What More Do You Need From Your Child’s Doctor? with Guest Dr. Elham Raker

Nellie Harden: 00:00:04

DHello and welcome to the 6570 family project podcast. If you are a parent of a tween teen or somewhere on the way, this is exactly the place for you. This is the playground for parents who want to raise their kids with intention, strength and joy. Come and hear all the discussions, get all the tactics and have lots of laughs along the way. We will dive into the real challenges and raising kids today how to show up as parents and teach your kids how to show up as members of the family and individuals of the world. My name is Nellie Harden, big city girl turn small town sipping iced tea on the front porch mama, who loves igniting transformation in the hearts and minds of families by helping them build self love, discipline and leadership that elevate the family experience, and sets the kids up with a rock solid foundation, they can launch their life on all before they ever leave home. This is the 6570 family project. Let's go Hello, everyone. Welcome to another episode of the 6570 family project podcast where we are putting aside the power struggles and really finding the path to lead our young women toward confidence, respect and wisdom that they need in order to prepare them for the world. And today I have a very special guest on today Dr. Raker, who is a board certified pediatrician and parent coach. And over the span of her career, she's really worked in many different clinical settings, hospital patient care, urgent care, private practice, and even making house calls. And today, she loves interacting with people through telemedicine and also coaching parents. And her platform is called Ask Dr. Mom and that is where that was born. Telemedicine virtual coaching and it really helps the overwhelmed parent find comfort in their home by providing trusted information. And so, in this discussion that we have today, we really cover three amazing conversations about how medicine is being transformed a bit right. And this whole idea of telemedicine is coming onto the scene much more than it ever did before, thanks to COVID and what that means and what that looks like, and what is okay to use in telemedicine and what is good for an office visit, right? So we talk about that we also talk about for our young women in particular, but really all have our teens how to and when to transition from the pediatrician to the quote unquote, adult office, because you and I both know that when you take your 1314 1517 year old into the pediatrician and they're surrounded by you know, Disney characters, they don't really feel open to discussing really what needs to be discussed in the doctor's office. So we talk about those things and when and how to do that. And then also, if you have kids like I do, that are maybe interested in medicine in the future. How do we have those discussions with them? What can we say now in order to prepare them for the decisions that they'll have to make later. And Dr. raker really goes through some discussions that she wished she wishes she would have had before she went into medicine and how it would have helped even better equip her and set her up for for her success. So I cannot wait to get into this discussion. So without further ado, let's go ahead and welcome Dr. raker. Hello, everyone. Welcome to another episode of the 6570. I have already given you some details on Dr. raker. And I am just so excited to have her on today. And so welcome.

Dr. Raker: 00:03:59

Thank you for having me. Absolutely.

Nellie Harden: 00:04:02

And I love speaking with you know, as a mom, I have four kids, I love speaking with doctors and pediatricians to get some insight as to what trends you're seeing what your kind of medicine is. And I'm going to get to your story in a second because you practice medicine in a very unique way that I think there is definitely a trend going toward and we even had an incident not too long ago that I'll share with you a little bit later that we needed something like that. And so I just want to start off with just having you share your story. How did you get to where you are today you are a pediatrician, but you also do telemedicine and you're also a parenting coach and I want to just hear how did all of those pieces come into play in order to get to you to where you are right now?

