What to look for in a Pediatrician

What sounds like such a simple question has an answer that may be more complicated than you might think. With the changes in health care in the U.S., unfortunately, who you choose may be limited by the health insurance you have. However, with some introspective thought about what you would like in a pediatrician and some checking around with friends, family, etc., you can usually decide on a pediatrician who is also a provider on your insurance plan.

HOW DO YOU FIND A PEDIATRICIAN?

Most parents say the best way to find a good pediatrician is to ask your friends whom they bring their kids to and why. However, there are certainly other sources:

• Your obstetrician
• Local hospitals
• The state and/or city pediatric society
• Nurses where you delivered
• Medical directories found at the library
• Local medical schools
• The Yellow Pages

WHICH PEDIATRICIAN IS RIGHT FOR ME?

Now that you have a few names, you'll need to list your own priorities. I think the best way to divide your wants and needs from a pediatrician is in the categories of tangible aspects and philosophy. The tangible aspects are those practical things that will make visits and interactions with the doctor and office more enjoyable. Philosophy is a somewhat intangible. There are many aspects about the health and rearing of children which have no right or wrong way of doing things. Therefore, it is important that you feel your philosophy and way of doing things are compatible with your pediatrician's.

TANGIBLE ASPECTS

1. Is the doctor's office conveniently located? I hope your child will not get very many illnesses, but when he does, sometimes a doctor's office close-by can be one of the most important aspects of the practice.
2. How early does the office open, how late does it close -- and do they have weekend/holiday hours? Evening hours may be absolutely necessary for you, especially if you are a single parent.
3. How are phone questions handled? Some doctors answer their calls immediately, while other have a "call hour" in which they answer all their calls. Some have their nurses answer the calls in consultation with the doctor. There are probably as many ways phone calls are handled as there are doctors, so be sure you are comfortable with it.
4. How long do you have to wait in the office? This can be one of the most frustrating aspects of going to the doctor. And the waiting time may vary widely, depending upon whether it is the cold- and-flu season; therefore, keep this in mind when you are asking. Ask the doctor or nurse directly. I would also ask the parents who go to that office.
5. Does the waiting room look nice and have enough toys to make the wait less painful?
6. How are bills handled? Some offices require some payment with each visit. Others will bill you. Much of the cost is dependent upon the type of insurance you have, but you should inquire about how this is handled.
7. Is the doctor board certified in pediatrics? To become board certified, a doctor must have completed four years of medical school, three years of pediatric specialty training and passed the board exam given by the American Academy of Pediatrics. The exam is taken every seven years for recertification.
8. Where does the doctor have hospital privileges? It would be optimal for the physician to have privileges where you will be delivering so she can see your infant from the very beginning. In addition, should your child need to be hospitalized, you would want to be comfortable with the hospital where your doctor attends.
9. If laboratory tests are needed, can they be done right in the office or will you have to go elsewhere to have them done?
10. How are urgent/emergency matters handled? Some doctors can handle most urgent matters in the office. Others will refer you to the emergency room. If you are referred to the ER, will your doctor meet you there or have the ER staff take care of it?
11. When your child is ill, do you call to make an appointment or just come to the office and be seen first-come-first-serve? There are pros and cons to both systems. Appointment making ensures your child will be seen shortly after you arrive, however, that appointment time may be later than you might like. Those who have first-come-first-serve ill visits usually do this in the morning, so your child will probably be seen earlier in the day; however, in the winter months when many are sick, you may arrive in the office at 8 a.m. only to be seen at 10:30 a.m.
12. Who covers for the physician when she is sick or on vacation? In small practices and practices which have several offices, the covering physician may be someone in a totally separate office who has never seen your child before, whereas, moderate-sized offices share call among the physicians within that office.

PHILOSOPHY

1. Breastfeeding: If you are very eager to breast feed or have strong feelings about how long you want to breastfeed, you will want a physician who knows a lot about the subject and is supportive.
2. Circumcision: It is your choice, so you want a doctor who will support your decision.
3. Special circumstances: Being a vegetarian, having specific religious beliefs, etc., will require both knowledge and understanding from the pediatrician.
4. Immunizations: Most pediatricians are very aware of the need for immunizations, but asking about their immunization rates would not be improper.
5. Antibiotics: When your child gets a cold which does not require antibiotics, you do not want a physician who is all too ready to give them to you for no good reason.

Srini, this is not meant to be an all-encompassing list and, certainly, being able to find a doctor who fits all your criteria perfectly will be virtually impossible. But, I hope this will help you in your search and eliminate those from your list who run absolutely contrary to specific matters you hold important.