Picking a Pediatrician

There are many things that new parents need to do while preparing for their baby to arrive.  One that frequently gets overlooked is choosing a pediatrician.  Pediatricians are doctors who specialize in the care of children from birth to 18 years of age and are trained to help parents care for their little bundle of joy.  It’s a good idea to start looking before your baby is born because the hospital will want to know who the baby’s doctor will be when you go in for delivery.

The first place to start looking for a pediatrician is in your own backyard.  Friends and family, especially those you trust, are a great place to look for a referral.  Many new patients I receive come from word of mouth.  Next, ask your obstetrician!  Most will have lists of pediatricians in the area.

At Children’s Primary Care Medical Group in San Diego, we offer complimentary prenatal Meet and Greet appointments for prospective parents.  This is an opportunity to see the office, get some information about the practice, and see if you click with the doctor and staff.  You’ll want to be prepared with some questions so here is a guide to get you started.

Location

In your baby’s first year of life you will be making many trips to the doctor.  Just in the first few weeks alone you may be going in several times to check your baby’s weight, check for jaundice, and to make sure feeding is going well.  Once feeding is well established, there are 6 more check ups within the first 12 months.  This doesn’t include potential sick visits in between!  Therefore, it’s a good idea to start looking for pediatricians within a few miles of home, or at least somewhere easily accessible.

Insurance

Not every practice takes every insurance, so before going in for an interview, make sure your (conveniently located) practice of choice takes your insurance.  A quick call to the office or to your plan can give you that information.  You may also want to inquire whether the practice is taking new patients. CPCMG never closes to new patients but some busy offices or smaller practices may need to do so from time to time.

Hours and After Hours

When calling to set up your Meet and Greet, be sure to find out the normal hours of operation and be sure that well visits are offered at times that work with your schedule.  For example, a few days a week I am in the office at 8 am for walk in appointments, so on those days I do not do well visits until later in the morning.  You may also want to ask if the practice offers evening hours or weekend hours.

Once you are in the office talking with the pediatrician, find out what your options are for getting advice when the office is closed.  Most practices will have a nurse triage service, as well as a doctor on call.  Also, many doctors have websites and blogs with lots of great advice that can help you right from your own computer.  Finally, ask about a patient portal.  At CPCMG, patients can sign up for an online portal which allows them to see their child’s medical record and also allows them to email their physician with non-urgent questions.

 Visiting the Office

When you arrive at the office for your Meet and Greet, make note of whether or not there are separate waiting rooms for sick kids and well kids.  Most practices will have separate entrances and waiting rooms in order to isolate kids who are contagious from kids who are well. Is the office clean?  Does the staff greet you in a friendly manner?  Does the office appear to be kid-friendly?

Meeting the Doctor

This is your opportunity to get to know one of the many people who will be part of your village that helps you raise your child.  Not only do you want to know different aspects of care he/she provides, but you want to see if your personalities fit.  Some people like a more direct style, some people don’t.  Some people like a sense of humor, some people don’t.  Some people like to schmooze, some people don’t.  Everyone is different so don’t feel bad if you don’t click with the first doctor you meet.

What should you ask?

  • Did the doctor attend an accredited medical school and residency program?
  • Is the doctor board certified by the American Board of Pediatrics?
  • Does the doctor have children?  ( I don’t think this necessarily matters to giving good care but some parents like to hear about what the pediatrician has done or does for their own kids.)
  • Where would the doctor send your child if you needed hospitalization, emergency care or a specialist?
  • What other areas of interest or experience does your doctor have besides primary care?

This next question gets its own paragraph for a good reason. It’s my least favorite question: What is the doctor’s philosophy on (insert anything here)?  I don’t particularly like this question because, in general, medicine isn’t a philosophy but is evidence-based.  Yes there is the art of medicine and there is something to be said for experience, but many issues we encounter have well established guidelines based on the latest evidence.  For example, there is no philosophy on antibiotics.  They are either indicated, like for pneumonia, or they aren’t, like for a cold or other virus.  If the doctor is up on the latest guidelines he/she will even tell you that in some cases, ear infections don’t even require antibiotics.  this also applies to the question of vaccinations.  The schedule is set by the Centers for Disease Control and adopted by the American Academy of Pediatrics after carefully being studied for safety and efficacy.  It is intended to protect your baby from some very devastating infections, which still exist, and is what your pediatrician should be recommending.  If your doctor allows patients who are unvaccinated or who are on a different schedule, he/she is likely leaving it up to the parents to decide which diseases they want to prevent and which they do not.

Of course there are some things in which there is wiggle room and advice will vary greatly.  For example, pediatrician’s will all offer slightly different advice for behavior, sleep (schedules and training, not safety) and even feeding.  You want someone who will be your partner in making the best decisions possible for your child and present you with the latest information, as recommendations are constantly evolving.  While your doctor should answer your questions in a non-judgmental way, keep in mind that there are some things that we just don’t agree with.  It is our job to let you know that some things you may do may carry risk or may not offer any benefit.  At the end of the day though, we all want the same thing: what is best for your child.

Overall, the best advice I can give is to make sure you find a convenient doctor who you feel comfortable with.