Why Choose A Pediatrician
To Care For Your Child?
How Are Pediatricians
Trained?
When Should
You Look For A New Pediatrician?
Finding
The Right Pediatrician: Where Do You Start?
Setting Up An Interview
Meeting
The Pediatrician: Questions to Ask
Going To The Interview
As A Family
As a general pediatrician, I frequently speak with both
current and expecting parents about choosing a pediatrician. Many parents
are not aware of the importance of selecting the right doctor for their
children, or of how to go about doing it. In this article, I offer some
guidelines that I hope will help them through this process.
Why
Choose A Pediatrician To Care For Your Child?
In deciding on a health care provider for your children,
you can choose from among a variety of different professionals, including
pediatricians, general practitioners, family physicians, and nurse practitioners.
A general or family physician may treat your children along with your entire
family. These physicians have less pediatric training than pediatricians,
but are licensed to care for children.
A family or pediatric nurse practitioner is a nurse with
additional training to provide independent care for your child, in partnership
with a licensed physician. There may be one or more nurse practitioners
working in a pediatrician’s office. An important point to keep in mind,
however, is that children and adolescents have very specific health and
behavioral needs. Pediatricians have the most comprehensive medical training
to respond to these needs.
How
Are Pediatricians Trained?
Pediatricians are medical doctors who have usually completed
four years of college, followed by four years of medical school and three
years of residency (on-the-job training). Some pediatricians have additional
subspecialty training beyond residency. Residency training prepares pediatricians
to help meet the needs of healthy children in such areas as normal growth,
development, nutrition and behavior. They are also trained to recognize
and treat both common and unusual illnesses and injuries that may occur.
After residency, the doctor may take a comprehensive exam
given by the American Board of Pediatrics. If the pediatrician passes this
exam, he or she is considered to be board-certified, and is then eligible
to become a fellow of the American Academy of Pediatrics (FAAP). You can
check on any doctor’s board certification at the following web site:
www.certifieddoctor.org
When
Should You Look For A New Pediatrician?
Parents may seek a new pediatrician for several reasons.
The most common is that they are expecting a first child. Or, they may
have moved to a new area, changed insurance coverage, or be unhappy with
their prior health care provider. Whatever your reason for looking for
a pediatrician, it is important to choose one as soon as possible and not
wait for your child to be ill. During pregnancy, it is wise to find a pediatrician
by the beginning of the third trimester, or seventh month, of gestation.
Finding
The Right Pediatrician: Where Do You Start?
Many people spend more time choosing a realtor or financial
advisor than they do picking a doctor for their children. Ask yourself,
which is more important? You should plan to meet with several pediatricians
before choosing one, so be sure to give yourself enough time. Begin by
compiling a list of candidates to interview. You may get their names in
a number of ways:
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Ask friends, family, coworkers and neighbors you trust.
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Contact your insurance plan for eligible pediatricians; many
plans have Internet web sites.
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Call local hospitals, many of which have referral services.
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If you are expecting, ask your obstetrician. You may also
ask your primary care physician or another physician you trust.
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Some Internet sites that may be useful in finding pediatricians
in your community include:
American Board of Pediatrics: www.abp.org
American Academy of Pediatrics: www.aap.org
American Medical Association: www.ama-assn.org
The Health Pages: www.thehealthpages.com
The Doctor Finder: www.docfinderplus.com
Some of these sites have information about the pediatrician’s
training, interests, office hours, and accepted insurance plans.
Setting
Up An Interview
Most pediatricians offer free interviews, although some
may charge for this preliminary visit. If there is a fee, ask if it can
be applied to a future office visit, since your insurance will not usually
cover this charge. Be wary of pediatricians who do not offer interviews.
Screening begins with the initial telephone call: Before
deciding to visit the pediatrician, you may gather some useful information
from the office staff, including:
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What are the doctor’s office hours?
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Does the pediatrician accept your insurance?
