Choosing a Pediatrician

Choosing Your Baby’s Pediatrician
by Jerold Aronson, MD and Susan Aronson, MD

Selecting the right pediatrician for your new baby is an important process which takes both time and thought. Every pediatrician is committed to helping parents raise healthy children with the greatest possible ease, confidence, pleasure and success. In addition, regular visits to the pediatrician are a key part of preventive health care. However, different pediatricians have different approaches, so you may want to interview several candidates before selecting the pediatrician who best suits your family’s particular preferences and needs, Conduct this search in your 7th or 8th month of pregnancy so you can make your choice well before the baby arrives.

A good place to start looking for a pediatrician is by asking your obstetrician or primary care physician or by contacting your local children’s hospital. Ask friends, relatives, the hospital staff where you plan to deliver or the American Academy of Pediatrics (AAP) can give you a list of member doctors in your area. You can reach the AAP by calling 1-800-433-9016.

Once you have names of several pediatricians you wish to consider, you should schedule a prenatal appointment with each of them during the final months of your pregnancy. Most pediatricians routinely schedule such preliminary interviews, often at no charge. The pediatrician you select should be a good communicator and treat you like a partner in your child’s health care by explaining diagnostic procedures, test results and medications, and by answering your questions.

Before your initial get-acquainted visit, prepare a list of questions about issues that concern you so that you won’t forget to ask the pediatrician about them during your visit. This list will help you decide whether you feel comfortable with the pediatrician’s policies and philosophy about child rearing. Don’t be afraid or embarrassed to ask about any concerns. Here are a few suggestions to get you started:

What are your qualifications and do you have a subspecialty?
Pediatricians are physicians who care for infants, children and young adults. A pediatrician should have graduated from an accredited medical school, and completed an additional three years of training in a pediatric residency. Ask the pediatricians you interview to tell you about their medical schools and residency program training. The initials "FAAP" after a pediatrician’s name, means Fellow (member) of the American Academy of Pediatrics. Only board-certified pediatricians who meet specific criteria can become members of this professional organization which sets standards for child health.

How soon after birth will the pediatrician see your baby?
Most hospitals ask for the name of your pediatrician when you’re admitted to deliver your baby. However, you should not rely on the hospital to notify that pediatrician, but call him/her yourself as soon as your baby is born. If you have any complications during either pregnancy or the delivery, a pediatrician should examine your baby at birth. Otherwise, the exam can take place anytime during the first twenty-four hours of life. If the doctor at the hospital will not be the pediatrician who will see your baby for ongoing care after you leave, ask how the doctors and nurses at the hospital will share information about the birth with your child’s pediatrician.

When will your baby’s next exams take place?
Routinely, pediatricians examine newborns and talk with parents before the babies are discharged from the hospital. This examination identifies any problems and gives you a chance to ask questions that have occurred to you during your hospital stay, before you take the baby home. Your pediatrician will let you know when to schedule the first office visit for your baby (usually in the first week or two after the baby leaves the hospital), and what to do if a medical problem develops before then.

When is the pediatrician available by phone?
Many pediatricians have a planned approach to respond to parent questions. Some have specific periods when they prefer that parents call for routine questions. If members of the office staff other than the doctor routinely answer these calls, find out what type of training they have and how to arrange to speak with the doctor if you feel the need for more discussion.

What happens in an emergency?
Find out how the pediatrician handles calls for urgent care. For example, some pediatricians have a nurse advice service available after the office closes. Others share telephone coverage with a group of doctors or have some other arrangement. Find out what hospital the pediatrician is affiliated with. Be sure that you are comfortable with the hospital where your child would be admitted for a serious problem, and that your insurance would cover the hospitalization at that facility.

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. In addition, meet the office staff as you will be interacting with them frequently. Even when a pediatrician practices alone, they usually have an arrangement for coverage with other doctors in the community. Your pediatrician’s answering service may 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 reaching your own physician.

If your child is seen by another doctor at night or on the weekend, you should check in by phone with your own pediatrician the next morning (or on a Monday). This phone call will give you a chance to bring your child’s record up to date and reassure yourself that everything is being handled as your pediatrician would recommend.

How often will the pediatrician see your baby for checkups and immunizations?
The American Academy of Pediatrics recommends checkups at birth, in the first week, by one month, and at 2, 4, 6, 9, 12, 15, 18 and 24 months, and annually after that, except for two year intervals between six and ten years of age. Ask whether your pediatrician works with a physician’s assistant or nurse practitioner. If so, ask who you should expect to be involved in your child’s care and how often your child will see the pediatrician.

What are the costs for care?
Your pediatrician should have a fee structure for the routine hospital and office visits and for special services such as after-hours visits or extended consultations. Find out if the fee for routine visits includes immunizations. Check what your insurance covers and what you will have to pay.

After you interview the pediatrician, ask yourself how you feel about what you have learned. You must feel comfortable with the office routines, the location and general atmosphere of the office. You must be able to trust the pediatrician and those who work in the pediatric office where you will take your child for care.

Once your baby arrives, the most important "test" of a pediatrician is the care your child receives and the way your concerns are handled. If you are unhappy with any aspect of the treatment you and your child are receiving, talk to the pediatrician directly about the problem. Give the pediatrician a chance to address your concerns properly. However, if after a reasonable effort, the problem simply cannot be resolved, arrange to change pediatricians.

Editorial provided by Jerold Aronson, MD, and Susan Aronson, MD, pediatricians at St. Christopher’s Hospital for Children in Philadelphia, Pennsylvania. Dr. Susan Aronson is also member of the board of Directors of the American Academy of Pediatrics.