My baby is due this month and I haven’t chosen a pediatrician yet. I’m wondering if anyone had any advice on how to make a good choice. What did you look for in a pediatrician?
I did some internet searches and found two pediatricians in my area that looked promising. [name]One[/name] was an MD with 20 years experience and lots of good reviews. The second is a physician assistant with a focus in pediatrics, and is a certified lactation consultant.
Breastfeeding is really important to me, and I like the idea of having a pediatrician who is also a lactation consultant, in case I run into any issues with breastfeeding. But I’m wondering whether I should be concerned that she’s a physician assistant and not a doctor. I’m not really sure what the difference is.
Does anyone have any advice on how to make the choice, or any experiences to share?
This is a great question. Since I’m in the business myself, I have a very strict list of criteria but know that they’re idiosyncratic.
I look closely at where the person trained for medical school, residency and fellowship. Years in practice is somewhat important-- I want the sweet spot, not too fresh but not bored and nearing retirement. I want an academic general practice where the physicians see a host of children with severe medical problems, teach medical students and residents, and are appointed faculty at a medical school. I would always been paranoid and suspicious at the typical community pediatrics practice full of mostly well children, where the pediatricians have been out of training for a while, haven’t taken care of anyone truly sick in ages, and are a bit rusty in their diagnostic skills; I would worry that they wouldn’t notice something alarming or might be tempted to brush something under the rug instead of working it up. Also I enjoy talking to smart people and smarter doctors stay in academics.
Lastly, this is completely unique to me, but I would be very very uncomfortable entrusting my child(ren)'s care to someone with less knowledge, education and training than I myself have. No PAs or NPs for me, even though they’re lovely people who fulfill a very valuable role. I would always be uncomfortable, again that there’s something they don’t know about or weren’t trained to take care of and therefore are missing.
Things I absolutely don’t care about:
how the office is decorated
sitting next to poor people while waiting (this bothers a lot of people, deep down; it makes them worry they’ve picked an inferior doctor)
bedside manner (there are no mean people in pediatrics anyway)
online patient reviews. They’re mostly scams or people who don’t really know what a good doctor is, just what a nice doctor is.
So, [name]Antoine[/name]'s pediatrician is the Chief of the Division of [name]General[/name] Pediatrics at a major medical school here, a former transplant nephrologist, and the former program director of the residency. I’m very happy.
I didn’t even think about this. I’ve been going to the same GP (UK version of a pediatrician I guess? There are no specific pediatricians here as far as I know, just general pediatricians) since I was about 5.
I have no idea what her qualifications are, I’ve never even thought to ask. All I know is that she’s never let me down in over 20 years. She’s kind, understanding, and knows me better than I know myself. She’s in her late 40’s as far as I know and I’ll continue going to her (along with my DD) until she retires. She’s a gem, one of a kind, and I feel very lucky to have such a great doctor.
We just decided on one last week…we went to several info sessions and chose mainly for easy location (less than 10 min away) and the fact that we just clicked with that doctor better than the others.
I asked everyone I know for recommendations and followed up with the names that kept coming up and the people who seemed really excited to share a recommendation. I put more stock in those than online reviews.
When I was first pregnant, I interviewed a few different pediaticians in my area. I ended up choosing a practice consisting of 4 doctors for the following reasons: At least one of the drs is always available and they see sick patients on Saturdays. The practice consists of 2 female and 2 male drs of varying ages. I assumed my daughter would eventually be more confortable with a female dr and now that I have sons, they may like to see a male dr. The drs are passionate about providing the best quality of care and are willing to consult or refer to specialists when needed. The practice has 2 waiting rooms, one for sick patients and one for babies/physicals. There is a nurse line 24 hours a day I can call with questions and, if needed, page a doctor. I have been very happy with all my experiences. [name]Just[/name] remember if you pick a dr you don’t like, you can always request a 2nd opinion or switch drs.
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. [name]Blade[/name]'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.
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?
[name]Do[/name] 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?
Medical expertise
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? [[name]Do[/name] 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]
[name]Do[/name] they conduct research or teach medical students, residents, PA/NP students, etc?
[name]Do[/name] 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 curious
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.
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. [name]Do[/name] you want every pill in the book, for everything? [name]Do[/name] you want an aggressive medical approach, or a holistic one? [name]Do[/name] 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.
@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.
[name]Blade[/name] - 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.
I don’t think interviewing a GP is even an option in the UK, I’ve never heard of anyone do it. I think because we have the NHS (free healthcare) most people aren’t fussy.
In the UK you’re assigned to a GP based solely on your address. The GP will refer you to a specialists as needed (including paediatricians for children with more complex medical problems).
