Parents who pass on Christianity to their children are presumed to be "forcing" it on them, whereas a child who goes off and becomes a Wiccan against her parents' wishes (this is a made-up example) led by some girl she met at school, would probably be treated as having made a mature, autonomous, and carefully thought-out decision.

The idea seems to be to make everyone a direct subject of the social-worker-run State. Several years ago I was disgusted by a Jonah Goldberg column in which he talked about how free everyone now is, because kids can choose to do things their parents may not want them to do, and the government will back them up. It was an amazingly juvenile column. And the foolishness of it comes, among other things, in not realizing that when children really are ruled directly by the State it is hardly freedom that they sense most! Whether it's putting them on drug treatments they don't want, snatching them from their parents, moving them from foster family to foster family, or drilling them every day in PC-speak, the hallmark of the agents of the state in the role of child-rearers is exactly the opposite of liberty.

Lydia, thanks for posting this. I received a free copy of the AAP's child-rearing book from our grocery store when my daughter was born, and I was surprised and put off by the section on guns in particular (which basically says that guns should NEVER be in a house with children, no matter what precautions parents may take, and that furthermore, no one should own a gun, anyway). I found this blatantly political statement (in the midst of cartoons illustrating diaper changes and bottle warming) disturbing and annoying-- I didn't know that this was such a wide-ranging problem.

Good illustration, Bethany. I've been spared that particular book. :-) But it sounds like par for the course. The attitude, of course, is that these (as you say) blatantly political statements are so much just part of being reasonable and rational that anyone who doesn't see them is virtually unfit to be a parent. That is how a particular type of person thinks.

Zippy, excellent point about technocrats. You sum up very well something I've long sensed but haven't been able to articulate.

First-year medical student here.

Unfortunately, I don't know if you can count on this kind of thing being confined to pediatricians. My school has a weekly small-group seminar dedicated to inculcating liberalism in us future doctors. My particular group's "facilitators" are a female social worker who has been a professor of family medicine (how a non-physician can be a professor of medicine is beyond me) and a female family practice doc at a large downtown hospital with a mostly black patient population. We had two sessions on interviewing adolescents, during which the necessity of getting the parents out of the room was emphasized. The social worker says that you should ask "are you sexually active?" and "with men, women, or both?" and the FP doc agrees.

Along the same lines, the FP doc says that when a woman comes to her for a pregnancy test, if the father is present, even if the couple came to the visit together expressly to find out if they are pregnant, she makes the father leave the room before giving the woman the results, and only then asks her if she wants to let the man know. Now, one might object that in this poor black population the incidence of dysfunctional relationships is quite high, but this is being promoted as the standard. And of course, you know that if the man objects to being asked to leave or even merely appears offended, he will be suspected of domestic violence and the first question asked once the door is closed will be "are you feeling safe at home?"

Zippy's comment is all that is need in response to Steve Burton's puzzlement. The left simply hates traditional morality, normality, and convention, and favors anything subversive of them. They think authority in parent-child relationships, and harmony and oneness in a marriage, are evil. There's nothing to be puzzled about here. The left just wants to destroy traditional society.

When it comes to boycotting pediatricians, all I can say is that professional societies don't represent all of their members. Those creating these "guidelines" inhabit an ivory tower and are out of touch with community private-practice physicians. However, when referring to generic pediatricians, you might use the pronoun "she" rather than "he," since something like 70% of med students going into pediatrics have been female for more than 10 years now. A fact which, I suspect, has something to do with the ultra-liberalism of the AAP.

Hermes, that's all really useful information. You're of course right that one can't be sure one won't run into this in a family practice doctor. I think my point is related to what the Boston Herald article said to the effect that one pediatrician felt she "had to" ask the intrusive questions. My impression is that this is because of the recommendations from the AAP. That then becomes "standard" and pediatricians feel professionally pressured to go along with it. It's also just been my experience (we had a pediatrician with our first child) that people expect pediatricians to have more connection to semi-medical issues like discipline, routine feeding, and the like, and that pediatricians oblige by being more social-worker-like and also by pushing routine checkups every single year for perfectly healthy children.

