The childless pediatrician: A parent’s worst nightmare?

“Do you have any children?”  I am asked this almost daily by families and parents of my patients, often as a means of small talk at the beginning of the visit, but more so at the end of an in-depth discussion, whether it be etiology of disease, prognosis, further lab tests, imaging, or suggested treatment.

I would be lying if I stated this question does not trouble me, usually producing strong feelings of inadequacy and sometimes fear. Does this parent feel I am incapable of caring for her child if I do not have kids of my own? I usually respond directly and honestly that no, I do not have children, but I do have several nephews and a niece that I love and cherish dearly. I then find myself intently watching their faces, desperately attempting to interpret their feelings regarding my response by analyzing a furrow in their brow or the small movements of their mouth. Will they smile and change the subject (I hope) or probe further?

Frankly, I have never asked the parents of my patients if being a non-parent influences their perception of my capabilities as their child’s physician. I imagine I would receive a wide array of responses, some that would reaffirm my efforts at appearing the most confident and competent that I can be, often when I am struggling inward. Other parents’ answers may leave me feeling inept, allowing all my anxieties to bubble to the surface of my mind’s awareness. When discussing this with a fellow physician and dear friend, she reports that prior to having a child, it did not seem to be an issue, but she now feels it is imperative for her baby’s pediatrician to also be a parent.

My concern that parents will not take me seriously as a physician and non-parent becomes palpable, at times, during well-child checks. I lack the experience and intuition that comes with the many sleepless nights trying to calm a colicky newborn. I have never had to childproof my home or deal with the daily tantrums of a self-centered toddler. I have never struggled with the concept of “being consistent” when it comes to time-outs and revoking privileges, and I have certainly never had to live with an unruly, opinionated teenager. How in the world do I provide advice when I have never done it? Do my war-weary parents, therefore, take my recommendations seriously or chalk it up to a young girl doing her best to appear knowledgeable in her somewhat ill-fitting pediatrician hat?

Despite these many fang-bearing worries that go bump in the night, I find myself circling back to the core of my being and existence. I absolutely love children, regardless of whether I have my own. Kids are the reason I pursued medicine and have fueled my persistence on this journey to completing my residency training, and being a non-parent does not alter my commitment to doing what is absolutely best and safest for my patients and their families. My hope then would be that my families would not focus on whether I am also a parent, but instead on the level of care I provide for their children; a level of care that I trust another pediatrician would one day give to my future child.

Allison R. Roland, M.D.
Chief Resident in Pediatrics
OHSU Doernbecher Children’s Hospital 

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Comments

  1. Having two sons of my own, I would have to say that I have never approached their care by inquiring from their doctors, “Do you have children?” Instead, I paid attention to how my children were approached, talked to, tended and their comfort with the persons with whom I entrusted their care. I can honestly say I haven’t a clue whether the doctors charged with their care through past years had children or not. But I can say I felt they were in excellent hands.

    If parents are going to earmark doctors without children as incompetent then perhaps the doctor is lucky not to have been given the responsibility of caring for that parents children. Like parents, there are both competent and incompetent doctors, so I would make this recommendation: parents search wisely and let your children show you how comfortable they are with those who care for them. Children tell you a great deal with their reactions and mannerisms.

    As the doctor, I can understand the regard for the feelings of parents of your patients and the hope they will accept you although you are childless, however, you must have confidence that you are doing everything in your power to treat every child with the best care possible. After all, as has been said, “The proof is in the pudding.”

  2. I think I’ve inquired of my son’s pediatrician in the past about whether or not they have children, but moreso as a means of small talk. I wouldn’t think less of a pediatrician for not having children any more than I would a male obstetrician for not having a uterus or an oncologist without a personal history of cancer.

  3. As a pediatric intensivist, I often am in the position of working with families in extremely difficult times, frequently helping them make decisions about life and death. I have been asked if I have children. I tell them honestly that I do not, but that I have helped hundreds of families in this same position. It is not my job to be a co-parent, but to be their doctor and give them the benefit of that knowledge and experience.

