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Thread: How to choose a pediatrician?
June 5th, 2013 08:15 PM #6Senior Member
- Join Date
- Jan 2011
I just switched doctors. We were going to a GP, but then he started telling me things like, "Your son is too fat. You should give him skim milk," and "It wouldn't hurt if he just skipped some meals." I felt like that MUST be wrong- my son WAS fat, but he was also a year old. I found a pediatrician by asking around. Blade's recommendations sound excellent, but I am afraid I did not follow any of these. However, we are very happy w. our new doctor. She is not technically a doctor, but a physicians assistant. She has many years of experience, though.
June 7th, 2013 01:32 AM #8
This is a really important topic and I want to try to be more generally helpful rather than just point out my own idiosyncracies.
What to look for in a doctor
So your friend tells you a particular doctor is "great! We love her!" Another person recommends interviewing several different pediatricians to see which practice you'd like to go with. What do you ask? What does it mean to be a "good doctor?"
I think, first and foremost, that while being friendly and approachable are givens [seriously there are no mean people in pediatrics] it's important to remember that you're hiring this person in their capacity as a highly trained, uniquely educated medical professional, not necessarily a listening ear or sympathetic voice of reassurance. What you really need to focus on is their competence in the medical specialty of pediatrics.
Ownership of patients
- how many doctors and physician-extenders (PAs / NPs) are in the practice? [The sweet spot is 3-10. Too few and they're burnt out from all that call, too many and it's a cattle call where you never see the same person twice]
- What is their call schedule like?
- Do they have an answering service for after-hours/weekend calls? If so, what sort of person staffs that service [you want to speak to a provider, not to a nurse!]
- if your child is admitted to the hospital, do they round on their own patients or only use pediatric hospitalitists? [Most hospitals use hospitalists, but you want your doctor to come see your child]
- do they round on newborn patients when they're still in the hospital?
- how long has your physician been out of residency? If more than five years, how are they keeping current with updates in treatments, medications, and paradigms? [Do not be afraid to explicitly ask this question. All physicians are required as part of their licensure to complete CME, Continuing Medical Education, but some of these are like 3-hr seminars or online question banks. On the opposite side of the spectrum, academic physicians engage in research, teaching, attend scholarly conferences and present their work].
- What kinds of medical problems do they take care of in their practice? [You want people who take care of genuinely sick children as well as healthy ones]
- Do they conduct research or teach medical students, residents, PA/NP students, etc?
- Do you see any scholarly journals in the waiting room or in the physician's office?
- What referral patterns do they have for specialists, should your child need one? Are they part of a multispecialty practice with in-house specialists, laboratory facilities, radiology, etc, or would you have to leave to a different office for those services?
- Which hospital do they have admitting privileges at [if it is at all available in your area, you really want an actual Children's Hospital, not just a hospital with a pediatrics wing]? Research that hospital and make sure you like it!
- Can they direct admit or would you have to go through the emergency room?
- Why did they choose to become a general pediatrician rather than a subspecialist or a hospitalist? What do they find intellectually challenging about their job [seriously, ask this]
- If the practice is composed of midlevels (PAs/NPs) as well as physicians, how do they allot patients between the two?
- If you are considering a midlevel provider as your primary care provider: ASK them under what conditions they ask for guidance or refer their patients to physicians. If the midlevel acts snippy about this or even worse, arrogant ["I've never needed to!"] look elsewhere!
Personality traits you want
- gives good, thorough anticipatory guidance for the next stage of your child's health and development
- competent and intelligent
- approachable and able to explain complex medical problems/concepts well in layman's terms [you should NEVER leave any kind of doctor's office confused and not understanding what they were talking about]
- does not shy away from discussing controversial social issues, like resistance to vaccinations or over-diagnosis of allergies, with parents who are curiousBlade, MD
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June 7th, 2013 10:42 AM #10Member
- Join Date
- Mar 2013
Thanks for the feedback everyone!
This may be a dumb question, but to interview a pediatrician, do you just call up the office and ask for an interview? Does it usually cost money?
I live in a small city now and we don't have a medical school, or a children's hospital either, unfortunately. So I will have to dig deeper and take a look at the individual doctors at the clinics. The point about after-hours and weekend service is a good point I didn't think of (along with the other great points blade brought up - thanks!).
I've asked family and friends for recommendations, but their highest criteria for choosing a pediatrician was whether the doctor was ok with them not vaccinating their children. I'm definitely not anti-vaccine, so that's not really helpful to me, and personally I'm not really sure whether I trust a doctor who's nonchalant about vaccination. The area I live in is reported to have one of the highest vaccine refusal rates in the country. This is something I'd like to get a potential doctor's viewpoint on, through I'm not really sure how to ask that.
June 7th, 2013 12:49 PM #12
I think gut feeling when you meet someone is important. If you don't trust someone and get on with them when you meet them, you're unlikely to see them as a great and useful source of help. I'd also advise finding a physician/pediatrician who fits your philosophy on health. Do you want every pill in the book, for everything? Do you want an aggressive medical approach, or a holistic one? Do you want the type of person who will investigate possible links to dietary intolerances, or someone who is focused only on addressing your immediate symptoms?
Personally I would never go to a doctor who bullied me into his preferred treatment option and completely disregarded my ability to make an informed choice as a patient about my own health and medical care. That would be a deal-breaker.Two small people, Mila and Cato.
If I had a baby tomorrow...
Atlas Arthur & Lyra Delphine
June 7th, 2013 03:12 PM #14Senior Member
- Join Date
- Apr 2013
@maltee - some pediatricians schedule interviews, and some don't. Call and ask for a meet-and-greet or a prenatal consult. Some will bill your insurance for an office visit, some will do it for free. Others don't do those at all, so you can ask questions of the receptionist and stop by to see the office and environment at those.
Blade - that's a great list, thanks for sharing! While I do agree a doctor's experience and training is most important, it was also really important to me to find an office that was nicely decorated, welcoming for a child, had nurses in friendly scrubs, etc...I don't want to bring my child to a doctor's office that is terrifying and completely industrial looking.Lillian Elizabeth 6.16.13