Find the Best Pediatrician

Admittedly, I got a late start looking for my baby's doctor. In fact, I waited until the day after my daughter Mirabel was born. We were living in Seattle only temporarily, so finding a pediatrician there hadn't seemed all that important. But even during that short time, we went for three well visits. Thankfully, my Seattle ob-gyn recommended a local pediatrician who answered all my questions and sat patiently as I thought up even more.

I was lucky, but it would have been smarter to scope out the M.D. scene while I was pregnant. "It's important to have a doctor you've already met and feel comfortable with, because you have enough going on after a baby is born," says Evaline Alessandrini, M.D., a pediatrician at Cincinnati Children's Hospital Medical Center.

Not only will you save yourself hassle, you'll protect Baby's health. Babies who see the same doctor for their first six months are up to twice as likely to receive key tests before they turn 2, according to a study that Dr. Alessandrini coauthored.

The best time to start the search for a pediatrician is between 28 and 34 weeks into your pregnancy. The process may seem daunting, but keep in mind that you're not trying to find the Best Pediatrician in the World -- you're looking for the best one for you and your child.

One mom's pick is sometimes another's pan, which is why you should gather three to six names from friends and coworkers. (Or try the American Academy of Pediatrics' listings at HealthyChildren.org.) Call your insurance company about any doctor you're interested in but don't see on the provider list, because lists change frequently.

Some parents prefer to make use of a family practice instead of a pediatric group so that everybody in the household can go to the same office, notes Jennifer Shu, M.D., a pediatrician in Atlanta. "Just make sure the family practice actually sees a lot of kids and babies and not mainly teenagers," Dr. Shu says. "Things change so much in pediatrics, and you'll want a doctor who's up-to-date on child care."

Other parents are increasingly drawn to nontraditional providers, including doctors of osteopathy (D.O.'s) and nurse practitioners (N.P.'s). D.O.'s may have completed a residency program at a medical school, and they practice an alternative, "whole-person" approach to medicine. Nurse practitioners have gone through nursing school and gained board certification in a specialty. (They're also known as advanced-practice nurses, or A.P.N.'s.) In 23 states, N.P.'s can even act as primary-care providers. "N.P.'s work under the guidance of a physician," Dr. Alessandrini says. You might have easier access to N.P.'s than to a pediatrician. (If you are considering a D.O. or N.P., make sure they did their residency or got board certified in pediatrics.)

It's also important to factor in the location of the doctor's office. Given how often you'll be schlepping there, you'll want an easy trip. And look into which hospitals your candidates are affiliated with; again, it's best to go with an institution that's both convenient and reputable.

Whittle down your list and schedule face-to-face meetings with three or more of the doctors. Ask if the doctor charges for such a meeting; some do, and insurance probably won't cover the fee. A number of pediatricians hold monthly group meet-and-greets. Others have sessions at hospitals, in conjunction with childbirth or breastfeeding classes.

By now you're probably starting to form opinions on, say, breastfeeding and vaccines, and these topics can be great conversation starters. You can also kick off the talk by asking what happens at the first well visits and how the office operates day to day.

Keep in mind that many docs only work certain days, so chat with a few at the practice, as one of them could be your regular "alternate."

The most important thing: Do you and this doc hit it off? "You want a well-trained M.D.," Dr. Shu says, "but what really matters for most parents is his or her bedside manner."

When you set up the prenatal visit, you can evaluate how the office works, including the all-important phone system. It's fine if assistants occasionally put you on hold for a long time, as emergencies do happen. Two mind-numbing delays in a row, however, are a bad sign. In the waiting room, chat with other parents, asking what they like and dislike about the practice. Also look around. Are there plenty of books or toys to distract children? You may have to wait on busy days; will you want to sit there?

Once you think you've found your doc, the true test is how she performs in real situations. Samantha Smeraglia, who lives in San Diego, found that her doctor went above and beyond when their 6-month-old daughter was diagnosed with a potentially serious genetic condition. "We were grateful when our pediatrician turned up at our first specialist appointment to see how we were doing," Smeraglia says.

Of course, things don't always go so smoothly. When Kristina Leyva, also of San Diego, noticed that, after her baby was born, her M.D. shrugged off her commitment to breastfeeeding, she knew her doc wasn't a good fit.

Unless a doctor makes a blatant error, though, give her a few visits before you switch. Decide it's a no-go? Simply call the office and ask them to transfer your records once you've found your new pediatrician.

"If your criticism is something the doctor could improve on, like 'Your waiting room got too full,' then it's helpful to tell them," Dr. Shu says. "But if you just didn't feel comfortable, move on. No one doctor is perfect for everybody."

Learn what matters, and what doesn't, in your pediatrician's practice.

• Having the doc's cell number and email: They're not as important as you'd think: You could end up playing phone tag. Plus, getting detailed advice via email may risk your online confidentiality.
• Web presence: Many docs let you make appointments, ask non-urgent questions, and access records online. It's not necessary, but it sure is convenient.
• Extended hours: They could help keep you out of the ER on a Sunday morning. Look for practices that stay open late and offer weekend hours.
• Well and sick waiting rooms: Good, in theory, but patients may flout the rules. Go for a doc who whisks infants into an exam room.

Once you've gotten referrals and searched online, it's time for a go-see. Be sure to find out:

• How do you keep current on medical practices? This is more telling than where she got her degree, according to Laura Jana, M.D., author of Heading Home With Your Newborn. See if the doctor regularly reads medical journals, stays on top of new policies from the AAP, and attends health conferences. Other reassuring signs: She works at a teaching hospital and often gives lectures or attends rounds.
• Which hospitals are you affiliated with? Once you know, find out if the doctor is in good standing there and if the institution has a pediatric ER.
• Will I be able to see you at all our appointments? If you can't ensure you'll see your doc each time, it's smart to make sure that the other doctors in the practice have similar approaches and that they communicate with one another.
• How do you handle sick visits? Ideally, your doc has slots reserved daily for under-the-weather wee ones.
• What advice do you offer moms who breastfeed? If you plan to nurse, it's helpful to have a pediatrician who is on board and able to refer you to a qualified lactation consultant if you need one.
• What is your approach to antibiotics? A good answer to hear: "I prescribe them only as necessary." You're probing to make sure the doctor isn't too quick to dole out doses, as this can lead to antibiotic resistance.

Originally published in the October 2011 issue of American Baby magazine.