Dr. Raker: 00:04:51

Yeah, that's an excellent question. So I been practicing for almost 20 years. And in that time, my husband's also a physician, and we met, and he was starting his training. So his training was a bit longer than mine. And I ended up just kind of following him through his journey, which meant that I have moved around a bit and did a lot of different jobs. So I worked in the hospital, I've worked in urgent care, emergency room, outpatient, inpatient, different types of outpatient settings. And last, my last stint was working for home health care. So I really got to get a breath of, you know, the different types of care and how we provide care and what I liked about it, what I didn't like about it. And what I really felt like was missing was a connection between the pediatrician and families. And now, not to say that pediatricians aren't doing an excellent job because they really are. But for some parents, I felt like there was just something missing in those office visits, you know, they're just getting shorter and shorter. And it's just hard to cover everything. And it's hard for the pediatricians to from from professionally from our side, we want to answer all the questions. But we know we think you know, there's three other patients waiting, and it's just, you got to keep that flow going. And so it was just getting really hard to, for me personally, to connect the way I wanted and to answer all those questions. So that's how the telemedicine came about was you, you know, you're in the comfort of your own home. You can schedule it, you can find more time, right? I'm gonna have more hours in the day, I was able to go later at night than traditional office could available on weekends. So just more available and more time to really answer all your questions. And the parent coaching piece really came up during COVID When I just realized not just the telemedicine answering urgent questions, but I love counselling. I love coaching. And that was the other piece that was missing in the office. There just wasn't enough time for that. So I decided to go official and get certification. And it's been great. It's actually helped me a lot with my own kids that not that I wasn't expecting it to help with my own kids. But I didn't think I needed it. I did with my own kids. And I was like, Yeah, that was that was good. So I got to go through it as you know, a client, and then I certified as a coach. So it was an all encompassing program. And I just wanted to be there. I wanted to be there for families be there for moms, it can just be really lonely. You know, and you just think you're doing it wrong all the time. And I just want to come and say you're not, you're really not. There's a lot of different ways to do it. And you know, sometimes you just need a little support and guidance, but for the most part, like you are what your child needs.

Nellie Harden: 00:08:08

Absolutely. And I often talk about that with all of my coaching clients in my community and talking about how every family is unique, every child is unique. And so, you know, I try to stay away from the shoulds as much as possible, because when you start going down that road, and I was definitely there. When I first had my kids, we went through to two and a half years of infertility and then we had four kids in four years. And so we were you know, went into one end of the spectrum to the other. And when I was going into those pediatricians, we were living in a big city at the time now we live in a small town. But we were living in a big city, when ever we had our kids from Chicago to Indianapolis. And every time I went in there, it was a very rushed process. It was very stressful. It was you know, don't touch anything. And it was in and out and in and out and what is going on and I actually remember so one of my children has vitiligo and for those that are listening that don't know it's an autoimmune skin condition and she just doesn't have pigment on part of her skin. She's a very fair hair or fair skinned blonde so you don't really notice it at all during the winter but in the summer when you know she has some but anyway my point is that I went into my pediatrician at her one year visit and their birthdays in our are in October so we had been through the summer and I was like there's just seems to be like this area that seems lighter than the rest and our pediatrician in haste and nothing you know, nothing more. I loved her pediatrician but there was just so much haste there and I do feel like and he said, Oh, it was just a Um, a sunscreen mishap, you know, that was all it was. And don't worry about it. And I was like, okay, year two comes around, and I come back in. So again, October and I was like, so this is still here. And he's like, oh, yeah, it was just a sunscreen mishap. And I was like, I did not put like,

Dr. Raker: 00:10:18

the same exact spot, right?

Nellie Harden: 00:10:21

For some reason on this exact same spot on my child's you know, face and forehead for two years in a row. You know, but I think that that can be a product sometimes of so like, okay, it's not like threat threatening, we're good, you know, get in and out. And so anyway, that just came to mind when you were talking. And I think taking that time to do telemedicine is so important. And we had an incident I told you about in the when we were first talking, and our daughter, it was after, I think it was her second COVID Booster. But anyway, she collapsed, and she was sitting there, she was playing a game of Monopoly. And all of a sudden, she's 14, and she just went down. And then she had complete vertigo for about 24 hours, and she couldn't hold anything down. And she just felt like the room was spinning. And it turned out to be just one of those weird side effects that can happen, right that they happen to many, but of course it happens to her. And but my point is, it was a Friday night, right? I couldn't you know, get to the pediatrician. And a friend of mine, who is a PA, a physician's assistant, I was able to call and, you know, coach me through some things and what to do, and we ended up just giving her a bunch of Dramamine for the for the time being, and it stopped after about 24 hours, but having that, you know, person in my pocket, and person I could reach out to like what you're doing, it changed everything. And it gave me so much peace. And I knew I was like, okay, all right, I know what's going on. Somebody is in in my corner. Somebody is monitoring this besides me. And so I figure you probably go through a lot of things like that of,

