6 Tips for Choosing A Pediatrician
Thirty-five years ago when I (Dr. Bill) was finishing my pediatric training and was about to hang out my shingle and open a practice, one of my professors advised me that there are three qualities parents look for in a pediatrician- the three A’s: affability, ability, and availability. Choosing a pediatrician for you and your child is one of your most important long-term investments. Medical care is a partnership between parents and pediatricians. You owe it to your child to find a good partner.
Depending on the health-care needs of your child, expect to be in your pediatrician’s office at least 15 times during the first five years of your child’s life. You might as well get the most out of it. Over my years in practice, I have been grilled by many parents as they begin to search for “Dr. Right” for their child. Most parents do their search wisely, but some don’t. I have learned the following tips on how to search for Dr. Right from parents who have made the right match of a health-care provider for themselves and their child. I also have a few tricks of the trade for extracting the best from your child’s doctor. Here is a step-by-step plan, along with some insider tips on choosing a pediatrician.
1. Interview Yourself
Before you interview prospective health-care providers, do some soul searching. What qualities do you need in your child’s doctor? Are you a new parent without a lot of experience with the usual childhood development quirks and the common childhood illness? Do you lack confidence (as some new parents do) and believe you need a pediatrician who will be very involved in your family, will help you understand normal growth and development, and will competently manage your child’s health care? Are you a worrier (as nearly all first-time parents are) who needs an empathetic listener to seriously address your concerns? Are you evaluating various parenting styles and need a doctor who will help you formulate a parenting philosophy? Or are you a veteran parent already firmly rooted in your parenting philosophy and style who simply needs a like-minded pediatrician? Does distance matter? Are you willing to drive farther for higher quality, or do you rely on public transportation and therefore need a doctor’s office close to your home or workplace and easily accessible by bus or subway?
Do you or your child have special needs? For example, if your child has a chronic illness, such as diabetes, naturally you would want to choose a pediatrician with expertise in that illness. If you are a first-time mother and are adamant about breastfeeding your baby, obviously choosing a pediatrician who is breastfeeding-friendly would be in your best interest. Or do you or your child have special communication needs? One of my favorite parents is blind, and I have learned so much from her about the power of a mother’s institution. I have also learned how to communicate better through voice and touch. During an exam I guide her hand over her baby’s body to help her develop the feel for normal skin and normal muscle tone and to help her appreciate the marvels of her baby’s developing body. One time she brought her infant in for consultation about a rash, but I couldn’t see it. The next day she returned to the office with her obviously spotted child. Nancy could feel the rash the day before I could see it.
Another mother in my practice is deaf and listens primarily by lip reading. Initially, we had a communication problem because I did not move my lips expressively enough when I talked for her to understand me. She politely informed me that I was difficult to lip read, which encouraged me to hone my communication skills by being more expressive with my facial language. Years ago, one of my favorite pediatric professors, Dr. Richard Van Praagh, professor of pediatrics at Harvard Medical School, gave me some valuable advice: ‘Surround yourself with wise and interesting parents and have the humility to learn from them.”
2. Get References
Interview friends who share your parenting philosophy when choosing a pediatrician. Pick out the most experienced and like-minded mothers in your neighborhood and get references about doctors they use. Ask them specific questions: “What do you like most about Dr. Susan?” “Is Dr. Tom available when you need him?” “Does Dr. Laura give you the time you need?” “Are his parents just as good?” Pick out at least three names before continuing your search. If you are choosing a pediatrician toward the end of your pregnancy, consult your obstetrician, who likely has a feel for your special needs. Your pediatrician should be right for you and your child.
Insider’s Tip: Suppose the doctor you have chosen to be your child’s pediatrician is not taking new parents. Write a brief letter personally asking the doctor to accept your child as a new patient, and follow up the letter with a phone call. This extra effort impresses doctors that you sincerely care and it may motivate them to actually want to open the practice to you. As I tell my receptionist, “There is always room for nice parents.”
3. Do Your Insurance Homework
It’s disappointing to have chosen Dr. Right only to find out you have the wrong insurance. Once you have a list of prospective doctors, check your insurance plan booklet to see which practices are participating members. After you have narrowed down the list to a few finalists, check with those doctor’s offices to be sure they are still members of the plan and are still accepting new patients from that plan. If you absolutely want to go to a certain doctor who is not a member of your current insurance plan, check your options with your insurance carrier. The best insurance carriers offer a Point of Service (POS) option that allows you to see health-care providers outside the plan, usually for an additional charge.
4. Check Out the Office Before Choosing a Pediatrician
Arrive early for your interview appointment and browse around the office a bit. Chat with others in the waiting room and ask what they like, or dislike about the office and the doctor’s practice. Notice and ask the staff about how their children with potentially contagious illnesses are handled. Many first-time interviewers ask whether there are separate waiting rooms for well and sick children, a question they obviously got from their childbirth class or a book written by someone who has never run a pediatric office. Most doctors who have tried separate sick and well waiting room found this system does not work. Nobody wants to use the sick waiting room. The more practical solution to minimize the spread of illness is to reserve the waiting room for well children only and to usher potentially contagious children into examining rooms immediately and if possible through a separate entrance. One comforting fact of germ spreading is that by the time many children come to the doctor’s office, they are no longer contagious.
Besides looking around the office, find out some basic information and compare it with what you know about other offices:
- What are the office hours?
