Culture Shock: Baby Clinic

As our little family is finally recovering from a season peppered with everything from bloody noses to terrible viruses and bug bite induced Emergency Room visits, I thought it finally time to circle back to a topic I have been avoiding for quite some time…the Baby Clinic.

Despite best efforts and an eagerness to adapt; learning and using new systems and processes can be frustrating, confusing and overwhelming.

It seems the UK health system has been a conversation piece for many years across, at least, the US. Comparisons have been drawn and suggestions or criticisms made as the US has examined and re-thought its own process. I should have a basic understanding of what happens over here, right? WRONG.

If you know me, you know that my relationship with all things medical is, well, as close to non-existent as you might be able to get these days. Somewhere between my inability to handle anything resembling a needle without passing out (ah, yes, I was once again a great source of giggles to the nursing staff as I lay on a hospital bed – tilted upside down – panicking while I passed out back in December…there’s a reason I stay away!) and more allergic reactions to migraine medicines than I think any body should encounter, I’ve opted to stay away from doctors whenever I can. And along with that, I think my brain has chosen to glaze right over all of these medical topics in protest.

Having a baby has forced me to read more, ask more questions and face my fears, and E’s pediatrician in Charleston was absolutely wonderful as I began my new journey. From reading materials to a very clear “well-visit” examination calendar, I was feeling confident about the expectations and subjects. Appointments were set up months in advance, and the office was available for emergencies and questions at any hour of the day. Dr. Herring saw us at each appointment and developmental milestones were covered with each meeting.

Then we moved to London.

With list in hand, I immediately set to work on finding a pediatrician. I phoned several offices and heard everything from “we don’t take that insurance” to “we don’t see children for vaccinations” (ummm…you’re a PEDIATRICIAN’s office?!) to “have you been seen by the health visitors?” (I’m sorry, who might they be?)

Looking back, I can see that all of these comments and questions were quite valid given the UK’s system; however, for someone new to the game, I found myself feeling lost and insecure about how to move forward once again. It could certainly be said that this was my greatest encounter with Culture Shock since moving to the UK! I mean, for goodness sake, I’m just trying to make sure we have a doctor on call for our little girl! Can’t someone just offer a little bit more color on the “whys” or “hows” of all of this?!

After taking a deep breath, setting aside my frantic confusion and coercing several people to stay on the phone longer than they would have liked, I was able to step back and be more accepting of this crash course I was getting on my baby’s healthcare in London.

Curious about how the system works in this part of the world? Here is what I’ve learned:

U.S. version of a Pediatrician = General Practitioner + Health Visitor in the U.K.

• The Role of the General Practitioner’s Office:

In the UK, the whole family is registered with the General Practitioner’s (GP) office in your neighborhood, and the GP offices host “Baby Clinics” once a week to care for your little ones. (Pediatricians are on a referral-only basis, and as far as I can tell, function more as a second opinion than your initial go-to doctor.)

These Baby Clinics are run by groups of rotating “Health Visitors,” or nurses (learn more about them here – they play an essential role in your child’s healthcare in the UK!), and serve as the designated time for all of baby’s “well-visits.” Ours, for example, is every Thursday from 1-3pm.

The drill for well-visits? (More detail on this later, but for immediate clarification – know that a “well-visit” in this sense is purely MEDICAL!) You show up when the clinic opens, get in line, and let the front desk know which “services” you’ll need that day – measuring (weight is standard, however, to get height or head circumference measurements, you’ll need to make a special request once you’re in!), vaccinations and/or a visit with the GP.

At first, I was a bit lost, but as I thought about this concept I actually found it to be a relief – no appointments to book ahead of time (or re-book!), a quick in-and-out appointment if you can get there early on and just need a weigh-in or vaccination, and a last minute option to see the GP, if you find yourself questioning something on the way to the clinic! I was feeling pretty proud of myself for seeing so many positives in something so drastically different from what I had known.

