WhatsApp messages: relief for parents and nightmare for pediatricians

Technology has simplified life by shortening times, distances and even physical efforts, but it can also be harmful. That is what happens to pediatricians in relation to the use that the fathers and mothers of their patients give to the cell phone and in particular to the WhatsApp messaging system.

Overwhelmed with work due to the lack of specialists in the area, pediatricians also have to deal with cataracts of messages that arrive at all hours and that do not always refer to pertinent consultations.

In the middle is the health of the children, for which parents despair and pediatricians do not stop answering telephone inquiries.

“The WhatsApp thing is permanent, with sometimes unusual questions. There are doctors who directly have two cell phones and one is only for patients,” says Luciano Astudillo, a pediatrician and head of neonatology at the San Roque de Gonnet Interzonal Hospital (MP 103.628).

“I have been a pediatrician since 2003 and at that time there was a cell phone but privacy was maintained much more. Now it is impossible, messages arrive at all hours and 90 percent of the time the consultations do not require urgency, they can wait for the corresponding control”, explains the specialist, who recalls that in emergencies, you must go to a guard and not wait for the doctor’s response.

FIRST TIME DOUBTS

Of course, not all families fall into the same bag. “New parents are the ones who have the most doubts. But there are two types: the quietest and those who call you at 2 in the morning due to a fever. And there are also the grandmothers who have a lot of opinions and influence the consultations”, highlights Astudillo.

The specialists consulted explain that they answer the messages at a certain time of day, outside office hours to respect the families that are being cared for.

“It is very common for photos of diapers with fecal matter, bites, vomit to arrive. But common sense questions surprise me more, such as whether a child with a fever can go to a birthday party. That upsets us a bit”, says Santiago Silva Loiacono, pediatric neonatologist (MP 115.414).

“The most frequent thing is that they send ‘he has a fever, what do I do’ or ‘vomit, what do I give him’. And they are things that are explained in the first consultations”, clarifies Astudillo and mentions an alarming situation. “Many doctors are afraid of malpractice complaints when answering questions over the phone. The telephone consultation should not exist, except in special cases, ”said the professional.

According to the pediatrician, families send photographs and audio recordings, pretending that the professional makes a diagnosis based on this brief information.

“I don’t make a diagnosis by photos,” advises Silva Loiacono. I can’t list the number of photos of baby and child poop I receive, as if that alone could prescribe a treatment or medication. You need to see the patient because something very banal can actually be a more serious pathology. I prefer that they bring the boys to the doctor’s office, but many families are comfortable, they don’t want to be in the waiting room, ”he says.

THE TASK OF SETTING LIMITS

“I try to set the limits in the first consultation, I explain about the guards and what things they should be aware of. I keep my phone on until 9:00 p.m. At some point I have to rest, take care of my family, distract myself. People have to be aware that sometimes we are slow to respond, not out of ill will, but because we can’t keep up. We are humans, not robots”, stresses the doctor.

Silva Loiacono remarks that “in the first consultations I clarify that WhatsApp is not the ideal means to give adequate attention and that they can write to us in exceptional cases. But multiple jobs make us available, which does not mean that it is good because one has other activities and family. It is not possible to be available 24/7, but you have to dedicate time to respond to the needs of families. In my case, for example, I don’t hear audio. Therefore, it is good to use social networks to give information and general dissemination that can be useful.

To this, pediatricians add another issue that harms them related to telephone consultations: in our country there is no regulation on this type of care “which in 80 percent of cases ends up being a job similar to that of the doctor’s office. If a consultation bonus were charged, parents would only ask important things”.

CRISIS IN THE SPECIALTY

The doctors consulted believe that this alienating form of work is one of the causes of the lack of specialists in the area: “The constant demand drives professionals away. It is exhausting to spend 24 hours every day responding to patients. This leads many to choose other specialties. The vocation is in the office, not on the phone. We became a central figure in consultation as the family doctor used to be”, they graph.

“One is grateful that they place their trust and the health of their children in us, you end up becoming attached to the families,” remarks Astudillo, who to reduce his work pace stopped receiving deliveries, although the list of patients is always expanding for the recommendations and the little brothers of the children that he has been taking care of for years.

A PROBLEM THAT IS STUDYED

Rodrigo Matamoros, pediatrician and president of the La Plata Society of Pediatric Physicians (MP 113,949) says that there are works worldwide on this problem.

“We are not against technological advances, but the indiscriminate use of WhatsApp can interfere with the doctor-patient relationship. This type of communication has a lot of advantages but it never replaces a consultation”, he highlights.

“With WhatsApp, faces cannot be seen and what is written can be misinterpreted, which is why diagnoses or treatments cannot be given that way. It can be used to clarify something that was not fully understood in the office, consult vaccination updates or report the follow-up of a pathology already diagnosed, but nothing that requires an immediate response, regardless of the fact that people expect it to be answered instantly ” clarifies Matamoros.

For this professional, the problem, beyond the abuse of families regarding telephone consultations, occurs when the doctor makes a diagnosis and treatment by means of a photo without seeing the patient. “The health of the patient is put at risk,” he points out.

Faced with this problem of the bombardment of messages, the doctor analyzes that it is a “snowball: there are fewer and fewer pediatricians and that means that parents end up using WhatsApp to answer questions because it is difficult to get an appointment,” he says.

Along these lines, the doctor clarifies that he uses digital tools, “but emergencies are attended in the office or on guards. Who better than the family doctor to clarify doubts, that’s why I teach with patients in the office ”, she declares.