Finding a Pediatrician
Written by Meg with editing and input from my dear friend and amazing pediatrician Kathleen O’Connell Pope, MD
Finding a Pediatrician
Finding a pediatrician you like is important… but how?
If you are as dumbfounded as I was, here are some techniques for finding a good one:
Qualify Your Short List
Once you’ve got your short list of prospective baby docs, you’ll want to call each one and ensure they:
a) are taking on new patients at this time (some practices or independent pediatricians may not take new patients during the pandemic);
b) and will accept your health insurance (or are “in network”) (if that matters to you)
Board Certification
For Dr. Pope, her #1 criterion in finding her own pediatrician was ensuring the prospective pediatrician (“pedi”) was board certified. Why? Board certification (DO or MD) means that the individual has finished an accredited residency program and passed a comprehensive and fairly difficult exam.
Staying current
Pediatricians who became board certified prior to 1988 do not have to re-certify, but those who have finished training since then have to re-certify via examination every 7-10 years. Board-certified pediatricians also have to complete a certain number of hours of continuing medical education to maintain certification. This is pretty important since advancements in medicine happen fairly quickly!
She went on to say: “It is the patient’s responsibility to find out if their doctor is board certified… you can’t just assume they are. For me, not being board certified would have been a complete deal breaker, as it would have been a red flag whether the doctor chose not to take the exam or simply could not pass it.”
It’s very easy to check via the American Board of Pediatrics website. Once you’ve checked these two (and possibly three) boxes, proceed to…
What else is important to you? Consider these factors:
— Proximity!!!!! When you are two weeks postpartum or have a sick and/or screaming child in the back seat, you are NOT going to feel like driving across town. During the pandemic, staying close(r) to home may be a major plus, too — after all limiting travel time and exposure to the public can play a big role in lowering your risks of contracting the virus. I’m not saying you should pick someone based solely on proximity, but don’t underestimate its importance.
— How can you get help if your child gets sick after hours? When your doc isn’t on call, who covers for them? Some doctors are affiliated with urgent care clinics, while others will meet you at the office even at night (in Fairyland). **This was a huge factor for me. When your baby has a 104 F fever at 6 pm on a Friday night and you really don’t feel like going to the ER, this is a lifesaver…
— How does your doc handle phone inquiries? Is there an advice line during office hours and/or do they set aside specific times for phone calls? Does the doc call you back personally or have someone else do it? ** Having an advice number to call is HUGE!
— Do the doctor’s hours suit your schedule? (See below for how often you’ll need to visit the pedi in the 1st year.) If you have a strict work schedule and have trouble getting away during biz hours, you might need one who works after hours or possibly on Saturday mornings.
— How long does it typically take to get an appointment? Do they have sick appointments? Most pediatrician’s offices reserve the first half hour (or so) of business for walk-in sick children only (say, 9:00-9:45). Others reserve afternoons. ** This is key!
— Are you and your doc philosophically similar on topics such as circumcision, vaccination schedules, breastfeeding/formula feeding, co-sleeping, etc.? If not, is he or she open minded about your preferences? Some docs see these things very black and white, which can cause conflict.
— Which hospital is the doctor affiliated with?
— Does the front office staff seem friendly and helpful?
— What is the parking/transit situation?
— Does the doctor answer questions by email (yeah right)?
** A note from Dr. Pope: “Another point that I think is important for someone who is going to take the time to interview pediatricians before deciding on one: find out who might see your child at an unscheduled sick visit or if your regular doctor is sick/on vacation/on maternity leave, etc. Much like with your OB, there are not that many solo pediatric practices anymore, so chances are, if your child wakes up with a sore throat and fever and the office can fit you in that morning, you may or may not see “your” chosen physician.
It is important to not only meet the primary care pediatrician that you are choosing, but also to meet the other doctors, as well as any nurse practitioners or physician assistants, in the practice who might see your child at some point. Perhaps it is not so important that you click perfectly with these other people, but you might be able to recognize if there is someone with whom you feel completely uncomfortable.