So I figure if you start with a big family practice and then check around through the doctors and the physicians' assistants, you'll probably find at least couple of them that you like who just treat your children matter-of-factly for what you bring them in for. I've been able to do that, anyway.

But again, I'm sure you're right about this attitude permeating other areas of medical practice, and what you say about the weekly seminar is pretty chilling. I've seen myself that questions for pregnant women have become weirder and more intrusive from one of my babies to the next. By the time I was going in for prenatals for my third daughter (now four years old) the forms to fill out had questions like "Do you have sex with multiple partners? Male? Female?" "Do you do street drugs?" and of course "Do you feel safe at home?"

Your reference to black populations is also relevant. It's been my experience that the medical profession tends to take the worst case scenario and treat it as expected among all patients. (The question about street drugs being an example.) I think that this is partly a politically correct desire not to appear "racist." Thus all women are subject to patronizing "parenting education" in their 48 hours in the hospital after childbirth regardless of their level of experience, their social background, etc. The examples given in the little pamphlets one gets in this "education" _clearly_ assume they are addressing a single-mother, black audience, but no one admits this, and all the mothers get the pamphlets. And the same, as you say, for treating all men as potential wife-beaters and the like.

I actually resented this statement and find it acutely repulsive that parents are unwilling to discuss items that are a serious concern to many. Being a patient in a "busy" practice where they push you out the door and aren't willing to ask these "questions" is a serious liability and if you knew anything about "liability" you wouldn't pass ignorant judgement. Pediatrician's ask these questions to acertain if there is a situation that to you may not seem serious but may be upsetting to a child. Or in other situations that one parent is abusive and the other is completely in the dark. It is not to say that some doctors that ask these questions are asking them in a manner that is unfitting and finger pointing. I understand that side. But look at it from a childs point of view. They feel intimidated by adults so if a parent or other person in their life is making them uncomfortable they don't feel they can talk about it. If you don't have the entire question, the entire exam would you want for them to miss the bigger picture? Cancer, diabetes, asthma, or the idea that the child HAS in fact thought of using the gun that dad has. (My husband has one and I have three children.) In the end I guess if you have a problem with these questions that physicians are asking; ask yourself Why am I so concerned about them asking them? (FYI if you aren't comfortable with asking questions of children or other patients maybe you shouldn't be a doctor.)

I just researched some of this information and I find that several people have had the same problem of doctors making parents a "suspect". If you find this happening it is not right! Doctors shouldn't be asking some of these questions (or at least not the way that they are asking them)and I know that some of these "wacko's" that put these guidelines out probably wouldn't agree on the insinuation of the specific questions. Physicians that I am aware of ask if there is alcohol in the house. Not if the parents drink. If there is a gun in the house. And if the patient is sexually active. I don't think being uncomfortably touched is a regular question. But it does sound like the doctor is a wacko not the AAP. I don't blame you for being upset if this is the case. Before the doc goes in with the kids alone with the doc ask what they are going to talk about. It is your child after all.

Rebecca, if you don't understand why a person would have a problem with a doctor's asking a child, on the basis of *no evidence at all*, if a parent was being sexually abusive, suggesting this out of the clear blue sky to an innocent child, then I cannot help you. "Look at it from the child's point of view." I am. Believe me, I am. No, guess what, perverted sexual behavior isn't like cancer. For goodness' sake! Now we are taking a "try to suggest it when there is no reason to suspect it for preventative and early-treatment purposes" attitude towards parental abuse of children, as if it were a hidden disease, like cancer? What a twisted idea. Parents, like everyone else, deserve to be presumed innocent unless there is evidence of guilt.

You resent my post? I resent your comment and your attitude. You are setting yourself up to be put into a nightmare situation by the medical establishment. But may it not happen to you, despite your foolishness.

