Pediatrician's Guide

M

aybe you are expecting your first child. Maybe you have moved to a new area, or have changed insurance coverage, or are unhappy with your current care. There are lots of reasons why parents seek out a new pediatrician. And whatever your reason, it's important to choose one as soon as possible and not wait for your child to be ill. During pregnancy, it is wise to find a pediatrician by the beginning of the third trimester, or seventh month, of gestation.

Finding The Right Pediatrician: Where Do You Start?
You should plan to meet with several pediatricians before choosing one, so be sure to give yourself enough time. Begin by compiling a list of candidates to interview. You may get their names in a number of ways:

  • Ask friends, family, coworkers and neighbors you trust.
  • Contact your insurance plan for eligible pediatricians; many plans have Internet Web sites.
  • Call local hospitals, many of which have referral services.
  • If you are expecting, ask your obstetrician. You may also ask your primary care physician or another physician you trust.
  • Some Internet sites that may be useful in finding pediatricians in your community include:

Setting up an Interview
Most pediatricians offer free interviews, although some may charge for this preliminary visit. If there is a fee, ask if it can be applied to a future office visit, since your insurance will not usually cover this charge. Be wary of pediatricians who do not offer interviews.

Screening begins with the initial telephone call: Before deciding to visit the pediatrician, you may gather some useful information from the office staff, including:

  • What are the doctor's office hours?
  • Does the pediatrician accept your insurance?
  • Are laboratory facilities on site? If not, where would your child be sent for these?
  • Is screening for hearing and vision done in the office?
  • Don't forget to notice how easy or difficult it is to get through on the telephone. Also, decide if you are more comfortable in a small office practice, or in a larger group practice.

Meeting the Pediatrician
It is useful to come to the interview with a list of questions. Be prepared not only to listen to the responses, but also, to pay attention to the way you feel about your interaction with the doctor.

Communication between the pediatrician, parents and child are key: Some things to think about are:

  • How well does the doctor listen?
  • Do your questions get cut off, or do you feel rushed?
  • Does the doctor treat you as a partner in the care of your child?
  • Do you feel a sense of trust in the doctor?
  • Does the pediatrician ask you important information about your home or family?
  • The safety of your home environment, presence of other children or pets, and family health problems can all affect the health of your present or expected child.

Look around you: Does the office seem clean and organized? Is the staff courteous? Is there a separate waiting area for sick and well children?

Check credentials: Remember that you want a doctor who is knowledgeable to handle both common and unusual health problems.

  • What is the pediatrician's educational background?
  • How long has she been in practice?
  • Is she board-certified?
  • How does she keep up-to-date with medical knowledge?
  • Does she have any special medical interests?

Determine the doctor's availability: Children get many acute illnesses, and it is important to know how available your pediatrician is to see your child, on the same day if necessary.

  • How do you reach him for routine questions or urgent problems?
  • Does he have specific telephone call-in times?
  • Can you reach him by email?
  • Does he have a Web site?

What if your child becomes ill?

  • If your child is ill, will she usually be seen in the office?
  • When would she be referred to the emergency room?
  • If your child needs to be hospitalized, what hospital would the doctor use, and who would be responsible for your child's care?
  • Who covers the pediatrician when he is away?

What type of staff is in the office?

  • Are there nurses, nurse practitioners, resident physicians or medical students on staff in the office?
  • Will any of these staff care for your child?
  • Are you likely to see different providers at each visit?
  • How much time will the pediatrician spend with you and your child at a typical visit?

Care of newborns:

  • When is the first newborn exam in the hospital?
  • Will your pediatrician be doing it?
  • When is the first newborn office visit recommended?
  • For breast-feeding babies, this should be within the first week of age. Formula fed babies may be seen first at 1-2 weeks. Is there office staff supportive and knowledgeable about breast-feeding?
  • What is the pediatrician's opinion about newborn circumcision?
  • How often are subsequent visits?
  • What is the physician's recommended vaccine schedule?
  • After the first visit, recommended checkups in the first 2 years are at 2, 4, 6, 9, 12, 15, 18 and 24 months. Depending on your child's individual needs, your pediatrician may recommend other visits, as well.

Explore the doctor's attitudes about things that are important to you: If you use complementary or alternative health methods, or traditional health practices, ask about the pediatrician's knowledge and acceptance of these. If you have important cultural, religious or moral beliefs related to your child's health care, express these to the pediatrician and observe the response.

  • When does she prescribe antibiotics?
  • How does she respond to parents' concerns or disagreements about care recommendations?
  • Are you a nontraditional family, such as gay, lesbian, or single parents? Are you separated or divorced? Are your children adopted or in your care as foster children? Are the pediatrician and her staff sensitive to these types of families?

Going to the Interview as a Family
It is useful to go to the visit with your spouse or partner, so that you may both get a sense of the interaction. Also, if you are interviewing the pediatrician after childbirth, you may want to bring your child along to the visit. It could be helpful to see how your child and the doctor relate to each other. However, if you are considering leaving another physician to whom your child has become attached, you may want to be careful about how and where your child meets a new doctor.

Remember that your choice of pediatricians is not permanent. If at any time you are not satisfied with your child's care, discuss your concerns with the pediatrician. If the problem continues, it may be time to find a new doctor.

Copyright HLTHO - Healthology
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