When to Look for a Pediatrician
It's smart to scope out the pediatrician scene while you're still pregnant. "It's important to have a pediatrician you've already met and respect, because you have enough going on after the baby is born without having to worry about finding a doctor," says Evaline Alessandrini, MD, a pediatrician at the Children's Hospital of Philadelphia.
The benefits of committing to a pediatrician early aren't just for parents. Dr. Alessandrini's recent study, which she co-authored, found that babies who see the same doctor for their first six months are up to twice as likely to receive important health tests before they turn 2. "You don't want to have to reinvent the wheel every time, like going over whether the immunizations are up to date," she says. "If you have a continuing relationship with a doctor, you have the time and comfort to go deeper."
The best time to start looking for a pediatrician is between 28 and 34 weeks into your pregnancy, when you likely know what you want and have at least a few weeks to do your homework. The process may seem daunting, but realize you're not trying to find the Best Pediatrician in the World -- you're looking for the best one for your child and a personal connection for you.
One person's pick is sometimes another's pan, which is why you should collect at least three if not half a dozen names from friends and coworkers. (If you're short on names, try the American Academy of Pediatrics' referral site at aap.org/referral.) Call your insurance company about any doctor you're interested in but don't see on the list -- provider lists change frequently, and the pediatrician may have been added recently.
Next, scout out the location of the pediatrician's office. Given how often you'll be schlepping there, you'll want a short commute. The day that my then 8-month-old daughter suddenly developed a weird body rash, I loved that I was able to call, drive to the office, and be in an exam room within 20 minutes. Also look into which hospitals your candidates are affiliated with; you'll want one that's both convenient and reputable.
Meet Doctors Face-to-Face
Now you can whittle down your list and schedule face-to-face meetings with some of the doctors (up to three is reasonable). When setting up an interview, or a prenatal visit as they're sometimes called, be sure to ask if the doctor charges for such a meeting -- some do, and the fees probably aren't covered by insurance. You should be able to get in within a few weeks, although some pediatricians do monthly group meet and greets.
By now you likely have opinions on, say, breastfeeding and vaccines, and these topics can be great conversation starters. This was the case for Kelley Thompson, from Flower Mound, Texas, when she met with one doctor and brought up breastfeeding. "It was important to me," she says. "But if it didn't work out, I liked that this pediatrician wasn't going to judge me."
Only ask questions that are relevant to you, not ones you think you're supposed to bring up. "Some questions, like about their education, make it seem like you're trying to 'catch' the doctor," says Laura Jana, MD, coauthor of Heading Home with Your Newborn. "When thinking up questions, ask yourself, 'If they answer a certain way, will I care?'"
Some questions, however, are essential. What is the doctor's availability? If she works with a group practice, as most pediatricians do these days, what's the likelihood of seeing her for most visits? And if your baby has a sudden high fever at midnight, who would be on call -- a nurse or your doctor?
Decide If You Click
Other factors may seem superficial but can still affect your rapport -- for instance, some people prefer a young female pediatrician, but others want a grandfatherly type. And some parents only have eyes for a doctor with parenting experience, no matter what their age. When Kim Pulvers, mom of two boys, chose her first son's doctor in Prairie Village, Kansas, she was most comforted by his having three children older than her own. "I liked that he knew what was coming for our son and what we were going through. He shared his firsthand experiences but balanced that with expert information."
The most important thing: Do you and this doctor click? In going through her basic questions, Thompson came away with a good gut feeling about her prospective pediatrician. "She had a personality that meshed well with mine," Thompson says. "She was patient with me without being condescending and wasn't so high strung or serious that she stressed me out."
See the Doctor in Action
From setting up the prenatal visit, you can evaluate how the office works -- for one thing, its all-important phone system. Having an occasional long hold is fine -- emergencies do happen -- but two mind-numbing delays in a row is likely a bad sign.
In the waiting room, chat up other parents, asking what they like and dislike about the practice. Also check out the area. Are there books, toys, or a TV to distract children? Even at a good office, you may have to wait on busy days -- will you want to sit here?
Once you've chosen a pediatrician, the true test is how she performs in real situations -- say, if there's a hive outbreak over a holiday weekend or if your baby has the dreaded colic. Samantha Smeraglia and her husband, of San Diego, found that their pediatrician went above and beyond when their 6-month-old daughter was diagnosed with a potentially serious genetic condition. "Our doctor turned up at our first specialist appointment to see how we were doing," Smeraglia says. "We were grateful for her concern."
How to Survive a Pediatrician Breakup
Sometimes things don't go so smoothly. Kristina Leyva, of San Diego, had interviewed and liked her doctor. But after her daughter was born and the pediatrician shrugged off her commitment to breastfeeding -- implying that formula was good enough and not lauding her breastfeeding efforts -- she knew they were a wrong fit.
But unless a doctor makes a blatant error in diagnosis, give her a few visits before you think about switching. If you do decide to "break up," just call the office and ask them to transfer your records -- after you've found a new pediatrician. Should you explain yourself? Not usually. "If your criticism is something the doctor or practice could improve on, like 'your waiting room got too full,' then it's helpful to tell them," says Jennifer Shu, MD, an Atlanta-based pediatrician and Dr. Jana's co-author. "But if you just didn't click, then move on."
Leyva switched when Isabella was 8 months old. "My new doctor trusted my motherly instincts and told me I was doing a good job," she says. "I wish I had switched sooner."
Questions for Interviewing Potential Pediatricians
- Are you a parent? Don't feel awkward asking this personal question. "You're trusting this doctor with your most precious possession, and you should ask what you need to know to feel comfortable," says Dr. Alessandrini. Many parents like their child's doctor to have the extra empathy and hands-on experience that comes from being a mom or dad. But childless pediatricians are also great doctors. It's really a personal decision.
- How do you feel about breastfeeding or circumcision? The American Academy of Pediatrics (AAP) recommends, as do numerous studies, that a baby be breastfed for his entire first year. Doctors vary on how much they press the issue; likewise, there are opposing sides to the circumcision debate. If you have strong feelings either way, make sure your doctor agrees with your view -- or at least respects it.
- How do you feel about vaccines? Keeping with AAP recommendations, most pediatricians urge parents to vaccinate their children. Some doctors respect parents who choose not to, but others are so strongly in favor of vaccines that they refuse to treat children who aren't on an immunization schedule.
How Credentialed Is Your Doctor?
Look for these key designations attached to your pediatrician's name.
- Board certified: A pediatrician has completed med school as well as a three-year residency in pediatrics, but a board-certified pediatrician has also passed a series of rigorous exams, which he'll routinely retake.
- AAP member: Check to see if a potential doctor belongs to the American Academy of Pediatrics, which indicates that he adheres to the organization's guidelines and standards.
- FAAP listing: These four letters mean that a doctor belongs to the AAP and is board certified.
Originally published in American Baby magazine.
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