I’ve become a tad wiser since I attended my first Baby Clinic – you learn things such as all new moms are able to schedule their 6 week appointments ahead of time for this window, so if you sign up to meet with the GP for your older baby when you arrive that day (as is the process!), you’ll be waiting in line behind these sweet little ones…even if they’re 30 minutes late to their appointment. And having your baby measured and weighed in the middle of the waiting room can be a bit strange when she fights the dreaded diaper re-do.  On a good day, this system is fabulous. In and out, no problem! On a bad day, this system can be pretty darn painful. Thankfully, it seems to balance itself out in time…

The drill for sick-visits? Just give your GP a call, like you would the Pediatrician at home! A few little tips I’ve been told over and over again? Call as soon as the office opens, and yes, it’s urgent, if they ask!

• The Role of the Health Visitors’ Clinic:

Health Visitors will typically contact a family to arrange a home-visit (that’s right: IN-HOME-visit. TOTALLY intimidating, actually not so painful) shortly after a baby is born in the UK. My understanding is, for families moving to the UK, the Health Visitors should become aware of you as a child is registered with the GP’s office. The process, in our case, was unfortunately a little less cut and dry. E did not reach the nurse’s radar until we physically attended our first Baby Clinic — without our oh-so-essential Red Book! (EEK!)

During the home-visit, the health-visitor will cover topics such as child safety (outlets, bedding, cabinets and chemicals, etc.), doctor’s offices available in your area (GP, dentist) and children’s activities nearby.

Likely the most essential part of the meeting, however, is the hand-off of the famous Red Book – the official record book of your child’s medical existence, if you like. It will hold information about every vaccination, milestone check-up, height and weight measurement and just about everything else you could possibly write down. The book will also outline vaccination schedules and milestone check-up timings. It takes some time to dig through and understand the information, but for those of us so far outside our comfort zone with the UK healthcare system, this booklet is amazingly helpful! It’s also a bit of an archaic system – all is hand written and copy slips are pulled out for the doctor’s records; however, it is an easy way to keep all of those details maintained in a single place!

Also a key role for the Health Visitors is Milestone Check-ups or Developmental checks. While these were always conducted right along side vaccinations and other components of our well-visits in the US, these are done at the Health Visitors office and are not considered a well-visit or located at your GP’s clinic in the UK.  Your baby will get another weigh-in in addition to some play time and conversation in the nurse’s office for these appointments!

This may have been my greatest and most frustrating learning point in the baby-doctor-learning-process. You’ll quickly see what I mean if you move to the UK, but you’ll receive a mailing about every. last. thing. you can imagine! (It’s no wonder the Royal Mail is alive and well!) So somewhere in one of those piles, I received a letter regarding E’s one year check up. I saw it, I read it, it likely made no sense to me without the appropriate context. So, the day before E’s first birthday, I packed up and set out for the Baby Clinic to get her vaccinations, measurements and a well-visit in with the GP.

Turns out, after two hours of waiting for the GP visit with a screaming, tired child, that the GP will not see your child for what I would consider a “standard check up.” That falls completely under the Health Visitors jurisdiction and requires a separate appointment at a separate location (that also happened to be a considerable distance beyond our GP clinic. Keep your eyes open for these letters and follow the directions…even when you don’t understand what on earth its for!! The letter supposedly clarified location and purpose of the visit…#momfail #ireallydidn’tgetit. Do make sure you ask questions once you have them on the phone, of course J). So always keep in mind:

General Practitioner = MEDICAL

Health Visitor = GROWTH & DEVELOPMENT

I can’t claim to be an expert on the UK medical system or even that I want to understand all of the nuances of the process – all I can do is share my experience and learnings. Hopefully, they do provide insight into what the process might look like for anyone preparing for a move and a good deal of comfort in knowing you’re not the only one to stumble through a new process like this one! Topics like your child’s healthcare bring such underlying stress and urgency with them that can quickly become amplified when you add in a little confusion or lack of sympathy for the situation.  Just remember to keep asking questions until you get answers that make you feel more comfortable and keep an open mind when it comes to learning a new way of doing things!

My heart goes out to all of the mamas out doing life in a new place with little ones.  It’s not easy, but the bigger picture is always worth it in the end!