  4. Hi, I came to this link through Laura Carroll’s FB page, “Childless by Choice”. I had such strong feelings about this that I decided to comment here (With fewer expletives…):

    Your job is to diagnose and treat maladies in children – NOT have and/or raise them! What PARENT would know how to look for signs of Rubella? Is the baby’s excessive crying due to Colic, or something worse? If a child seems to have frequent attacks of vomiting, pain and panic, would parents even know what Cyclic Vomiting Syndrome is?? (Full disclosure, I have CVS and Jesus FC… since it’s rare and considered wrongly as a “Pediatric illness”, though it is mostly prevalent in children, more adults are being diagnosed.)

    With the attitudes of these parents, it’s like demanding your doctors actually GO THROUGH an illness themselves! That should give some perspective to parents. It’s THEIR job to raise the child, it’s YOUR job to heal them. The idea is so absurd – not trusting a doctor because of her lifestyle choice rather than trusting in their, oh, I don’t know – MEDICAL EXPERTISE??? Ugh, and I thought my opinions of the pronatalist community couldn’t get any lower.

    Hats off to you, and good luck in your field!
    -Ash

  5. In a response to this post, and in part to Ash, I would say that, while I trust pediatricians I’ve seen who do not have children, ones that do will be better able to empathize with parental struggles and emotions, and may give more credence to parental instincts on what might be wrong with the child when faced with an uncertain differential diagnosis.

    Additionally, pediatricians often given advice on the care of children (feeding, sleep, etc. etc.). An experienced pediatrician will know that the standard evidence-based advice can be difficult to follow for various real-life reasons. If I feel the doctor just doesn’t understand our home life and other struggles, I realize that the medical and care-taking advice may not be as personalized as it could be.

    However, some of my friends who know the most about infants and children are themselves childless, but simply have spent a lot of time caring for and loving them.

    In summary, I’m fine taking the advice of pediatricians who are young, inexperienced (comparatively), and childless, if they are also willing to learn from their patients. Ask the parents questions about what they have heard works, or found works!

    For instance, if nursing in the middle of the night, it’s sometimes impossible for a mom who falls asleep to wake up and place the baby back in the crib. If you’ve been an exhausted nursing mom, you would know this first hand. However, the partners of some new moms ensure they partner to put the baby back after nursing. I can read a pamphlet for generic “back to sleep, firm surface, close-fitting sheet, no other objects in crib” advice.

    I’ve found that sometimes, the most inexperienced doctors come across as the most arrogant, simply because they do not feel that the patients will respect their medical advice/authority. Ask questions, learn from your patients, and communicate clearly and this will not be a problem. The best doctors explain carefully and do not mind being questioned or even challenged until trust is established.

    I’ve had the best male OB. I LOVE him. I know he didn’t experience pregnancy firsthand, but he was knowledgeable, dealt with all my questions carefully, and talked through his decisions rather than thinking I didn’t need to know information about my baby and body. He wasn’t paternalistic. He was my partner in health. That’s the key.

  6. And here Elaine proves my point about childfree stigmatism. The job of a pediatrician is to TREAT children, POINT BLANK, FULL STOP. Parents can often hinder doctors by insisting they know what is wrong with their child. Pediatricians are TRAINED in SO many different areas of childcare and symptoms and treatment that it baffles me, truly, that ANY parent would claim to know more than their doctor. That is the absolute height of arrogance.

  7. In my experience as an FNP, my ability to relate to my patients and give practical medical advice changed significantly after I had children. While it is still possible to give caring, evidence based guidance to families with children, there is certainly an element of compassion and understanding that comes with experience. When giving behavioral advice, this certainly helps prevent judgmental attitudes toward our patients.On the other hand, health care providers need to provide objective care and not base treatment on anecdotal personal experiences. One does not have to have had cancer to be a good oncologist. Our patients know when we really care, and this is what matters most.