I appreciate the clarification, but I disagree with even this modified statement. The Boston Herald article suggests that asking, "Does your father make you feel uncomfortable" _is_ suggested by the guidelines. You can take that up with the Boston Herald reporter and see if a copy of the guidelines can be obtained. It is intrusive to ask if there is a gun in the house. There I adamantly disagree with you and agree with Maximos, above. That is unprofessional and not an appropriately medical question. And finally, you betcha it's your child, and so you are not obligated to let the child be interviewed by the physician alone. And if you have reason to think he is operating with these guidelines and is going to ask questions about areas that you think intrusive, you should not send your child in alone with him.

I think I came off the wrong way with this subject obviously. I understand, like I said, what you are saying. These physicians who have asked these questions are suspect. They are too specific, the guidelines are meant to be generalized. I don't agree with a parent having to leave the room except that I was once a child and knowing my parents I felt I couldn't talk about somethings. They were very strict and unyielding in their beliefs. I really am trying to be way more easygoing and willing to talk with my kids about any and ALL subjects. I really don't agree with Doctors bringing up subjects that are not a concern in the first place. But I think that some societies overlook these things because they are "subjects" that are untalked about or people who look the other way. (And I am seriously sorry that I am so cynical that I believe this, trust me I have reason to) And the bigger picture I was referring to was the statement that someone made that go to a bigger practice where they are pushing you out the door not having the time to ask these questions. You want that patient doctor time, (but you hope they don't ask these questions) I have seen cancer overlooked in some cases until a doctor really took the time. Not saying that these questions should be asked in that manner. Maybe more like Has anyone you know talked to you or made you feel uncomfortable? Not has your dad done it or has someone touched you. They are too specific and leads a child, teenager, etc. to question their own trust in a adult or parent. The gun question again is a borderline question. I know there is issue with gun control, trust me I think the sane and able should have the right to bear arms. I grew up with a father who collected them and did a lot of hunting. I just feel that parents sometimes do overlook the safety hazards of guns and doctors are the most able to find if they are safely put away(they see them way more often and schools don't talk about it). After my son was at the doctors with me and I answered the question (not my son) I felt I was being blamed for having a gun but you know, I just overlooked it as another thing that I don't live up to like the medical and food standards they put on you with a one year old. Back to my point was that my son who knew we had a gun and I had never discussed it with asked where it was. That is frightening, to be asked and then aware that my son who is so smart would and could be unknowingly dangerously curious. It tipped me off, I should talk to him about guns. Do I think a doctor should know about whether you have guns? No. Do I think that they should know whether you eat breakfast with it resting on the table (now that is scary) or safely locked away? NO. Because ultimately we as parents are responsible for this. When my children reach the age for these "alone visits" I won't let it happen. Just so you know the doctors ask questions that are based off a printed sheet from the AAP. They are guidelines but not all the doctors do ask all these questions. (they actually aren't questions they are phrases or words to show them what to ask about. The doctors form the questions, therefore making them look really dumb and unprofessional. And they don't use the info for some "government" mass gun collection. THAT IS A HIPAA VIOLATION! Please don't get mad about my opinions cause it's like they say [end of sentence edited]

P.S. Sexual abuse is a hidden (secret, unknown) disease until someone finds out about it, right? Most victims won't talk about it or discuss it.

Here via Touchstone Magazine's blog "merecomments"

Here's your "no pediatricians" icon: http://farm3.static.flickr.com/2250/1807765618_62359e452e_t.jpg

And yes, I'll be cross-posting this to LJ. Maybe if enough parents grill their pediatricians we can nip this in the bud.

Thanks, Carbonel. How do people do those graphics things? I never know. Thanks for the cross-posting, too.

