S P E C I A L F E A T U R E
Attitude is the Key to Working with Health Care Providers
The Court Report featured articles in the last two issues detailing circumstances whereby home schooling families faced being reported to Child Protective Services (CPS) for failing to comply with medical recommendations. On reading these articles, my thoughts drifted back to a couple of home schooling families in my own practice who chose to pursue a non-traditional approach to medical care for their children. In both circumstances the parents had opted to forego the usual childhood immunizations. One family (family A) politely refused the standard regimen, stating their concerns for both short-term risks and potential future complications. The second family (family B), by both word and demeanor, demonstrated an attitude of distrust and disdain for the medical establishment and failed to articulate a sound rationale for their decision. While both families A and B communicated the same message, A parted with my blessing, while B managed to generate within my carnal heart the same distrust for them that they so obviously had for me. Now I did not, and would not, report them to CPS; however, someone less sympathetic to parental rights may have.
Using these examples as a backdrop, let us explore why home schooling parents sometimes find themselves at odds with the governmentally sanctioned powers that be, and then discuss some practical tips for avoiding these conflicts.
Because of the lawsuit mania that has gripped our nation for the last decade, physicians have become a paranoid bunch. Nearly every decision we make is framed in a consciousness of potential legal ramifications. Since laws now require physicians to report any suspected cases of abuse and/or medical neglect to social services, most doctors have a low threshold for reporting parents to the authorities when parents choose treatment options at odds with standard medical care. Whether we like it or not, we physicians now bear ultimate responsibility for bad outcomes when parents choose to ignore standard medical advice.
Having ascended the educational ladder and having been reminded by everyone from grandma to Hollywood that doctors are pretty special, its not easy for physicians to have their expertise and credibility questioned. In fact, to be told by a patient Thanks, but no thanks in response to your best medical judgment can be downright irritating. With the intense pressure of our current legal arrangement coupled with the innate human tendency of a prideful spirit, there is little wonder that the number of social service cases referred by doctors is so great.
And pride is not merely a sin of physicians! Home school parents, anti-establishment by nature and buoyed by their childrens behavioral and educational success, can also be prone to a haughty spirit. The rejection of advice because of a heartfelt conviction is generally well received by physicians. Unfortunately many of us adopt an I dont want to and you cant make me attitude when presented with medical advice. This approach can only serve to generate an adversarial relationship and is not honoring to God (Romans 12:18).
History certainly teaches us that those who think, act, or look different than the norm always face pressures to conform, are discriminated against, and are even hated. While home education is certainly growing in our country, we still are a distinct minority. We can expect no better treatment than other minority groups have received, and perhaps worse, since many of our number claim the name of Christ (John 15:18-19).
We have so far discussed a few reasons why parents (and particularly home schooling parents) may find themselves at odds with the medical establishment, thereby running the risk of CPS referral. Now let us analyze how we might avoid those pitfalls.
Obviously, to completely avoid medical care is unwise, comparable to throwing the baby out with the bath-water. When simple home remedies have failed, a parent should not hesitate to ask for help. It is most helpful if parents know their physician, and have a trusting relationship with him prior to needing urgent care. Discuss openly with your family physician or pediatrician your personal beliefs regarding such issues as immunizations, antibiotic usage, and the ultimate authority and responsibility of parents in the medical decision making process. If your doctor is uncomfortable with your views, it may be wise to look elsewhere for medical care. It is not unreasonable to ask for an appointment to interview a new physician, prior to seeking care (but be prepared to pay for this visit, since the doctor is taking time out of his schedule to answer your questions).
What if you find yourself in the emergency room, not having had the luxury of a pre-established relationship with the health care provider? Under these circumstances, basic rules of courtesy and respect are key. You have come seeking help; be open to the recommendations offered. If these recommendations dont square in your mind with rational therapy, ask questions and give the physician an opportunity to explain. If you are still unable to see eye-to-eye, politely ask the emergency room physician if he would be opposed to your seeking a second opinion (from your family physician for example). It would be rare indeed for an appeal of this type to be denied. If your consulting physician agrees with the treatment program recommended by the emergency room physician, and unless you are strongly convicted otherwise, it is probably best to go with the flow. If your consultant disagrees with the emergency room physician, its his neck on the line and not yours! When parents simply refuse care and shoulder the responsibility alone, the urgent care provider is placed in a precarious legal position. This may trigger a phone call to the local CPS agency in an effort to protect his own legal interests.
Lastly, the fact that your child is home educated is probably of little historical value to an urgent care provider. We ought to not apologize for choosing to teach our children at home. It is both a great privilege and, in my opinion, a God-given responsibility (Deuteronomy 6:5-7). However, given our earlier considerations of human prejudices, it is generally best not to advertise our educational opinions in an urgent care setting.
The threat of CPS referral is real, but we must never allow a man-made institution to deter us from our God-ordained parental responsibilities.
Providing appropriate medical care for our children is one of those responsibilities. We need only continue to seek His protection and wisdom in these matters.
Rodger and Mary Ellen Sayre are the parents of nine children and have been home schooling since 1984. Dr. Sayre is a family physician and graduated from Jefferson Medical College in Philadelphia. He joined the HSLDA board of directors in 1997.