Consultations go badly for predictable reasons. The clock, mostly, and the fact that the most important question usually occurs to a parent in the car afterwards.
These twelve questions are worth writing down and carrying in. They work in any clinic. If a doctor is unwilling to answer them, that is itself useful information.
About the diagnosis
1. What do you think is going on, in one sentence I could repeat to my family? If it cannot be said in one sentence, ask for the sentence anyway. It exists.
2. What else could this be, and what would make you change your mind? Good clinicians hold a differential. Hearing it tells you how confident the answer really is.
3. Is this something my child will grow out of, live with, or be treated for and finished with? These three futures feel completely different and are often not distinguished explicitly.
About the tests
4. What will this test change? The best question on the list. If the plan is identical whatever the result, ask why it is being done.
5. What does the test involve for my child: fasting, needles, time, cost? You are the one who has to deliver the child to it. You need the practical version.
6. What does a normal result rule out, and what does it not? Normal is rarely the same as nothing.
About the treatment
7. What happens if we do nothing for now? Watchful waiting is a legitimate plan, and often the right one. It should be offered explicitly rather than discovered by default.
8. What are the side effects I should actually expect, and which ones mean I should call you? Ask for the second half of that sentence specifically.
9. How long will this go on, and how will we know it is working? A treatment without a defined endpoint or a defined measure of success is difficult to sustain and difficult to stop.
10. What does this cost in total: the medicine, the monitoring, and the follow-up visits? Cost is a clinical variable. A plan a family cannot afford is not a plan, and there is very often a less expensive route that works. Say so early; it is not embarrassing and it changes what gets prescribed.
About everything else
11. What should I tell the school? Almost every childhood endocrine condition has a school dimension: a hypo box, a toilet pass, a PE adjustment, an exam accommodation. Ask for it in writing.
12. When do I come back, and what should bring me back sooner? Never leave without both a date and a list of red flags.
On second opinions
Ask for one whenever you want one. Any clinician who has been in this speciality for long has had a colleague spot something they missed, and knows it.
To make a second opinion genuinely useful rather than a repeat of the first, carry:
- Every previous report, in date order
- The growth records, including the old ones
- The current prescription with exact doses
- A one-paragraph summary in your own words of what has happened so far
What you should not have to carry is the cost of repeating investigations that were done properly two months ago. A good second opinion starts by reading, not by re-ordering.
Written for parents of children under endocrine care anywhere. Please take it with you wherever you go.