Father's World | Dr. Paula | Choosing The Right Pediatrician

Choosing the Right Pediatrician

by Dr. Paula

Expectant parents are often overwhelmed with decisions: What to name the baby, which crib to purchase, whether to breast or bottle feed and how much visiting from the grandparents will be just enough. Often the very important decision of who will care for the baby’s medical health is left to the last minute and maybe even left to the obstetrician to choose. This choice will have huge impact on the birth experience and should be made with an eye towards establishing a long term relationship. The pediatrician should be a vital part of your new family’s life, not only as the guardian of your child’s health but also as a guide and a resource as you inevitably muddle your way through the process of becoming a family.

There are several guideposts to keep in mind as you make this conscious choice.

But first and foremost, of course, is to make sure your child will receive the highest quality care.

Is your prospective doctor well trained?

Generally, board certification in pediatrics is good assurance, but if the doctor is not fresh out of school you might want to ask what recertification or updating criteria does s/he use to stay current. (The Physician’s Recognition Award renewed every few years by the AMA for physicians who complete a minimum number of hours of current education and evaluation is one way to make this judgment.)
Another way to check out your doctor is to contact the local medical society and ask for the public record of complaints or citations for the physician in question. Although this may not be an accurate indication of quality of care, if there are many complaints it would cast some doubt on your choice.
Another measure of quality of care is the hospital affiliations of the doctor and what, if any, teaching positions s/he holds. Generally, teaching hospitals only permit the very best practitioners to participate in student and resident education. Where there are no local teaching hospitals, doctors who participate in local health concerns and regional medical boards are usually those who are keeping most abreast of the progress in the field.

Recipients of teaching commendations or community service awards are often the most committed to excellence in care.

Is your prospective doctor available and affable - is s/he easy to reach and easy to deal with?

What are the doctor’s usual hours and what is the procedure for getting help after hours?
Are there other doctors involved in the "on-call" system for the doctor’s office and if so how available are they?
Do you have access to your doctor for questions of non-urgent matters and if not, what is the training of the person who is designated to answer these questions? Often a busy pediatrician will train a nurse practitioner or medical assistant to answer the common, non-urgent day to day questions about infant care and as long as there is close communication between these professionals this is usually very satisfactory.
If you specifically need to speak with your pediatrician can s/he be reached even if only later in the day; and if your questions are more pressing how soon will your doctor call you back?
Is the pediatrician relaxed in her answers or do you feel that your questions are not really welcome? Can you see yourself asking a "silly" question or does the style of the doctor intimidate you?
Do you sense that the doctor sincerely likes children and enjoys the work of caring for children? Would you feel safe letting this doctor hold your baby?

What are the office rules for emergencies?

Where would you be expected to take your child in an emergency and is the doctor able to attend to your child at that facility?
Is the office equipped to handle common pediatric emergencies and can the office arrange easily for expert outside consultations?
Does the office have a laboratory and if so which tests can be run there? At a minimum any pediatrician should to be able to do routine urine analysis, urine and throat cultures and check blood for anemia and glucose.

How are messages taken and is the staff friendly and inviting?

Does the office feel safe and clean, a place you would let your child crawl around in assuming, of course, no one nearby was sick?
Is there a method for separating very sick children from well visitors?
Is there a triage system for very sick children to get priority and does the staff make an effort to contact well visitors about possible lengthy waits when sick children overrun the schedule as often happens in the winter time and just after school starts in the Fall?
What is the usual wait time when there are no emergencies?
Are there weekend and evening appointments for well care or only for sick visits - if you are a working family this can be a very important consideration.

Is the office a good source of information and networking?

Is this pediatrician interested in developmental pediatrics and can you rely on this doctor to help guide you through the times your child may need assistance that is not limited to prescription writing and medical instructions?
Is the pediatrician a child advocate with vocal opinions about children and drug use, violence, media influences, etc and if so do his opinions match your own beliefs or are they radically different in ways that might make communication difficult?

Try to make an appointment to meet the pediatrician -- or if the office policy does not allow for that -- at least make a visit to the office that includes 15-30 minutes in the waiting room. You can learn a lot about a practice this way including how other parents feel about the doctor. You will get a first hand view of how the staff handles children, (who may be irritable), parents, (who may be equally irritable), and you may even see the pediatrician if s/he routinely accompanies a child either to or from the examination -- sometimes a picture is worth a thousand questions and answers. Don’t assume that the doctor is mean or uncaring if some children refuse to leave the toys in the waiting room to be examined or emerge from the examination crying. Pediatrics is tricky business, as is parenting, and much of what happens in the doctor’s office is a lot less than pleasant from the receiver’s viewpoint -- you might recall your own childhood vaccinations and understand things haven’t changed much when it comes to needles! The key to recovery for children is in how the parents manage the visit and is determined by the general mood of the office -- the staff’s sympathetic manner, and the presence of rewards such as stickers and "high-fives" from the nursing professionals. Put yourself behind your child’s eyes and ears and evaluate the environment for kid friendliness -- are the toys "fun" and are there enough trucks and blocks to go around?

Picking a pediatrician can be an intense and challenging task but it can also be an educational and enlightening one. Often parents, after visiting in my office, tell me how much more excited they are about the upcoming birth, now that they have seen the "in-living color" version of being a parent; and nowhere is being a parent more deeply felt than when bringing your precious child to the doctor’s office. Evaluate carefully but also look to enjoy the experience. Instincts do count in choosing a pediatrician, and if possible both parents should feel equally as comfortable with the choice since this is a very long term relationship. You are creating a long term partnership with all members aimed at one goal -- the healthy and happy development of your new family.

Dr. Paula is a well-known and loved pediatrician in Manhattan. She is dedicated to helping you in your demanding job as a parent. She has her own Web site at DrPaula.com

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