Selecting a Pediatrician
Among the dozens of "the most important decisions you'll ever make" about your child, this one deserves your careful attention. Most doctors will want to see your child at two days, two weeks, two months, four months, six months, nine months, 12 months and then annually. You and your child will be spending a lot of time with the doctor the first year, and you will hopefully continue the relationship through adolescence.
For a newborn, a good place to start looking for a pediatrician is by asking your obstetrician for a referral. He or she will know local pediatricians within the medical community. Other parents also can recommend pediatricians who have treated their own children. In addition, Baldwin Health has an online physician referral system where you may select a pediatrician based on proximity to your home or work.
Once you have the names of several pediatricians you wish to consider, arrange a personal interview with each of them (for newborns, do this during the final months of your pregnancy). Most pediatricians routinely grant such preliminary interviews. Both parents should attend these meetings, if possible, to be sure you both agree with the pediatrician's policies and philosophy about child rearing. Don't be afraid or embarrassed to ask any questions. Here are a few suggestions to get you started:
How soon after birth will the pediatrician see your baby?
The hospital will ask for the name of your pediatrician when you're admitted to deliver your baby. The delivery nurse will then call that pediatrician as soon as your baby is born. If you had any complications during delivery, your baby should be examined at birth. Otherwise, examination can take place anytime during the first 24 hours of life. Ask the pediatrician if you can be present during that initial examination.This will give you an opportunity to learn more about your baby and get answers to any questions you may have.
For newborns, when should I choose a pediatrician?
It's best to select a pediatrician after 20 weeks. This helps ensure that they have the information they need if you have to visit the hospital prior to your due date.
When will your newborn's exams take place?
Pediatricians routinely examine newborns and talk with parents before the babies are discharged from the hospital. This lets the doctor identify any concerns and also gives you a chance to ask questions before you take the baby home. Your pediatrician will also let you know when to schedule the first office visit for your baby (as early as one day after discharge) and how he or she may be reached if a medical problem develops before that first appointment.
When is the doctor available by phone?
Many pediatricians encourage you to phone their office with questions. If members of the office staff routinely answer these calls, you should ensure they are consulting with the pediatrician. Also ask your pediatrician for guidelines to help you determine which questions can be resolved with a phone call and which require an office visit.
What happens if there is an emergency?
Find out if the pediatrician takes his/her own emergency calls at night. If not, how are such calls handled? Also, ask if the pediatrician sees patients in the office after regular hours or if you must instead take your child to an emergency room. In many cases, serious medical problems are usually better handled at the hospital, where staff and medical equipment are always available.
Who "covers" the practice when your pediatrician is unavailable?
If your physician is in a group practice, it's wise to meet the other doctors, since they may treat your child in your pediatrician's absence. If your pediatrician practices alone, he or she will probably have an arrangement for coverage with other doctors in the community. Usually your
pediatrician's answering service will automatically refer you to the doctor on call, but it's still a good idea to ask for the names and phone numbers of all the doctors who take these calls – just in case you have trouble getting through to your own physician.
If another doctor sees your child at night or on the weekend, you should check in by phone with your own pediatrician the next morning (or on Monday). Your doctor will probably already know what has taken place, but this phone call will give you a chance to bring him/her up to date and get reassurance that everything is being handled as he/she would recommend.
How often will the pediatrician see your baby for checkups and immunizations?
The American Academy of Pediatrics recommends checkups by one month, and at two, four, six, nine, 12, 15, 18 and 24 months, and annually after that. If the doctor routinely schedules examinations more or less frequently than this, discuss the difference with him/her.
What are the costs of care?
Your pediatrician should have a standard fee structure for hospital and office visits as well as after-hours visits and home visits (if he or she makes them). Find out if the charges for routine visits include immunizations. If not, ask how much they will cost. Also, if you are covered by a managed-care system (HMO, etc.), check whether the pediatrician is on the panel of physicians.
After these interviews, you need to ask yourself if you are comfortable with the pediatrician's philosophy, policies and practice. You must feel that you can trust him/her and that your questions will be answered and your concerns handled compassionately. You should also feel comfortable with the staff and the general atmosphere of the office.
The most important "test" of the pediatrician you have selected is how he/she cares for your child and responds to your concerns. If you are unhappy with any aspect of the treatment you and your child are receiving, you should talk to the pediatrician directly about the problem. If the response does not address your concerns properly or the problem simply cannot be resolved, don't hesitate to change physicians.
What else should I consider?
How are non-emergencies handled? Some practices have nurse practitioners on-call to answer routine questions. Doctors also make themselves available for telephone consultation at specific hours. Some practices offer extended hours and the ability to make appointments online. Ultimately you have to figure out what's important to you and select a pediatrician that works best for you and your family.