Dr. Raker: 00:12:10

yeah, for sure. And that was another thing that prompted it, you know, it was like, Well, my friends can call me. But what if you don't have a friend, you know, and I was getting a lot of those phone calls, especially on the weekends. And my goal was really to try to keep them out of the ER or urgent care. And, you know, see if I can get them through the weekend until they can go see their pediatrician. So that alone, I think is worth a lot, especially now who wants to really be there. So yeah, and a lot of things really can wait, you know, I mean, honestly, sometimes even broken bones, if you think they're broken, it's not an emergency, they're not going to do anything that you probably can't kind of do at home. And then meanwhile, unless it's an obvious break or something, right, like we're talking fracture, like not sure, right, like, but you know, emergencies or emergencies. Sure. 100%. But then then there's that, like, I'm not really sure do, I really need to go, you know, the ear infections, you can give them Motrin, and you can kind of make them comfortable and wait till the morning. So there's like things that you can do that you don't have to be seen right away. And then I do think telemedicine will advance more and more to the point that I won't be able to look in your ears, you know, there'll be an app on the iPhone, and I will be able to listen to the lungs, because you'll have an extension. And so I think things are going to advance where we actually can do like a physical on through a computer screen.

Nellie Harden: 00:13:41

Yeah, no, I completely agree. And so that was going to be my next question to you in the field that you actually work in with your colleagues. Do you see a convergence or migration toward telemedicine in general?

Dr. Raker: 00:13:57

So you know, that everyone was doing it? Right, we had to do it during COVID. And it became a thing, and I think a lot of doctors have adopted it. But I think most people, especially if you are someone that is in an office setting prefer to have hands, but I do think telemedicine really is great for like follow up visits, right, where you're just kind of checking in. It's great for like psychiatric type visits. So there's a lot of ways that it is perfect for and right now I think since it was so much during COVID and so many people are really wanting to get back to the face to face, but it's not growing like the same way. But III think in the future, it'll continue to become a bigger chunk of what we do. It's just it's just progress in technology, right? I mean, you get everything delivered to your door you get, you know, it's just people are gonna want That flexibility in that ease of maybe sleeping in the other room, but I can do this. Or, you know, I don't have to leave the house right now. So I do think we're gonna see more and more of it in the future. But there I think whatever lose that office sending either you know, there's there's so many, there's only so many things that you can do without being face to face. So I think it'll be more adjunctive. Yeah, I hope I hope I don't I don't want us to ever lose that face to face time. Yeah, yeah, you know, I think that those yearly visits are crucial. And obviously, you need vaccines and things like that. So I think even if you have like the yearly visits, or the, you know, monthly when you're younger, and then in between as things come up, and like I said, for me, parenting and counseling, and just that other support that you need. I think that would be amazing to have an online support system.

Nellie Harden: 00:15:53

Yeah, I agree. Us. You mentioned vaccine. And my first thought was some like weird extension of off my phone, because you're talking about like, Oh, that would be quite the extension kit yet. Yeah.

Dr. Raker: 00:16:08

I know, is I mean, right? Yeah, totally could be the Jetsons in a few years.

Nellie Harden: 00:16:14

That is true. There is a show that we watch occasionally. And it's it takes place in the future. It's called upload, and it is on I don't I think it's on Amazon Prime. But my, it takes place so far in the future, and they have these different things. And last night, there was this, this older gentleman that it has been diagnosed with vape lung, that in the future. And so it basically it sounds very much like emphysema, you know, type of thing or something. And his daughter asked, When was the last time you are at the doctor? He's like, I just had a Google visit yesterday, you know, and it was?

Dr. Raker: 00:16:53

Yeah, it was,

Nellie Harden: 00:16:54

it was pretty funny. So just kind of went along with our conversation. But I want to kind of take a take a turn here in our conversation, because I think one of the important things and you have teenagers too. And you know, and I have all teens, almost tweens or almost teens, I have a 12 year old to 14 year olds and a 16. And I noticed and I felt this way too, that when I get into later middle, and especially high school, and also especially as a young woman, that going to the pediatrician was like, Are you serious mom, right? Like, do I have to go to the pediatric? Can I just go to the like, Doctor doctor, right? But then that also had its own, you know, angst that was stapled to it. So can you walk me through a little bit? When is a good transition? How is a good? How does a parent do a good transition between pediatrician and adult, you know, quote, unquote, adult years.