  8. Is this about how parents view childless pediatricians; or about the fears and trepidations of childless pediatricians?

  9. Don’t worry about what others think god gave you a gift use that gift to help others and be proud of who you are and what you have accomplish in your life being a doctor is not a easy job your very blessed to be where you are.

  10. I do not understand why a parent would have fears about a childfree pediatrician. Becoming a parent does not automatically grant you a medical degree, and wouldn’t all parents want to know that their child is seen by a well trained doctor? It does not matter whether the doctor has children, so long as they can accurately treat their patient. Yes, parents may have “intutitions” and “feelings”, but the pediatrician is the one who will be able to medically treat the child and care for them.

  11. Ash, you clearly believe in the infallibility of highly trained professionals. I don’t. I’ve attended enough M&Ms to know better.

    The best, most highly trained professionals listen carefully to their clients, ask good questions, then bring their considerable knowledge to bear to find the best solution. It’s teamwork, not arrogance. Pam summarized perfectly.

  12. It takes a lot of courage to write about this openly. Thank you, Dr. Roland, for writing this essay and allowing the OHSU community to make comments.

  13. Thanks, Dr Roland for a thoughtful and insightful article.

    My daughter is grown now, but honestly, not having children of his/her own was never an issue with me when it came to my daughter’s care. I figured if you don’t have kids of your own, you just may have some extra time to spend with mine!

  14. Allison,
    I have done this both ways, before I had children and after. I think an excellent doctor is an excellent doctor, regardless, and you are an excellent doctor.

  15. Allison,
    Thanks for your insightful article. You write very well and with sincerity and empathy.
    Years ago I did an interview for a national parenting magazine. Subject: How do you choose a pediatrician?.
    Among many other criteria, I said that all things being equal, find a pediatrician who is also a parent.
    When the article was published I received several letters from single, gay, and childless pediatricians objecting to my comments.
    Through the next decade, I received several personal letters from those same pediatricians who had become parents in the interim. Each expressed the same thought: “In my mind, I am a better Pediatrician since I’ve become a parent.
    Just another thought from a senior (mature) pediatrician.

  16. I haven’t gotten asked this question since I completed my fellowship. Maybe I just started looking too old to be asked.

    You could try – for a week or two- to simply reflect the question back to the parents. Might be interesting to learn what their motivations are. That way you don’t have to guess, and possibly wrongly guess what drives the question.

  17. Having children makes you a better pediatrician. Pediatricians I have worked with who were good pediatricians became better pediatricians after having kids.

    Why? Because the majority of my day as a general pediatrician is not in diagnosing illness but in helping parents to parent. Frankly that is not training I received as a resident. Most of it was OJT.

    Only after you have kids and began to realize the challenges of parentling and how one thing works for one child and not for another do you come to truly empathize with the parents of your patients.

    How do you capture that experience if you don’t have kids? Listen to your experienced parents. Ask them what works in difficult situations – temper tantrums, kids that won’t go to bed, children who fall apart at the drop of a hat, kids who won’t stay seated at the table during dinner. Accumulate those stories and experiences and then when the situation comes up, you can say, “An experienced parent once told me that what worked for her was… You might give that a try.”

  18. Women go to male gynecologists and don’t seem to have a problem with it, so why should parents have an issue with you being a pediatrician?

    Thank you for writing this blog post. I wish you well in your practice.

  19. The worst experience I ever had with a pediatrician was with one who was a parent. She was trying to extrapolate her experiences as a parent to mine and was greatly insulting. She was condescending in a way that no other doctor I’ve ever worked with has ever been. It’s never occured to me to ask if any of the other pediatricians have been parents, because it truly doesn’t matter.

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About the Author

Tamara Hargens-Bradley is Associate Director of Media Relations for Oregon Health & Science University, OHSU Doernbecher Children's Hospital. She is the editor of the Healthy Families blog.
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