Choosing a Pediatrician

You’re 34 weeks pregnant and you’ve got baby’s names picked out, you’ve bought clothes for baby, but have you chosen a pediatrician? This is an important decision and parents need to take many factors into account. Sadly, it’s often a more difficult decision than it should be due to the fact that insurance companies play a big role in your access to a particular provider, whether on your end or the pediatrician’s.

First, what is it that you want from a pediatrician? What sort of relationship are you looking for? Some people want to bring their child in and be told what to do at the very first sign of a fever, some just want to come in for a diagnosis if something particularly wacky is going on and then go home to use their own alternative remedies, and some want to come in just for an annual checkup. Being honest with yourself about what you want and need from your care provider is the first step to making sure you find the right fit. Some parents choose not to have a pediatrician at all but prefer a family doctor, although some will not see children under age 3 or so. Others see a chiropractor or naturopath as their family’s primary care provider and establish a basic relationship with a pediatrician for acute  situations. There are many ways to create a good support system to help you keep your child as healthy as possible.

Ask around. It’s much better to set up an appointment with someone based on a personal recommendation than picking a random listing out of the phone book, insurance directory or the web. Ask friends with children or join local online parenting groups and ask there. You’ll often find people have very different experiences with the same practice but if there’s a common thread or general consensus, it can sway your decision one way or the other. Your midwife or childbirth educator may be able to point you in a good direction. (I’m not mentioning names here because my recommendations change regularly depending on ever-evolving policies and practices and feedback from other students.)

You should always feel respected. At the end of the day, this is YOUR child we’re talking about. There are no dumb questions when it comes to the wellness of your child and you should always feel comfortable talking with your child’s doctor and feel like your questions are being answered thoroughly enough for you.

Remember that you are paying your pediatrician and they are running a business. If you are not happy with the service you receive, you can – and probably should – let your concerns be known and if they are not adequately addressed, consider taking your business elsewhere.

Having said that, you can’t expect to be on the exact same wavelength as your pediatrician on every topic or like every person who happens to work in the office. I’ve heard regular complaints about certain office staff but many parents look past that because ultimately what matters most to them is having a pediatrician who respects, or at least tolerates, their choices. This is especically true if you are planning to do anything “alternative” such as having an out-of-hospital birth, delaying or rejecting vaccinations, having an extended breastfeeding relationship, co-sleeping, preferring alternative remedies to antibiotics whenever possible, etc.

Questions to ask the Pediatrician

You are selecting this person for an extremely important job: helping you to keep your family healthy. Of course, this responsibility lies primarily with you and your choices in terms of diet, physical activity, lifestyle, home environment, parenting approach…. But sickness, accidents and injuries happen, and when they do, it’s important to have someone you trust on your side.

I like to group types of questions to ask pediatricians into the three Ps:

Practical Stuff: hours and availablility, location, hospital privileges, email contact, phone support, same-day sick appointments, late or weekend hours, sole or group practice, board certified, length of appointments, back-up physicians, insurance/Medicaid, typical wait time, well-child/sick-child waiting areas, and so on.

Policies for Health Care: you may wish to ask about their philosophies on immunizations, under what circumstances they prescribe antibiotics, if they are foreskin friendly and know not to retract the foreskin of an intact infant, when you should call if your child has a fever, what they typically recommend for ear infections or colds, if they discuss diet and nutrition, etc.

Parenting Practices: you may also like to hear their opinions on alternative medicine (if they are open to any homeopathic, herbal, chiropractic or acupuncture remedies or practices you use), breastfeeding, attachment parenting, co-sleeping, gentle discipline, potty training, babywearing etc.

You won’t necessarily want a health care provider to counsel you on each of these topics, but it’s helpful to know their stance on one or two that are the most important to you in order to see if you’re on a similar wavelength or at least to get an idea if they know local resources to which they can refer you for further support. Also, it’s good when they know their limits and are willing to admit they don’t know much about (homeopathy or whatever else) but have nothing against it. As long as you can have a dialogue about it, that’s a good thing!

Most doctors will ask about risk factors of exposure to lead or smoke, but only one of my children’s doctors once asked about whether we watched TV in the house, whether the kids – and I – all wore bike helmets and whether I used any Teflon pans or microwaves in my cooking. I thought that was great because he was asking about the child’s environment rather than just treating the symptoms before him. For me, that’s important.

Use your BRAIN!

It can be very difficult for most people to think of all the questions they want answered when they’re on the spot. How often have you left a care provider’s office only to then remember a question or two you had wanted to ask? You are never more emotionally vested than when it comes to your children, especially when you’re there because your child is sick and you want to do the best thing for him or her. If you remember to use your BRAIN, you will at least have asked three very important questions to jumpstart your conversation:

  • B: What are the Benefits of the drug/test/procedure that is being recommended?
  • R: What are the Risks of the drug/test/procedure that is being recommended?
  • A: What are the Alternatives of the drug/test/procedure that is being recommended?
  • I: What does your Instinct tell you? Take a moment and listen to your gut – it’s usually right.
  • N: Need more time? If it’s not urgent, maybe you want to do Nothing until you’ve done further research, sought a second opinion or waited a little bit longer.

Consider seeking another provider if:

  • You are not comfortable with the provider’s bedside manner or the way in which you or your children are treated.
  • You feel your questions and concerns are dismissed or you feel rushed through appointments.
  • You think the treatments recommended are too aggressive or not in line with your parenting philosophies.

Remember:

You want to find someone who respects you as the parent, is available when you need him, and offers guidance, support and information in a way you feel comfortable with. At some point along the way, you will hear opinions that differ from yours or observations you didn’t want to hear. Remember that YOU are the parent of your child. Be confident, be aware of your options, be responsible. Read, research and question, don’t be afraid to speak up or say NO, and if push comes to shove, don’t be afraid to get up and leave — you are your child’s biggest advocate.

Trust your gut. Listen to your instinct. You will know if you’re with the right provider or not.

What do YOU look for in a pediatrician?  

 

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