Dr. Raker: 00:17:58

And I'll share a funny story about that. So I actually went to my pediatrician until I was in med school. So that's like mid 20s. Ish. And I remember actually doing my pediatric rotation and got so sick. I mean, pediatricians, we have the best immune systems. But obviously, this was my first stint. And it just got some awful, awful virus. I don't think I've ever been this sick in my life. And I went to my pediatrician, and I sat there in the office, waiting room, and people were staring at me, like, Where is the kid? What is she doing? You know, because I was just sitting there no child with me. So anyway, that was a very rare situation. I know my pediatrician for years, he had a big influence on me. But yeah, I don't, you know, I don't recommend that. And even he was like, Okay, it's time for you to move on.

Nellie Harden: 00:18:49

No more lollipops for you.

Dr. Raker: 00:18:53

I love you that like you need to go find some enough. So I think it really depends on your child. You know, I think for a girl, it can be uncomfortable. You know, I think having you know, we always say like having a female pediatrician or a male for a boy, it doesn't matter so much when they're younger. But maybe when they're doing their physical exams when they're older. If there's an office with different doctors, you can always switch that some kids really don't care. And I don't think I would make it like, you know, a point. But just ask them. Are you comfortable with this? This is what the exam is going to entail. They just they have to look, you know, and if they're not comfortable to have an open discussion about it, I think is really important. I don't think it's good to assume and you know, they may grow up and have a male OB GYN or I mean, it's just it's your own comfort level. And I don't want to make them think it's weird if they don't think it's weird, right? Like, right. It's It's not weird, it's totally fine. But if you would rather have a male if it whatever it is, it's like having a female on the suit. versus the mountains, it just it's come from levels. And then I think that age as far as aging out, usually we say around college time, because it just seems like a natural progression there, you know, usually moving out of the house moving into the dorms, they can find maybe a doctor within the college system or depending on what city they're in, or whatever it may be. But sometimes kids come back from college for like checkups or if they're sick, don't during because technically, it's till 21, that we can see kids. So we still sometimes can see kids when they're a little bit older, especially if it's just like, a cold or something, right. But part of it also is, you start to have adult problems or adult diagnoses, and then it's better to go see a family medicine doctor or an internal medicine doctor. So it just depends. And then as far as like transitioning to OB GYN, you truly don't need to do that, or to get a pap smear or any of those things until a few years after being sexually active. So I know that was like 18, you have to go to OB GYN, I think that was back when like we were growing up, that was kind of the thing, but like, you really don't need that, you know, you're not going to see changes on a pap smear after your first sexual interaction and things like that. So again, I would leave it up to your daughters and just say, Hey, this is you know, something you need to do yearly. This is when you need to start, I just think that the more open conversations you can have about it, the better, you know, and the thing that I will say if if for some reason is uncomfortable, if you feel like your daughter can't be open with you, then I would suggest going to maybe OB GYN or someone sooner because maybe they will be able to talk to that person. And ultimately, we just want them to be safe. So as a physician, like you know, I'm sure you've experienced this, we will kick you out for teen visits, right and have a conversation with a child. And we tell them that this is confidential except for certain things. Because we just want them to be able to tell someone and want them to be safe. So I do think that's really important. So for some reason you feel like, not sure if my daughter is telling me she may be wanting to be sexually active, but I don't know, you know, go ahead and make that OB visit and just say, We're just doing this as routine. Yeah, and let them talk and let your you know, let your daughter get what she needs to get. I think that's the most important and be safe.

