Three types of relationships tend to develop between doctors and parents.

Paternal. In a paternal relationship, the parent is submissive, and the doctor assumes a parental role. This dynamic may seem desirable to parents who are uncomfortable or inexperienced in dealing with medical issues, but it places all the responsibility for decisions and monitoring on the doctor. Although you may feel overwhelmed and nervous at the beginning, it is important to remember that you are the expert when it comes to your child, and you know best how to gauge his reactions to drugs and treatments.

I once asked a fellow about my daughter’s blood work. She literally patted me on the head and said it was her job to worry about that, not mine. I said in a nice voice that I thought it was a reasonable question and that I would appreciate an answer.

Some parents are intimidated by doctors and fear that if they question the doctors their child will suffer. This behavior prevents the child from having an adult who speaks up when something seems wrong.

Adversarial. Some parents adopt an “us against them” attitude, which is counterproductive. They seem to feel the disease and treatment are the fault of the medical staff, and they blame staff for any setbacks that occur. This attitude undermines the child’s confidence in her doctor.

I knew one family that just hated the children’s hospital. They called it the “house of horrors” or the “torture chamber” in front of their children. Small wonder that their children were terrified.

If you or someone in your family has had negative interactions with medical professionals in the past, it can be difficult to get past those feelings and work comfortably with doctors and nurses. The pediatric oncology world is often more collaborative and open to family input than other arenas of medical care. It’s helpful to find out which people are responsible for various parts of your child’s tests and treatments, and to try to get to know each of them. That way you can feel more comfortable asking them questions and will have a better sense of when care is being handled well. Also, if something goes wrong, you will have good relationships with the people you need to call on to correct it.

Collegial. This is a true partnership in which parents and doctors are all on the same footing and respect each other’s domains and expertise. The doctor recognizes that the parents are the experts on their child and are essential in ensuring that the protocol is followed. The parents respect the doctor’s expertise and feel comfortable discussing various treatment options or concerns that arise. Honest communication is necessary for this partnership to work, and the effort is well worth it. The child has confidence in his doctor, the parents have lessened their stress by creating a supportive relationship with the doctor, and the doctor feels comfortable that the family will comply with the treatment plan, giving the child the best chance for a cure.

We had a wonderful relationship with our daughter’s oncologist. He perfectly blended the science and the art of medicine. His manner with our daughter was warm, he was extremely well-qualified professionally, and he was very easy to talk to. I could bring in articles to discuss with him, and he welcomed the discussion. Although he was busy, he never rushed us. I laughed when I saw that he had written in the chart, “Mother asks innumerable appropriate questions.”

Another mother relates a different experience:

We tried very hard to form a partnership with the medical team but failed. The staff seemed very guarded and distant, almost wary of a parent wanting to participate in the decisions made for the child. I learned to use the medical library and took research reports in to them to get some help for side effects and get some drug dosages reduced. Things improved, but I was never considered a partner in the healthcare team; I was viewed as a problem.