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Are laboratory facilities on site? If not, where would your
child be sent for these?
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Is screening for hearing and vision done in the office?
Don’t forget to notice how easy or difficult it is to get
through on the telephone. Also, decide if you are more comfortable in a
small office practice, or in a larger group practice.
Meeting
The Pediatrician: Questions to Ask
It is useful to come to the interview with a list of questions.
Be prepared not only to listen to the responses, but also, to pay attention
to the way you feel about your interaction with the doctor.
Communication between the pediatrician,
parents and child are key: Some things to think about are:
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How well does the doctor listen?
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Do your questions get cut off, or do you feel rushed?
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Does the doctor treat you as a partner in the care of your
child?
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Do you feel a sense of trust in the doctor?
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Does the pediatrician ask you important information about
your home or family?
The safety of your home environment, presence of other children
or pets, and family health problems can all affect the health of your present
or expected child.
Look around you: Does
the office seem clean and organized? Is the staff courteous? Is there a
separate waiting area for sick and well children?
Check credentials: Remember
that you want a doctor who is knowledgeable to handle both common and unusual
health problems.
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What is the pediatrician’s educational background?
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How long has she been in practice?
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Is she board-certified?
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How does she keep up-to-date with medical knowledge?
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Does she have any special medical interests?
Determine the doctor’s availability:
Children
get many acute illnesses, and it is important to know how available your
pediatrician is to see your child, on the same day if necessary.
-
How do you reach him for routine questions or urgent problems?
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Does he have specific telephone call-in times?
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Can you reach him by e-mail?
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Does he have a web site?
What if your child becomes ill?
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If your child is ill, will she usually be seen in the office?
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When would she be referred to the emergency room?
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If your child needs to be hospitalized, what hospital would
the doctor use, and who would be responsible for your child’s care?
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Who covers the pediatrician when he is away?
What type of staff is in the office?
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Are there nurses, nurse practitioners, resident physicians
or medical students on staff in the office?
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Will any of these staff care for your child?
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Are you likely to see different providers at each visit?
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How much time will the pediatrician spend with you and your
child at a typical visit?
Care of newborns:
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When is the first newborn exam in the hospital?
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Will your pediatrician be doing it?
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When is the first newborn office visit recommended?
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For breast-feeding babies, this should be within the first
week of age. Formula fed babies may be seen first at 1-2 weeks. Is there
office staff supportive and knowledgeable about breast-feeding?
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What is the pediatrician's opinion about newborn circumcision?
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How often are subsequent visits?
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What is the physician’s recommended vaccine schedule?
After the first visit, recommended checkups in the first
2 years are at 2, 4, 6, 9, 12, 15, 18 and 24 months. Depending on your
child’s individual needs, your pediatrician may recommend other visits,
as well.
Explore the doctor’s attitudes
about things that are important to you: If you use complementary
or alternative health methods, or traditional health practices, ask about
the pediatrician’s knowledge and acceptance of these. If you have important
cultural, religious or moral beliefs related to your child’s health care,
express these to the pediatrician and observe the response.
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When does she prescribe antibiotics?
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How does she respond to parents’ concerns or disagreements
about care recommendations?
Are you a nontraditional family, such as gay, lesbian, or
single parents? Are you separated or divorced? Are your children adopted
or in your care as foster children? Are the pediatrician and her staff
sensitive to these types of families?
Going
To The Interview As A Family
It is useful to go to the visit with your spouse or partner,
so that you may both get a sense of the interaction. Also, if you are interviewing
the pediatrician after childbirth, you may want to bring your child along
to the visit. It could be helpful to see how the doctor and your child
relate to each other. However, if you are considering leaving another physician
to whom your child has become attached, you may want to be careful about
how and where your child meets a new doctor.
Remember that your choice of pediatricians is not permanent.
If at any time you are not satisfied with your child’s care, discuss your
concerns with the pediatrician. If the problem continues, it may be time
to find a new doctor.