When they know they're "going to the doctor," kids might wonder or even worry about the visit. Whether they're going to see their primary care doctor for a routine checkup or a specialist for a problem, kids might have fears or even feel guilty.

Some of these feelings come up easily, so that kids can talk about them. Others are kept secret. Here's how to help your child talk about and overcome any worries.

What Worries Do Kids Have About Medical Exams?

Things that kids worry about when going to the doctor include:

• Separation. Kids often fear that their parents may leave them in the exam room and wait in another room. This fear of separation during mysterious exams is most common in kids under 7 years old, but can worry older kids too.
• Pain. Kids may worry that a part of the exam or a medical procedure will hurt. Kids ages 6 to 12, for instance, often worry that they'll need to get a shot.
• The doctor. Some kids' concerns may be about the doctor's manner. A kid may think that if the doctor works quickly and efficiently, or seems detached, that means they're stern, mean, or don't care about them.
• The unknown. Kids sometimes worry that a medical problem is much worse than their parents are telling them. Some who have simple problems worry they may need surgery or have to go to the hospital; some who are ill worry that they may die.

Also, kids often have feelings of guilt: They may believe that their illness or condition is punishment for something they've done or should have done. Kids who feel guilty also might believe that exams and medical procedures are part of their punishment.

How Can Parents Help?

Encourage your kids to express their fears, and then address them in ways they understand. Here are some practical ways to do this:

Talk About Why You're Going

Prepare kids by giving them advance notice of a visit so it's not a surprise. When explaining the purpose of the visit, talk about the doctor in a positive way.

If you're going to a regular health checkup, explain that it's a well-child visit: "The doctor will check on how you're growing and developing, and also ask questions and examine you to make sure that your body is healthy. And you'll get a chance to ask any questions you want to about your body and your health." Explain that all healthy kids go to the doctor for such visits.

If the visit is to diagnose and treat an illness or other condition, explain — in non-scary language — that the doctor "needs to check you to find out how to fix this and help you get better."

Talk About Any Negative Feelings

If your child goes to the doctor because of an illness or other condition, discuss the health problem in neutral language and reassure your child: "This isn't caused by anything you did or forgot to do. Illnesses like this happen to many kids. Aren't we lucky to have doctors who can find the causes and who know how to help us get well?"

If you, your partner, other relatives, or friends had (or have) the same condition, share this information. Knowing that others have been through the same thing can help ease fears.

If your child sees a doctor for something that led to ridicule or rejection by other kids (or even by adults), work to relieve shame and blame. Problems like head lice, embarrassing scratching caused by pinworms, and daytime wetting or bedwetting are often misunderstood by others. Stay supportive, and keep reassuring your child that the condition is not their fault and that many kids have had it.

If your child was injured while disregarding safety rules, point out the cause-and-effect between the action and the injury, while avoiding blame. You could say, "You probably didn't understand the danger involved in doing that, but I'm sure you understand now, and I know you won't do it that way again." If your child repeatedly disobeys rules and is injured, speak to your doctor. This sort of worrisome behavior pattern needs a closer look.

In every case, though, be sure to explain, especially to young kids, that going to the doctor is not a punishment. Help your kids understand that adults go to doctors just like kids do and that the doctor's job is to help people stay healthy and fix any problems.

What Should Kids Know About Routine Checkups?

Young kids learn best during play, and this can be a way to answer any questions and talk about fears they may have. You can use a doll or teddy bear to show a young child how the nurse will measure height and weight or demonstrate parts of the routine exam.

Many children's books are available to help explain a doctor visit. It also helps to use role-playing to show how the doctor might:

• use a blood pressure cuff to "hug the arm"
• look in the mouth (and will need to hold the tongue down with a special stick for just a few seconds to see the throat)
• look at the eyes and into the ears
• listen to the chest and back with a stethoscope
• tap or press on the tummy to listen to or feel what's inside
• look quickly to see that the "private areas" are healthy
• tap on the knees
• look at the feet

It's important for parents to let their kids know that what they've taught them about the privacy of their bodies is still true, but that doctors, nurses, and parents must sometimes examine all parts of the body. Emphasize, though, that these people are the only exceptions. And reassure your child that you will be in the exam room with them.

What Should Kids Know About Other Exams?

If your child is going to the doctor because of an illness or medical condition or is going to visit a specialist, you might not even know what to expect during the exam.

When you make the appointment, ask to speak to the doctor or a nurse to find out, in a general way, what will happen during the office visit. Then you can explain this in gentle language, appropriate to your child's age. Be honest if you know that a procedure might be somewhat embarrassing, uncomfortable, or even painful, but don't go into great detail. Your child will feel more secure knowing what's going to happen and why.

Kids can cope with discomfort or pain more easily if they know about it ahead of time, and they'll learn to trust you if you're honest with them. If you don't know much about the illness or condition, admit that but reassure your child that you'll both be able to ask the doctor questions about it. Write down your child's questions.

Reassure your child that you'll be there and that the procedure is truly necessary to fix — or find out how to fix — the problem. (Teens may prefer to be examined without a parent or with only a same-sex parent or same-sex chaperone present. That preference should be honored.)

If a blood sample will be taken, be careful how you explain this. Some young kids worry that "taking blood" means that all their blood will be taken. Let your child know that the body contains a great deal of blood and that only a very little bit is needed for testing.

Again, be sure that your child understands that the doctor visit is not a punishment for any misbehavior or disobedience.

How Can Kids Be Part of the Process?

• Gathering information for the doctor. If the situation isn't an emergency, your child can help make a list of symptoms for the doctor. Include all symptoms you've seen, even if they seem unrelated to the problem. Also prepare a list of your child's previous illnesses and medical conditions and a family history of illnesses and medical conditions among close members of the family (parents, siblings, grandparents, aunts, and uncles).
• Writing down questions. Ask your child to think of questions to ask the doctor. Write them down and give them to the doctor. Or, if kids are old enough, they can write down and ask the questions themselves. If the problem has happened before, list the things that have worked and the things that haven't worked in previous treatment. Kids will be reassured by your active role in their medical care and will learn from your example. And you'll be prepared to give the doctor information needed for an informed diagnosis.

How Should I Choose a Doctor?

It's important to choose a doctor carefully. You want one who's smart and competent. But you also want a doctor who understands kids' needs and fears and who communicates easily with them in a friendly manner, without talking down to them.

During a physical exam, the doctor inspects, taps, and checks various body parts — some of this can be embarrassing (or even physically uncomfortable) for kids. A good relationship between doctor and patient can help ease these feelings.

If a doctor seems critical, uncommunicative, aloof, or unsympathetic, do not be afraid to change doctors. Ask for recommendations from other parents or other doctors whose opinions you trust.

If your child needs to see a specialist, ask your doctor to recommend someone who's knowledgeable, experienced, and friendly. After all, we want that in our own doctors, so should find the same for our kids.