If you're like most parents, your child's pediatrician is a pretty important person in your life. After all, you're partners in building healthy, happy children. But how do you know whether your doc really rates? In most cases it's more than just board certification, a stellar academic performance, and impeccable credentials. Among other things, it's the way a doctor handles your child's needle phobia, how quickly his office responds when you call for anything from an appointment to advice on bringing down a fever, and how expertly he translates medicalspeak into parent- and kid-friendly language. But don't take our word for it. We asked pediatricians around the country what qualities they valued in their colleagues, their practices, and their own kids' doctor. Here's what they had to say.
Whether your child's been diagnosed with asthma or whooping cough, if you don't understand the condition, you may not understand the treatment. And when you use medications improperly or don't recognize worsening symptoms, your child's health is at risk. "Doctors often don't realize that the things they explain are hard to understand," notes Andy Spooner, M.D., director of general pediatrics at the University of Tennessee and Le Bonheur Children's Medical Center, in Memphis. "So being eloquent and clear is one thing, but doctors have to go beyond that. They have to use a variety of communication methods. For example, if I saw an infant with eczema, I'd explain the condition, give the parents some printed material to take home, and also ask how they were going to bathe the baby that night, getting them to talk through what they're going to do."
Granted, doctors are busy people, but you want yours to act like someone who has more than a nanosecond to spare. "A lot of it is about body language," says Ellen Kempf, M.D., medical director of the Children's Hospital Physician Associates, in Akron, Ohio. "As a mom, I want someone who is on my level -- who is sitting down instead of standing with a hand on the door."
Don't worry about taking an extra few minutes to ask questions -- a really great pediatrician will never make you feel guilty for worrying about your child's health. And he knows that your asking questions can actually save him time in the long run. When you're aware, for example, that a cold can last up to 14 days, you may be less tempted to bring your child back in on Day 5 because the sniffles persist. "If things are explained clearly and correctly from that first visit, parents will feel more reassured," says Mark Colon, M.D., a pediatrician at the Children's Hospital of Orange County Boys and Girls Club Clinic, in Santa Ana, California.
That's not to say you should expect an endless conversation with the doctor. "Say a child comes in with a rash, and the appointment is scheduled for ten minutes," Dr. Kempf says. "If the mom says, 'By the way, I need to talk to you about his school problems -- he's a bully on the playground, and he's not achieving,' then I'll say, 'We need to schedule an appointment to address this properly.' That gives credit and value to the problem, but I'm not ramming it into a ten-minute visit. Devoting insufficient time to an issue is no good for anyone."
You don't need to be a doctor to give an immunization, take a throat culture, or perform a weight check, and a first-rate pediatric practice recognizes that, employing well-trained support staff like registered nurses and pediatric nurse practitioners. "Nurses can essentially do anything under the supervision of a doctor," Dr. Spooner says. "And, in fact, a lot of them do take on the exact same role as a physician." Because nurses' schedules are generally less hectic than a doctor's, you wait less and may have an easier time getting an appointment.
Stomach bugs, croupy coughs, and frightening high fevers don't always respect the Monday to Friday, 9 to 5 workweek. They crop up on Christmas Day and on Saturdays at 11 p.m. But just because it's after hours, your pediatrician shouldn't be AWOL. "Don't expect your doctor to be there 24/7, but he should have a system that gives you access to round-the-clock medical care," Dr. Kempf says. That may mean having an answering service or registered nurses staffing the phone in the middle of the night with a doctor always on backup call.
Who wants to sit, and sit, and sit in a waiting room with a cranky, sick child? Worse yet, who wants to have a feverish kid and find out the office closes early on Wednesdays? A pediatrician worth his weight in thermometers will have office hours that work with your schedule, will allow a same-day sick visit, and won't keep you waiting. How long is too long? With a routine visit, you shouldn't have to wait more than about half an hour, and you should be in and out of the office within an hour, Dr. Kempf says. "Well-checks can take longer, because they involve hearing and vision screenings and immunizations."
Your child has vomited six times in the last 12 hours. She can't even hold water down. You call your doctor for advice and, of course, a spoonful of reassurance. How soon should you expect a call-back? A well-run office will have a triage system in place, with nurses answering medical calls and directing the ones they can't or should not handle to the doctor. "If a patient is asking for immediate medical advice, that should be given right away," Dr. Spooner says. "And if a patient needs a call-back regarding the problem, that should happen within 30 minutes to an hour." If you're calling for a nonclinical matter -- a prescription refill or advice on whether to introduce fruits or vegetables first to your baby -- most pediatricians will return the call within 24 hours. She has an efficient, friendly office staff.
What good is a great doctor if a surly, uncooperative office staff makes it difficult to get to her? Whether you want a referral, an appointment for a sick visit, or some help clearing up an insurance problem, it pays to scout out a practice where the staff is as competent and affable as the doctors they serve. "In any office, a patient spends more time with the support staff than with the physicians," Dr. Kempf says. "A really great pediatrician will have an office staff that exudes the same qualities as the doctor."
You might be the one who answers the questions for your shy toddler, but a really good pediatrician will never forget that the concerns and comfort of his patient -- your child -- come first. "I'll examine a child where he or she feels most comfortable, whether it's on the exam table or a parent's lap, if possible," Dr. Colon says. "I also never lie to a child -- if something is going to hurt, I tell him so, but I'll also tell him why I have to do it. In general, I think a good pediatrician will treat a child the way he would treat his own kids."
Chances are you deal with one physician in your pediatrician's practice more than the rest. "But all the doctors should have the same standards," Dr. Kempf says. You don't want to walk into the office when your doctor is on vacation and get subpar treatment from her partner. The doctors may each have a different personality, but they should all give the same quality and style of care and have the same medical approach.
One thing you definitely don't want in a pediatrician is an ego. Because pediatricians are generalists, they aren't always the right physicians to handle problems like food allergies or skin disorders. "A pediatrician should know his limits," Dr. Colon says. "What I know, I know very well, but certain things are beyond my training. If I've done the appropriate things and a child is not getting better, he needs a different type of care, and my pride is never wounded for recognizing that. That's why there are specialists."
Copyright © 2003 Donna Christiano. Reprinted with permission of Parents magazine December 2003 issue.
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.