Nellie Harden: 00:22:39

Yeah, no, I totally agree. And, I mean, we practice in my family, but also in my in my coaching practice, we practice those open conversations constantly. Because that's what's needed for everything, not just in this, but I do find it interesting and I have yet to run into and you might have a different experience. And I hope so. But I have yet to run into a pediatricians office that I I did this when I was a kid. And I know that my teams now you walk in and everything is so cute, right? Everything, you know, you got the little fishies on the wall, you got the little, you know, the cartoons and all of this. And so that's definitely part of the hesitation, right? As they're growing up. They're like, I don't need to go into the ELMO room, you know, and they're 14 or 16 or whatever. And so I think it would be great. Any anybody out there building pediatrician buildings, listening to have like a teen weighing? Yeah, like, have, yeah, one or two, three, whatever rooms that feel, you know, more mature. And I feel like that would really help with the transition process. Because every pediatrician I know, and they have such a beautiful heart, and you know they're doing it because it makes the younger ones feel more comfortable and at ease. Yeah. Then it makes the older ones not feel as comfortable.

Dr. Raker: 00:24:08

Yeah, that's an excellent idea. You know, thinking back to practices that build. They're usually starting with babies. Yeah. Right. Like they don't have teens yet. So I think that's part of it is that, you know, most practices that are being built or had been built, we're just getting referrals for babies, because they're just building their practice. So yeah, it's a great idea to kind of grow like to have that. Build an option.

Nellie Harden: 00:24:38

Yeah, yeah,

Dr. Raker: 00:24:40

build the practice.

Nellie Harden: 00:24:41

There you go. Yes, please, please do that. And my kids will be way out of Pediatrics ages. But But yeah,

Dr. Raker: 00:24:48

I think it's a great idea. Just helping them

Nellie Harden: 00:24:50

feel and it gives them the sense of I'm growing up and they can take on more of that responsibility now and and you You know, to your point, when the doctors, you know, have the parents leave, and they're sitting there and talking to them about, you know, very intense issues or some things that they might, you know, even have shame or guilt around, you know, and then they're surrounded by, you know, Disney characters. They're like, I should be right, there's that should again, I should not even having this conversation in this environment, but I don't even know what to say.

Dr. Raker: 00:25:27

So that's a really great point. I'm really glad you brought that up.

Nellie Harden: 00:25:31

Yeah. So anyway, anything that we could do in order to help our help our kids or our young men, young women, and let's just face it, young women are having more of these, you know, changes that are happening, you know, I see, especially young women in middle school, right, they start to have physical changes before the boys do. And so there's this sense of I'm growing up, I'm leaving childhood behind a lot sooner than the boys and so having that being mirrored in their medical care, which is why I think telemedicine, also might be such a great idea in that regard. So that they feel safe, but safe and sure, open to talk about those conversations. And our last point I want to touch on here because and I say this kind of selfishly, because I have a child that is interested in medicine, and what she talks about So, and she's 14 Right now, so we have a few years. But what do you how? How would you recommend talking to anyone today, considering the fast change that is happening with medicine? How would you talk to somebody that might be interested in it in the future? Is it really just coming back to, you know, if you're called to take care of people in this way, this is you know, what you do? And then you just adjust to whatever and how it's being done then or I don't know, what advice would you have for young people that are looking into medicine in the future,

