How to Choose a Pediatrician
Editorial provided by Carole Allen, MD, Specialty Director of Pediatrics, Harvard Vanguard Medical Associates and President, Massachusetts Chapter, American Academy of Pediatrics.
One of the important first decisions that you will make as a parent is the choice of a pediatrician. Many expectant parents can feel overwhelmed at the prospect of finding the right one. You will be selecting this expert as the provider of medical care for your child and an advisor for you for many years to come. Before making this decision, it is helpful to consider all aspects of the care that a pediatrician can provide - from their training and experience to practice logistics like office location and hours. Doing some "homework" can go a long way in helping you to find a pediatrician you can trust and with whom you can build a great relationship.
What is a pediatrician?
A pediatrician is a physician with at least three years of training beyond the standard four years of medical school he/she attends after college. During these additional three years, physicians acquire the skills to treat a range of medical issues in children from infancy to the teenage years. After successful completion of the additional training, a pediatrician can become board-certified by the American Board of Pediatrics. A good pediatrician is not only a physician who treats illnesses, but one with expertise in disease prevention and child development as well. It is also important for him/her to be warm, compassionate, and open minded to your thoughts and views about child rearing.
When and where to start looking
Compile a list of candidates two to three months before your due date. This should allow adequate time to talk to other people, research any recommendations they give you, and interview 1 or 2 prospective pediatricians. The more time and effort you put into your search, the more well-informed and well-educated your choice will be.
Asking your friends, family, and even neighbors with children for recommendations is a good place to start. Parents of current patients are valuable resources and will tell you if they are satisfied with their own pediatric practice. Your obstetrician is also someone who can provide recommendations. After all, he/she has gotten to know you over the course of your pregnancy, has a good understanding of the qualities you feel are important, and typically knows pediatricians in the community.
What to look for
Given routine check-ups (often with immunizations, but not every time) at 1 to 2 weeks, 1 month, 2 months, 4 months, 6 months, 9 months and 12 months, on average, you and your baby will visit the doctor's office 7 times in the first year just for "well visits" alone. You want those – and all future appointments – to be comfortable, informational, and helpful all at the same time. As part of your evaluation, consider:
- Does the doctor take time to discuss problems and listen to concerns?
- Does the doctor welcome questions?
- Does the doctor seem to know about the latest medical advances?
- Is the waiting room pleasant and kid-friendly?
- How is the doctor supported? Are there other doctors and nurses who can provide back-up to ensure that you can see someone when needed for urgent issues?
- If the doctor works in a collaborative relationship with a nurse practitioner, physician's assistant, or another pediatrician, will you have an opportunity to meet these providers?
- If you are planning to breast-feed, can the office provide you with support?
- Does the practice use an electronic medical record so that information can be easily shared with others who may care for your child?
- Does the doctor's office offer a secure electronic service for e-mail, accessing history and lab tests, etc. for your convenience?
- Is the location of the office convenient for you? Are the hours convenient?
- With which hospital(s) is the pediatrician affiliated? If your child needs lab tests or imaging, are these offered in a convenient location?
- Is the physician board certified in pediatrics by the American Academy of Pediatrics?
Schedule an interview
Once you have narrowed your choices down to one or two pediatricians, a face-to-face meeting (preferably with both parents present) may be scheduled. Some practices offer "meet the pediatrician" nights instead of individual meetings. Arrive with specific questions about the topics that are most important to you. Keep in mind that most pediatricians do not charge for prenatal interviews, but occasionally some do. It is always good to check with your insurance carrier.
The following questions can be used as a starting point. Add to the list to make sure you cover all of the topics that are important to you. In case time runs short, be sure to ask the questions that are most important to you first.
- Do you and the doctor have similar views on topics such as immunizations, alternative medicine, and parenting issues? If not, is the doctor open to and supportive of other opinions and approaches?
- What is the scheduled length of the pediatrician's appointments?
- How long does it take to get a non-emergency appointment with the doctor or with another provider in the office?
- How is care handled outside of office hours? Will you have access to medical advice 24 hours per day? What is available for weekend coverage?
At the end of the interview you should have a sense of whether the doctor's background, style of communication, philosophies and office meet your requirements. Ultimately the decision usually revolves around that intangible feeling that you will be comfortable with the pediatrician's style and approach.
Final thoughts
Expecting parents should feel as if the pediatrician they choose is their partner in ensuring good medical care for their child. If you have put in the time and effort, you can feel good about the fact that you've made a responsible and well-informed decision for both you and your child.
