The newborn period, Nilay Donmez will tell you, is when the questions flood in. First-time parents arrive carrying anxieties that a standard well-visit rarely has the bandwidth to absorb. What typically happens is they leave with unresolved worries, and sometimes those worries become an emergency room visit that might have been avoided with a phone call. Donmez has structured her practice around that gap. Longer appointments. Text and phone support between visits. The explicit goal, she says, is that families leave feeling confident and reassured.
It sounds straightforward. In practice, it requires swimming against the current of how most pediatric care is delivered. The transactional visit, in which a physician moves through a checklist and hands a parent a printout, is the norm in high-volume settings. What Donmez describes is something closer to a relationship, one that doesn't end at checkout.
As children age out of the newborn period, the clinical conversation shifts considerably. Growth, development, language acquisition, school performance, sleep, and eventually mental health each take their turn at the center of the visit. "Every age brings new questions and challenges," Donmez notes, "and no two visits are ever quite the same." That variety is part of what draws physicians to pediatrics, but it also raises the stakes on communication. A parent navigating a toddler's speech delay and a parent trying to understand a teenager's anxiety are not having the same conversation, and the physician has to be genuinely present for both.
"To me, patient advocacy starts with listening to parents without rushing or judgment. It means understanding their values, worries, culture, and the kind of parent they want to be."
That framing is worth sitting with. Donmez is not describing advocacy as a matter of fighting insurance denials or pushing back on systemic policy, though those things matter too. She is describing it as something that happens in the room, in the quality of attention a physician brings before saying anything at all. The best outcome of a visit, in her view, is that the physician has truly heard the parent, provided the most current and reliable information, and then respected and supported whatever decision the family makes. The physician's role, as she sees it, is not to override parental judgment but to inform it.
What that model asks of a practice is real. It asks for time that fee schedules rarely reimburse adequately, for availability between appointments that most workflows don't accommodate, and for a kind of cultural attunement that takes years to develop. Whether the broader system is built to support it is a different question entirely.
