Choosing a Pediatrician

Selecting a pediatrician is one of the most important first decisions a parent has to
make. And if all goes well, you will be partners in your child’s health until college
graduation! In fact, in my office often the relationship lasts even longer as my senior
partner now sees not only children of his patients but grandchildren of his former
patients as well.

As a pediatrician, I view the relationship as a collaboration between the child,
the parents, and myself. While we don’t have to agree on everything, I think it’s
important that we see eye to eye on certain fundamentals like safety, vaccines,
preventative health, and the use of medications. The earlier we understand each
others’ philosophies, the better.

How to choose a pediatrician? I would start by asking other members of your
community who they use, what they like, and what they don’t like about their
practice. Many offices now have practice websites. These are a great starting point
for general information about the number of doctors in the group, their bios, and
office hours.

Once you have a list of doctors, it’s often helpful to meet with them ahead of time
to find the right fit. Most pediatricians offer this visit as a courtesy to prospective
parents. Just sitting in the office waiting room listening to how the staff handles
established patients can provide a great deal of information about how the office
runs. And a face-to-face interview really helps parents get a sense of the doctor’s
practicing style. Since many parents rely on their pediatrician for both medical and
parenting advice, style can really become important.

The following are the topics I try to cover in my new patient interviews:

General information: It’s important to know how many providers are in the
group and if you will only see one doctor, or if the group shares its patients similar
to an obstetrics practice. Many offices now use nurse practitioners and physician
assistants too. You want to know who answers the phone — is it a receptionist or
a nurse who can give out medical information? Are there evening and weekend
hours? What about holidays?

Insurance: Practices can have many different policies regarding health insurance.
Some try to take most major plans, while some don’t participate at all. There
are also concierge practices where you pay an annual fee and high out of pocket
expenses each visit to ensure more time and personalized care. You need to be
aware of your own coverage. Do you have out of network benefits? What is your
deductible? This information will help you decide which practices are affordable for
you.

After Hours: There are many different ways that offices handle after hours calls.
All practices have 24/7 coverage. Some practices choose to handle their own after
hours calls, while others share the work with other pediatric offices. Some also use
a nursing triage call center. It’s a good idea to know what the average response time
is. Typically I aim for 30 minutes or less. You also want to be familiar with how the
practice handles patients who need to be seen after the office is closed. Are they
referred to a specific emergency room or urgent care center? Will your doctor meet
you there, or call ahead to let them know you are coming? Who will see your child if
he gets admitted overnight to the hospital?

Questions for the Doctor: How are your questions between visits handled? Does
a nurse return your call or the doctor? Can you expect to be called back before the
end of the day? Does your doctor communicate via email?

Schedule of Well Visits: How often are routine appointments? Usually it’s more
frequent in the first year of life and then for healthy children becomes bi-annual and
then annual from age 3 and up.

Selecting a pediatrician is one of the most important first decisions a parent has to
make. And if all goes well, you will be partners in your child’s health until college
graduation! In fact, in my office often the relationship lasts even longer as my senior
partner now sees not only children of his patients but grandchildren of his former
patients as well.

As a pediatrician, I view the relationship as a collaboration between the child,
the parents, and myself. While we don’t have to agree on everything, I think it’s
important that we see eye to eye on certain fundamentals like safety, vaccines,
preventative health, and the use of medications. The earlier we understand each
others’ philosophies, the better.

How to choose a pediatrician? I would start by asking other members of your
community who they use, what they like, and what they don’t like about their
practice. Many offices now have practice websites. These are a great starting point
for general information about the number of doctors in the group, their bios, and
office hours.

Once you have a list of doctors, it’s often helpful to meet with them ahead of time
to find the right fit. Most pediatricians offer this visit as a courtesy to prospective
parents. Just sitting in the office waiting room listening to how the staff handles
established patients can provide a great deal of information about how the office
runs. And a face-to-face interview really helps parents get a sense of the doctor’s
practicing style. Since many parents rely on their pediatrician for both medical and
parenting advice, style can really become important.

The following are the topics I try to cover in my new patient interviews:

General information: It’s important to know how many providers are in the
group and if you will only see one doctor, or if the group shares its patients similar
to an obstetrics practice. Many offices now use nurse practitioners and physician
assistants too. You want to know who answers the phone — is it a receptionist or
a nurse who can give out medical information? Are there evening and weekend
hours? What about holidays?

Insurance: Practices can have many different policies regarding health insurance.
Some try to take most major plans, while some don’t participate at all. There
are also concierge practices where you pay an annual fee and high out of pocket
expenses each visit to ensure more time and personalized care. You need to be
aware of your own coverage. Do you have out of network benefits? What is your
deductible? This information will help you decide which practices are affordable for
you.

After Hours: There are many different ways that offices handle after hours calls.
All practices have 24/7 coverage. Some practices choose to handle their own after
hours calls, while others share the work with other pediatric offices. Some also use
a nursing triage call center. It’s a good idea to know what the average response time
is. Typically I aim for 30 minutes or less. You also want to be familiar with how the
practice handles patients who need to be seen after the office is closed. Are they
referred to a specific emergency room or urgent care center? Will your doctor meet
you there, or call ahead to let them know you are coming? Who will see your child if
he gets admitted overnight to the hospital?

Questions for the Doctor: How are your questions between visits handled? Does
a nurse return your call or the doctor? Can you expect to be called back before the
end of the day? Does your doctor communicate via email?

Schedule of Well Visits: How often are routine appointments? Usually it’s more
frequent in the first year of life and then for healthy children becomes bi-annual and
then annual from age 3 and up.

Sick Visits: Are sick visits seen the same day? Most pediatric offices save space for
urgent appointments in the schedule so children can be seen the same day if they
are sick. Some office have a walk-in sick visit time while others have a specified call
time where you can be sure to get a same day appointment.

General Philosophies: This is probably the most important. You want to be
sure that you and your doctor can work together on general health topics like
breastfeeding (some offices have their own lactation consultants), vaccines, safe
sleeping practices, antibiotic use, your need for anticipatory guidance, injury
prevention, etc. Knowing this information from the start can avoid many conflicts
later on.

Are sick visits seen the same day? Most pediatric offices save space for
urgent appointments in the schedule so children can be seen the same day if they
are sick. Some office have a walk-in sick visit time while others have a specified call
time where you can be sure to get a same day appointment.

General Philosophies: This is probably the most important. You want to be
sure that you and your doctor can work together on general health topics like
breastfeeding (some offices have their own lactation consultants), vaccines, safe
sleeping practices, antibiotic use, your need for anticipatory guidance, injury
prevention, etc. Knowing this information from the start can avoid many conflicts
later on.

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