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-baby visits. I'm thankful that my Seattle ob-gyn recommended a local pediatrician who answered all my questions and sat patiently as I thought up even more about life with a newborn.
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 a hassle, you'll also protect your child's health. Babies who see the same doctor for their first six months are up to twice as likely to receive key tests before age 2, according to a study Dr. Alessandrini cowrote. The ideal time to start the search for a pediatrician is between 28 and 34 weeks into your pregnancy. The process may seem overwhelming, 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.
First, Check Them Out On Paper
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."
Some parents prefer to frequent 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 opt for doctors of osteopathic medicine (D.O.'s), who practice a "whole person" approach to care. Like M.D.'s, D.O.'s attend a four-year medical college and have a variety of specialties. Nurse practitioners (N.P.'s), are another available option. N.P.'s have graduated from nursing school and gained board certification in a specialty. (They?re also known as advanced-practice nurses, or A.P.N.'s.) In many 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 an easier time getting an appointment with an N.P. than with a pediatrician. (If you are considering a D.O. or N.P., make sure she did a residency or is 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.
Next, Check Them Out in Person
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 may be starting to form opinions on, say, breastfeeding and sleep training, and these topics can be great conversation starters. You can also ask what happens at the first well-baby visit and how the office operates day to day.
Keep in mind that many docs work only certain days, so chat with a few at the practice, because 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."
Last, Watch the Doctor in Action
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 have to occasionally put you on hold for a long time; after all, emergencies do happen. Two mind-numbing delays in a row, however, are a bad sign.
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.
In the waiting room, chat with other parents and ask 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, appreciated that her doctor went above and beyond when her 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 check in," Smeraglia says.
Of course, things don't always work out so smoothly. When Kristina Leyva, also of San Diego, noticed that her M.D. shrugged off her commitment to breastfeeeding once her baby was born, she knew the 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 when you've found a 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 him," Dr. Shu says. "But if you just didn't feel comfortable, move on. No one doctor is perfect for everybody."
Give That Office a Checkup
Learn what matters, and what doesn't, in your pediatrician's practice.
- Doc's email and cell number: They're not as important as you'd think: You could end up playing phone tag. Plus, getting detailed advice via email may compromise confidentiality.
- Web presence: Many docs let you make appointments, ask nonurgent questions, and access records online. It's not necessary, but it sure can be helpful.
- Extended hours: This perk 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. For more office ins and outs, visit americanbaby.com/docsecrets.
What to Ask Any Potential Pediatrician
After you have referrals and search online, it's time for a go-see. Get answers from the doc to these questions.
- 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 for all of our appointments? If you can't be sure 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 about patient care.
- 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 nurse? If you plan to breastfeed, 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 is: "I prescribe them only as necessary." You're probing to make sure the doctor isn't too quick to dole out doses, which can lead to antibiotic resistance.
Get the Most from Pediatrician Visits
A helpful quiz to prep you for the new doc in your life. Hint: Some Q's have more than one correct answer!
1. The best time to have an appointment is:
A. First thing in the morning.
B. The last slot of the day.
C. Right after the office staff gets back from lunch.
A and C. "Early morning and after-lunch slots are least likely to have a long wait," says Laura Jana, M.D., a pediatrician and coauthor of Heading Home With Your Newborn. The later your appointment in the morning or afternoon, the more likely it is that the doctor will have gotten backed up, especially with the rush of older kids (and all their germs) after school lets out. You?ll also want to avoid scheduling during naptime whenever possible. Crankypants alert!
2. At well-baby visits during the first year, you should expect your doctor to:
A. Track your child's growth and developmental markers, do a thorough physical exam, and administer immunizations.
B. Discuss your child's nap and nighttime sleeping schedule as well as his eating habits.
C. Allow time to talk about any behavioral issues you've noticed or have questions about.
A, B, and C. "I like to start each visit by asking parents if they have questions," says Alanna Levine, M.D., a spokeswoman for the American Academy of Pediatrics. "I also go over changes parents may need to make. For instance, if their baby is rolling over, I remind them it's time to lower the crib mattress."
3. To prepare yourself before the appointment, you should:
A. Call the office to see if the doctor happens to be running late.
B. Load up your diaper bag with a bottle and a stash of small toys.
C. Inform the office administrator of any changes to your insurance or contact information.
A, B, and C. "It's a good idea to call to see if the doctor is running on time," says Dr. Levine. Emergencies can arise, so you may end up waiting, and you'll want to keep your tot occupied with your own bag of tricks. Update the staff on key info in advance so that's one less thing to deal with.
4. Never visit your doctor's office without making sure you have:
A. Your child's vaccination records.
B. A list of your questions.
C. A list of symptoms (runny nose? weird rash?) your tot may
A, B, and C. "I'm a big believer in parents writing down their questions and kid's symptoms before they arrive, because they're so easy to forget during the appointment," Dr. Jana says. Noted! It's also important for you to keep track of your child's health history and document any reactions to vaccines or medications. Throughout your little one's childhood, many doctors will ask for these detailed records.
5. If you hate to see your little one get a shot, make it easier for you both by:
A. Giving him something to suck on.
B. Standing back so the doctor has elbow room.
C. Dosing Baby with a children's pain reliever ahead of time.
A. It's hard to get around the discomfort of shots, but studies suggest that babies cry less and exhibit fewer signs of pain when they suck on a pacifier, especially one dipped in sugar water, for the big pinch. If it's okay with the doctor, hold and comfort your baby during the injection too. Most M.D.'s don't recommend using topical numbing solutions or preventative pain medications. "You should only give acetaminophen if a fever occurs after the shot," Dr. Jana says.
6. If a doc dismisses your concerns, you should:
A. Switch doctors immediately.
B. Ask her to discuss the issue with you in more depth.
C. Research the topic online and follow the advice you find.
B. As in parenting, there isn't always one right answer when it comes to medicine. So if a doctor recommends something that makes you uneasy, politely ask her to explain her reasoning. If you have an article from a magazine or a reliable website that's relevant to the topic, bring it in to discuss. If, however, your pediatrician consistently refuses to consider you a partner in your child's health care, it may be time to start seeing a doc whose style you prefer or who can better explain the rationale behind her suggestions.
7. The fastest way to get a reputation as Annoying Mom at the office is to:
A. Ask tons of questions during all your appointments.
B. Page the doc after hours to discuss issues you could have raised earlier in the day.
C. Bring your baby into the practice at the slightest sneeze.
B. "It doesn't bother me when parents bring their children in frequently," Dr. Levine says. If the situation is urgent, most docs won't mind if you disturb them (even at 3 A.M.). But if you're worried about, say, a cough that's been lingering for days, rather than page the doc, wait until office hours. Don't hesitate to call after hours if you have a truly pressing need -- for example, if your baby is absolutely inconsolable or has a fever that just won't let up.
Originally published in American Baby magazine in 2011. Updated in 2014.
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