Case in point: I left a perfectly nice pediatrician’s office, because I found her “grandfatherly” partner to be intolerable and practicing 1970s medicine. She only worked part-time hours, and it became clear that I was never going to be able to only see her for every one of my kids’ visits, so I switched practices entirely. If I had interviewed both of them from the start, I would probably have never chosen the practice in the first place.”
First Year Schedule
To give you an idea of how often you will be paying him/her a visit (assuming all is well), your 1st visit after leaving the hospital is about 2-3 days later (especially for breastfed babies, as it’s harder to tell if they are truly eating enough). After that, visits should occur roughly at the following ages:
— 1 month
— 2 months
— 4 months
— 6 months
— 9 months
— 1 year
… and corresponding vaccines (on a ‘normal’ schedule) occur like this.
In the midst of COVID, pediatricians have seen a significant drop in patient visits. This means that many children are behind on vaccinations and are missing physical exams, screenings, and other needed care.
Though it can be scary to take your new bundle out in the world during a pandemic, the AAP recommends continuing preventative care visits, so make sure to schedule your little one’s checkups to keep an eye on his or her development and ensure that it’s on track (this is especially crucial for newborns and infants, whom need close monitoring). Rest assure that doctor’s offices are following CDC guidelines and taking extra steps to protect against the coronavirus.
Speaking of, your little one’s checkups are likely to be different (much like your prenatal visits). In an effort to optimize social distancing, many pediatrician offices are limiting each visit to one healthy caregiver or guardian to accompany the child who has the appointment.
This means that your partner won’t be able to accompany you. We know it can be disappointing — there’s something exciting about witnessing your little one’s first doctor’s visit(s) as family, but this new rule can actually come in handy, especially if you have another child at home. Think of it as the universe forcing you to divide and conquer… 😉
Sick Visits during COVID
Many practices currently only schedule well visits in the office and conduct sick appointments through virtual visits, in an effort to minimize potential risk of exposure to staff and other patients.
If, during the virtual visit, your doctor assesses that your child needs to be seen in person, he or she may schedule an appointment in a specifically designated office.
While you are searching for a pediatrician, make sure to ask your top contenders how they are handling sick visits and virtual appointments, as it may vary from practice to practice.
Finally, insurance companies are currently allowing for virtual visits in lieu of in-person visits, so they should be directly billed to your child’s insurance provider, but make sure to check with your insurance, just to be safe.
How will they get the memo that I’ve delivered my baby?
Magical telepathy! Kidding.
The delivering hospital will ask you for your pedi’s name when you check in, and most will notify the doctor when your baby is born. Many docs come to the hospital to visit your newborn (sweet!) and many will send another doctor from the practice (whoever loses rock-paper-scissors that day). Some won’t see your baby until the first office visit, so ask to be sure.
** A note from Dr. Pope: “I would point out that not all pediatricians have privileges at every newborn nursery in town. For one’s pediatrician to come in and see your newborn while still in the hospital, do an exam, write a note in the chart, etc., he/she has to have privileges at that hospital to do so.
A lot of pediatricians do make sure they have privileges at every big labor & delivery hospital in town so that they can go into the nursery and see the babies there, but it doesn’t really mean anything negative if a pediatrician doesn’t have privileges at the hospital where you’re delivering. I make this point only because I don’t think it’s necessarily a deal breaker if you find a pediatrician you’re excited about, and they just don’t happen to see patients at the hospital where you’re delivering.
A perfectly well-trained provider, either a pediatric hospitalist or in some cases a nurse practitioner, will see your baby after delivery in the nursery, and your chosen pediatrician will be seeing your baby soon enough (usually within a week for the first visit) in his or her office.”
Go With Your Gut
If you desire, you can interview your top prospects before deciding who will receive your final rose (remember, it will likely be virtually). This is really the only way of getting a gut-check on your prospective doc. Some practices will do this for free and some will charge for it (your insurance may or may not cover it). You don’t have to do this (I didn’t, but I’m pretty lazy like that).
If a doctor feels good to you (or rubs you the wrong way)… listen to your gut. It will rarely lead you astray. Remember, you can always change docs later on if you don’t like them. Nothing is set in stone.
Good luck on your doc search!! — Meg & Dr. Kathleen
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