Optimizing Care in Pediatric ENT: Clinical and Ethical Considerations When Families Are "Difficult"

PROGRAM DESCRIPTION: One of the most challenging things for many otolaryngologists treating children is not the formulation of appropriate diagnoses or treatment plans, but that of working with families that may make visits and the execution of treatment plans more laborious. This can be for numerous reasons, including differing cultural, language, social, economic, legal, and intrinsic family factors. When a family is labeled as "difficult," this can impact the patient's care and can be exhausting for the otolaryngologist.

This panel will explore several scenarios that can be experienced in treating a child with otolaryngologic issues with a challenging family dynamic that makes providing care stressful or a chore for the practitioner. We will draw on the presenters' experience from pediatric otolaryngology, public health, and ethics standpoints to provide attendees a better understanding of the root cause of the "difficult" family and pearls to permit optimal treatment without as much of a challenge to the clinician.

Scenarios that we will be touched upon include:
-When families are told by non-otolaryngologists that surgery is required though they do not meet criteria for a procedure
-Medically complex children
-Families lacking medical sophistication or literacy to understand the nature of their child's healthcare problem
-Mother-infant dyad concerns
-When parents cannot agree on a treatment plan
-Families that have a great suspicion of Western medical management and prefer treatments that may lack any scientific plausibility
-Scenarios in which consent may be required from the court or in which mandated reporting may be necessary

An audience response system will be utilized to create a more interactive discussion.

OUTCOME OBJECTIVE 1: Recognize factors that can make families seem "difficult" when caring for children as otolaryngologists: cultural, social, economic, and unique concerns of parents as healthcare decision-makers for their children.

OUTCOME OBJECTIVE 2: Understand ethical considerations in working with families of children with otolaryngologic issues

OUTCOME OBJECTIVE 3: Implement strategies as otolaryngologists to optimize the care of children with "difficult" families

BACKGROUND STATEMENT: Most otolaryngologists are comfortable with diagnosing and treating all manners of illness, but when a family is "difficult," it can lead to stress and challenges in achieving best results. Developing a strategy for these situations can improve care and patient and physician satisfaction.

Comprehensive Otolaryngology Track Statement : This is being submitted under care equity, quality, and safety area as communication with the patients and their healthcare surrogates is a necessary factor in informed consent and achieving best healthcare outcomes.