Interviews are free. Most primary care physicians will do them. Specialists (including surgeons), usually not. @maltee, the vaccination question is unfortunately so predominant that most pediatricians anticipate discussing this with parents, and it is almost expected that you will ask about it. In areas with high concentrations of anti-vaccers many pediatricians have made a choice to accept those children into their practice despite near-unanimous medical agreement on the necessity of routine childhood immunization; their thought is that obviously those children need doctors, too, despite the choices their parents have made for them. [name]IMO[/name] you should ask about that because it will mean that children-- including your children-- will be exposed to the diseases the vaccines protect against in the waiting rooms, etc.
Most pediatrics offices are friendly, cheerful, bright places. I think the most important thing to look for in terms of the office itself is whether or not they have separate sick and well child waiting rooms. But the stuff I listed above is what I think is really crucial.
So much great advice! As a person whose child has had 5 different pediatricians before finding the right fit, I have some advice as well…
Look for a pediatrician with a nurse advice line. Make sure that they’re open to advising you on any matter that comes up. For example, dietary questions or milestone questions. Stuff that isn’t directly medical.
Look for a pediatrician whose child rearing philosophies are similar to your own. If you are interested in holistic parenting, attachment parenting, prolonged breast feeding, you might want to find a different type of office than if you are an old-school Ferberizer who plans on using formula. Ask in a neutral way what the doctor’s opinions are on things that matter to you. For example, do they do vaccinations on a set schedule or are they ok with spacing them differently if you’re more comfortable with that.
Ask moms who have been in the community longer than you. [name]Don[/name]'t be afraid to approach someone. You could even keep an eye out for moms whose parenting style seems similar to your own.
Ask if the office looks for developmental issues. The office that I finally ended up with is so great for this. When I brought in my daughter the doctor presented her with a tongue depressor to see if she would reach for it. Handed her another to see if she would take that & hit the two together. What seemed like play to me, she later explained was her checking up on how my daughter interacts with new people, if she can connect the two objects, every little playful thing had the ulterior motive to look out for special needs issues cause the office is very into early detection.
[name]One[/name] more thing on the subject of “sitting next to poor people” hahaa
The offices that take charity care or medicare patients often have better hours than the ‘rich people’ offices and seem to be able to fit you in more easily. They also tend to have nicer front desk workers in my experiences. Those front desk people can really be the worst!!
However, in my experience the “rich people” offices are usually less crowded and have less wait time, it’s more difficult to get an appointment, but it seems less likely to get really packed in the waiting rooms.
That’s just my experience at the 5 offices that I’ve ended up in within 1 year of my daughter’s life!!
At the hospital I went to, you are required to choose a pediatrician to do the “newborn evaluation” after your baby is born. So I went to a few pediatricians offices when I was pregnant to “interview” them. First I went to a doctor my friend recommended and he was very nice but he was in his late 50’s and seemed a little too lackadaisical to me. I also went to an office consisting of 4 women doctors who were all in their mid 30’s-early 40’s and the office seemed very warm and welcoming. I had decided on one of the doctors and then as I was leaving the office, I heard someone mention one of the doctor’s daughter was named [name]Rowan[/name] and it kind of “clicked” with me. So, our pediatrician is probably in her early 40’s, very energetic, and seems to be extremely intelligent and well versed in just about every topic we throw at her. She’s never come across as judgmental or disapproving, and always gives a straight answer and doesn’t sugarcoat. She is also very “natural” but is not anti vaccination, which is something that was very important to me. I live in a very hippie town and it’s so common to not vaccinate your children here, it scares the hell out of me. There’s actually a whooping cough epidemic going around locally… every kid we come across has some nasty upper respiratory infection and what sounds like a smoker’s cough. I almost don’t want to take [name]Rowan[/name] out in public anymore. :mad:
I don’t know if it’s just because I live in the South or what, but I would guess 75-80% of the families that go to my pediatrician’s office have Medicare (state insurance) Families that make a modest income but aren’t offered healthcare through their jobs, usually their children will still qualify for Medicare. That’s the case with most everyone I know (including us) We have a home business and while we make decent money, can’t afford quality healthcare for ourselves. But [name]Rowan[/name] is covered through state insurance because she’s a child.
I am with @rowangreeneyes, I also talked to a few pediatricians and was able to choose. We had a quick visit with [name]Cornelia[/name] and picked the one who wasn’t just intelligent, qualified and kind but who [name]Nelly[/name] did feel comfortable with. She smiles every time she visits us and we have almost no problems with examinations.
We were torn between middle aged professor and this young woman. Honestly, I was kinda afraid to let young doctor look after [name]Nelly[/name] but she was much more advanced when she seemed to be and also quite patient when it comes to vaccinations. [name]Male[/name] doctor was more conservative and had less individual treatment to every child.