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Dear Adoptive/Foster parent…

In medicine, we face new situations every day.  No two patients and families are the same.

The 3 children I saw with ear infections this morning all had different symptoms: one was fussy, the other had fever and the last cough and runny nose.  Patients and families not only have different medical stories, they have different personal stories.  Just this week, I’ve seen babies with mom and dad, mom and mom, grand-ma, foster mom and adoptive mom.  One of these situations is particularly close to my heart: adoption.  I’m sure I have said some stupid stuff to families in the past but the important thing is that I’ve learned some things along the way and I will continue to learn going forward.

Just like any other “type” of family, I’ve dealt with adoptive families that are really easy and really difficult, fun and hard.  There are some characteristics of those that make my job easier.  Here are some things I’ve noticed that you can do to help me take care of your child better.

Be honest…

There’s no reason to keep something from me.  It’s my job to take whatever is going on, apply my filter as a doctor to the situation and come out the other side non-judgmental and as an advocate for you and your child.   Whether it’s something difficult about your child’s past or something particularly tricky that is going on in your house, I need to know about it so I can help you in the best way possible.  I’ve particularly seen foster families try to paint a rosy picture because they constantly feel threatened on all sides (bio-families and their agency).  All the while, their child is struggling with ADHD, learning or other behavioral issues that I could have helped them address had they only asked.

“But wait,” you say, “you don’t know my doctor.  I’m afraid they’ll turn me in for (x, y and z).”

There are 2 answers, you’re either doing something wrong that deserves to be reported or you need to find a new doctor.

Be direct…

If there’s something that you think your child needs ask directly for it.  This strategy is useful for any child but, I think particularly important for adoptive children.  I think this is best addressed with a particular example.  If an adoptive family comes in with a new child who is delayed in some way (especially speech), I commonly take the approach to wait a little bit and see what happens.  I’ve seen it happen so often that with a new environment, the child takes off and ends up catching right up.  This, however, is completely a matter of style and I don’t believe that there is a right and wrong answer about what to do.  So, if asked directly, I’ll certainly any request and either comply with the request or discuss and explain why I think a particular intervention (medication, therapy or otherwise) is unnecessary until you understand.

“But wait,” you say, “you don’t know my doctor.  They’ll get mad at me and think I’m demanding.”

There are 2 answers, you’re either asking for something ridiculous or you need to find a new doctor.

Be gracious…

All people say and do dumb things sometimes.  Medical professionals are people too.  There are certain things that might be unforgivable.  There are certain statements and situations that are so hurtful you can’t go back to see someone again.  I’m pretty sensitive to parents and children but I know I make off-handed statements that are unintentionally hurtful.  My goal is that I’ve provided great care to you before and/or I’ve shown you enough of my heart that you realize I didn’t mean to be hurtful and I do love your child.  Extending some grace when you are able provides a great opportunity to teach people some of the insight you have about how an adoptive family thinks to someone who has never considered it.  Maybe they won’t say the same thing again to someone else.  Maybe they’ll explore a hidden prejudice that they didn’t know they had.  Maybe they’ll just blow you off but you will have the satisfaction of knowing that you tried.

“But wait,” you say, “you don’t know my doctor.  They’ll get mad at me and think I’m complaining and oversensitive.”

There are 2 answers, you’re either complaining or oversensitive or you need to find a new doctor.

You can find information about Dr. Smith’s practice here- (he is accepting new patient appointments to begin in March)

Follow Dr. Smith on Twitter! @TheDocSmitty

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