Dr. Raker: 00:27:03

I think I would say look at all of healthcare, you know, not just being a physician, it's amazing. It is remarkable what we do and what we can provide, but it is rapidly changing. And it's just hard to say the future of medicine right now, you know, as far as what it's going to look like in the workplace. So I would say look at all types and get out because I think, I don't think I was exposed to it. So that's why I just want to be kind of transparent. Like, I think growing up, it was like nurses and doctors, right? But there's physical therapists and occupational therapists, and physician assistant and nurse practitioner, who all play like really important roles that are important in different ways. So really think about what is your goal? How do you want to help people what what your interests are, and go from there, you know, look at all the different fields, medicine in and of itself, it's just a long process. I mean, it's a four year college with getting ready to apply to med school, you know, taking the the exams and applications and the interviews and all of that. And it's, you know, it's hard to get into, they're competitive. And then there's a residency after that. So residency is there anywhere from three years to seven years, depending on what you want to do. And it's all amazing. I think it's just truly like you said, like, it's, it's your calling, it's, you feel really like driven to do this. And someone said to me, when I was thinking about it, you know, and I said, Well, I think this is going to be really hard or something that I like, well, everything's hard. You know, every career and every choice, everything is going to be hard to a certain extent, right. And I always tell my kids like, if it's worth it, it's hard. So it's not so much. I don't want to discourage anyone from doing something because it's hard. It's more just really going into it with open mind open heart, and knowing when it's going to be, I will say as a woman, and again, not to discourage anyone, I think there's in pediatrics in particular, I think there's more women than men and men medical class, it was 5050. So that's amazing. And I think more women should do it because they want to do it. But I also think that I wish again, someone had this conversation with me, my mom was a stay at home mom, and that's what I knew. And then all of a sudden knows like, Oh, I'm gonna be working full time and having kids like, I don't want to do that. So, you know, something to think about is what do you want your life to look? Like, in the future, right? I think we get kind of, you know, as young woman, I can do this, I can go to med school, I'm, you know, I got this and more power, and it's the quality and all that which is fantastic 100% Like you go, but me personally, I wanted to be a mom, I wanted to be there for my kids, I wanted to see their recitals at school, and you know all those things. So think about that and think about a career that maybe is a little bit more flexible, or that you can do part time or, you know, just don't think we think about those things in our 20s. Yeah. And then you have kids, and you're like, Oh, I kind of want to be home with them. You know, and I'm not saying good or bad. Or I know some parents or some mothers that are like, I'm much better when I work full time. And I spend quality time with my kids in the evenings and weekends. Fantastic. Like good for you. It's not about being a better worse mother. It's about what speaks to your heart. And for me, personally, it took me going through med school and doing all that. And thinking like, yeah, I can work four days a week, no big deal, to then having my own kids and being like, Oh, I don't really want to miss all of that. So, and there is flexibility I listen, I was able to do a part time I was able to do when I was a hospitalist I worked overnights and you know, for me, I slept a lot during the day, but still was around. So there are different ways to do it. I'm not just trying to discourage people it just more to think about. Because I don't again, I don't think anyone really sat down and had that conversation

Nellie Harden: 00:31:46

with me. And I think that's fantastic. Again, those open conversations and just exploring all the possibilities, so you can make an informed decision for herself. But you are very right, you know, some of those ideas, and some people just don't even know like, Will I even want kids? Will I even want to you know, how will that look down the future. And then as we all know, life twists and turns and but having those conversations and just having those thoughts is really, really important in order to you know, set yourself up. I started my career in marine mammalogy. And now I am a family life and leadership coach and I worked the first, like seven, eight years in the animal field and the last 12 or so in the human field. So you never know where we're

Dr. Raker: 00:32:34

gonna take you. You never know. Absolutely.

Nellie Harden: 00:32:38

Absolutely. All right, well, let us know how we can connect with you. And well tell us a little bit about your parent coaching. Because I know that you were talking about a little bit about toddlers and things like that. So tell us a little bit about that. And then where we can connect with you.

Dr. Raker: 00:32:55

So um, yes, so peer coaching, is I would say I'm open to all ages, even if your kids are grown. Honestly, I think that this can help anyone, even with, you know, the whole re parenting ourselves and just figuring out what we needed so that we can show up the way we want to, I think it's gonna help. So any age kids, I think will help. It's a 12 week program. And we really go into the science and the research and it all makes so much sense. So I love that being a medical background, and also available for just one to one coaching sessions so that if you're not ready to commit to 12 weeks, but just have some questions, that's another option. And then telemedicine is for anyone that lives in California at this time, so you can find me at Ask Dr. Mom with a dash between doctor and mom.com. And also a lot on Instagram for anyone that's on Instagram. Also Ask Dr. Mom with a with a dash at the end underscore end. And yeah, those are the main ways my Instagram has ways to get to my YouTube channel and and my blog so that way you can kind of reach branch out from there and always reach out if you have questions. I'm always happy to answer DMS or even do like videos based on questions. So love questions.

Nellie Harden: 00:34:27

Awesome. Well, thank you so much for being on the show. We covered some big things today about telemedicine about how to transition your daughters and your kids, from pediatrician to adult doctors. And we also really focused on how to help our younger people. We always are going to need doctors, there's never going to be a time that we don't need doctors. Yes. And so thank you so much for being on here and sharing all of your ideas and your insight.

Dr. Raker: 00:34:58

My pleasure. Thank you for having To me, it was great. Absolutely.