I'm not too hopeful about nipping it in the bud, as it's really been growing from bud to flower over several years. The questions about the guns apparently started a few years ago. Now they are expanding their repertoire. And, once again, this isn't just a sort of spontaneous grass-roots movement among pediatricians. Given that the suggestions for kid-grilling are apparently coming from their professional organization, many risk-averse pediatricians are going to feel constrained at least to touch upon all the subjects in The List. It is quite striking to what extent medicine in the United States is governed by pre-set protocols. You have to ask such-and-such questions. You have to push such-and-such screenings, etc. This is visible in many branches. Sometimes it's relatively innocuous, as when any ob-gyn feels morally bound to push a mammogram each year even when a patient has refused it in ever previous year. Why does he do that? Because his pre-set protocols require it. At that point, the question becomes what set of protocols one's particular doctor feels bound by.

I felt compelled to write. Having a sixteen year old and six month old son, I have re-entered the world of baby well visits. The nurses have been the inquisitors in my case and while the questions always start down a logical path, they have been becoming stranger and more intrusive with each visit. From how many diapers to how many bottles to do you own pets. Pets? Well okay. Perhaps they are concerned with allergies. How many? Breed? Oh come on. At the next visit I got the gun question. Do you own a gun? Um, yes. Is it kept in a gun safe? Uh...Is it loaded? You get the idea.
Ultimately I refused to answer and I am switching doctors. I have been advised by friends and family to lie to the doctors. I don't like to lie and I don't like my privacy invaded.
How Orwellian is the world today?
It isn't about the gun for me. I sold my last one when my oldest son was a toddler. I resent the hell out of the implications.


Thanks for commenting. I think you are right to refuse to answer and also to switch doctors. The best advice I can give is this: Switch to a family practice rather than a pediatrician. Try to get a recommendation from friends for a family doctor. Third, _only take your baby to the visits when he actually has to go_. That is, if you want the shots recommended at a particular age, then you have to go at that age. But if there are no shots recommended at some given six-month period (or whatever), or if there is some flexibility, then go as few times as possible, combining shots when possible to make fewer visits. Finally, do not get onto the "yearly physical" track with your child once he has all the shots you are getting for him as a baby. Once you are on record as bringing him in once a year when he is perfectly healthy just for the heck of it, they will wonder why you don't if you stop. And when the child becomes a teenager and is brought in for a yearly physical, or even a pre-teen, they will most likely have a list of topics to discuss and such that could be inappropriate, and they may try to exclude parents from the visit. Nature abhors a vacuum, and a visit that has no actual medical purpose will probably end up with content you don't like, provided courtesy of some group or other. If the doctor suggests a yearly physical for a perfectly healthy and normal child, just say something non-commital and don't make the appointment. There should be a reason to take a child to a doctor. One of the nice things about a large practice is that if Doctor A says something that makes you uncomfortable, the next time Junior has an ear infection, you can call the anonymous girl at the switchboard and make an appointment with someone other than Doctor A. Eventually you may well find somebody low-key and laid-back that just treats Junior for whatever is wrong and who is perfectly professional and doesn't give you a hard time.

I am a little late joining this conversation, but I just received an email link to this article. As I read the article and all of the comments, the same questions kept coming to mind: why would you ever let your child be in the room alone with a nurse, doctor, etc.? Even if you have known the person all of your life, do you really trust them with your precious child? Even into their teen years?

I loved my childhood pediatrician so much that he felt like a second father to me. I was a sickly child, and we saw him a lot. As a teenager in foster care, then a teenager on my own, I often went to his office by myself. I trusted him, and nothing ever happened because he was (is) a wonderful man. I was 19 the last time I visited his office as a patient and he told me he couldn't see me any more because I was getting married, and with a chuckle he said my insurance wouldn't pay for a married woman to see a pediatrician. I laughed and cried at the same time.

I look back and realize how TRULY BLESSED I was that my doctor was a wonderful man and that nothing happened to me! That very well could have been a horrible situation, given the state of this world. I could have had a doctor who was unscrupulous, who could have molested or raped me. My children will NEVER visit the doctor alone until they are of age and out of my home. It is my job to protect them, and you never know when that protection is needed. And you can rest assured that if someone at the doctor's office asks questions that are inappropriate or that I don't like, I will thank God that I am an American and can choose my own doctor as I call my insurance company to find a new provider! That's what protecting my children is all about.

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