- Are there any evening or weekend hours?
- Is there a doctor on call after hours and overnight, or is it an advice nurse?
- How much are checkups and sick visits (If you don’t have insurance)?
5. Interview the Office Staff
Introduce yourself to the office staff. Are they friendly and accommodating? You’re likely to be having as much contact with the office staff as you will with the doctor. During doctor shopping interviews, I love to hear new parents say, “Your staff is so helpful.” To maximize the time you have with your doctor, get as many questions answered and facts you need to know from the office staff before meeting the doctor: hospital affiliations, after-hours coverage, appointment scheduling, and anything else that is important to you.
6. Interview the Pediatrician
Remember, the goal of your interview is to decide whether this pediatrician is the right match for your family. Try these interviewing tips for choosing a pediatrician:
Since most doctors do not charge for these interviews, expect the doctor to give you about five minutes. This is usually enough to make a doctor assessment. If you or your child have many special needs and you feel you need more time, schedule a regular doctor’s appointment for a checkup rather than an interview.
Being a short list of your most pressing parenting issues. If your baby is 1 year old, this is not the time to ramble on about future behavior worries, such as bed wetting or learning problems.
Avoid opening the interview with an “I don’t want” list, such as “I don’t want my baby to have shots…” I remember parents who once opened their interview with “We don’t want to give our baby eye drops, vitamin K, newborn shots, newborn blood tests, immunizations…” While it’s good to do your homework and formulate opinions about certain routine medical practices, it’s better to phrase your question positively, such as “Doctor, what is your custom about routine immunizations?” This allows you to learn the doctor’s perspective and opens the door to factors you may not have previously considered. You owe it to your child to keep an open mind. Negative openers put doctors on the defense, as they recognize the mismatch between the parent’s desires and their professional beliefs.
Once, when a couple of first-time expectant parents were checking me out as a prospective doctor for their baby, the opened their interview with the impressive line: “This is a well-researched baby.” I immediately warmed to these parents because this statement impressed upon me that they had done their homework thoroughly. Both parents were in their mid-thirties, well established in their careers, and were now ready to settle down and begin their parenting career and “do everything right.” These parents had carefully chosen their obstetrician and explored their birthing options, and now I was on their list of pediatric finalists. They conveyed that the choice of a pediatrician was high priority for them. Because these parents expressed that they expected a higher level of medical care, I was motivated to be a more attentive doctor for them. I always advice parents about the law of supply and demand. Attend the doctor interview with as many family members as possible, preferably both parents. A new family recently moved to our area and was interviewing our practice. Grandmother came along. She sat quietly across the room while the parents grilled me. I took cues from Grandmother’s nods as to whether or not I was a Grandma-approved pediatrician.
Avoid pediatrician turnoffs
Remember, doctors take a lot of pride in being chosen by selective parents. Don’t reveal that you chose this practice “because I found you in the yellow pages” or “because you’re on my insurance plan.” These openers do not make good first impressions.
Within a few minutes, you should get a gut feeling about whether or not this doctor is Dr. Right for your family. While this may sound subjective, try to get a feel for whether the doctor really cares about kids and enjoys his or her practice. When our two sons Dr. Bob and Dr. Jim joined the Sears Family Pediatrics practice, I (Dr. Bill) advised the young Sears, “Run your practice the way you do your family. As you develop a parenting style to help you enjoy your children, develop a style of pediatric practice that you enjoy, because you’re going to be doing it for a very long time.”
Discover the pediatrician’s basic parenting philosophy
It’s important when choosing a pediatrician to pick one who agrees with or at least supports your basic parenting philosophy. Ask a few leading questions to get a feel for the type of parenting advice the doctor will likely give you in the coming years such as, “I’m worried I won’t succeed at breastfeeding. Is it really that important?” or “My sister used the cry-it-out method to help her baby learn to sleep well. How will I know this will work on my baby?” While these types of questions may not really have right and wrong answers, you will get a sense if this doctor’s advice will fit well with what you feel is right for you baby.
Uncover the pediatrician’s basic approach to medicine
You may prefer a doctor who practices straightforward standard medicine. On the other hand, you may enjoy one who likes to think outside the box and provides some alternative approaches to treatment and prevention, or is at least open to your doing so on your own. Ask the doctor what his or her feelings are about antibiotics and other prescription medications, about adjusting your baby’s vaccination schedule to suit your preferences, and about how to treat ear infections.
Being your child along
If you have recently moved to the area or are switching pediatric practices, take cues from your child. Watch how the doctor approaches your child and how your child reacts. Children are amazingly perceptive about their caregivers, including health-care providers.
It’s important when choosing a pediatrician to find someone who gives you the impression of really wanting to make a difference in your life and your child’s life. Among the joys of pediatrics is watching patients grow from infancy through childhood. I once attended the wedding of one of my patients whom I had first cared for 22 years earlier when he was a 4-pound premature newborn. During the wedding, my mind filled with memories of Mark’s life from incubator to altar. I was so happy that Mark’s parents had chosen me as their child’s pediatrician. Most doctors go into pediatrics because they can truly make a difference in the lives of young people. When our two oldest sons, Dr. Bob and Dr. Jim, joined the Sears Family Pediatrics practice, I gave them another bit of doctorly and fatherly advice: “Bob and Jim, your success in life will be measured not by how much money you make, but by how many of these little lives are better because of what you did. Be successful pediatricians.”