During your sixth or seventh month of pregnancy, you might want to begin finding a pediatrician for your baby. A pediatrician is a specialist who spent at least three years studying children's health beyond medical school. Many will even sub-specialize in a particular area such as heart, lung, or endocrinology.
Not all families use pediatricians as their child's primary caregiver. In many parts of the country, over half of all children receive routine care from someone other than a pediatrician, like family practitioners or nurse practitioners, both of whom are quite capable of caring for the common health care needs of children. The popularity of family practitioners versus pediatricians may depend heavily on where you live.
If you are able to choose, you will need to consider the needs of your family. If your child has a chronic medical problem, for example, you may be better off with a pediatrician because she will likely have more experience with these problems than a family practitioner. However, many family practitioners manage children's chronic illnesses very well. Even in the absence of a serious problem, some families just feel more comfortable with a specialist for their child.
Finding a Good Pediatrician
Before choosing a pediatrician, you will want to get recommendations from friends, family, and medical practitioners. You might try calling the nursery or delivery room at a nearby hospital and ask for a few recommendations. You might also ask your OB-GYN or general practitioner for suggestions.
Calling a physician referral service probably won't help you find the best doctor. Often these services give recommendations by simply giving you a name from a list of doctors on the hospital or health plan staff. Referral services frequently redo and rotate their lists, so the recommendation you receive may depend on which doctor is next on the list. Most often the people who staff the referral service are not in a position to know which doctor is best.
Another indication of a physician's competence is board certification. Your child's pediatrician should be certified by the American Board of Pediatrics if he or she has been in practice for more than a few years. Pediatricians certified after 1988 must take an examination every seven years to re-certify and retain their board certification.
Interview the Pediatrician
Do some research and narrow it down to three or four choices. If this is your first pregnancy, you may want to meet the pediatrician before your baby is born. Building a relationship with your child's pediatrician before you need her services reduces anxiety. If a pediatrician is too busy to provide a prenatal interview, this may be indicative of how busy the practice is and the amount of personal attention you are likely to receive. No matter how good a pediatrician is reported to be, if she is overworked, your interaction is unlikely to be satisfactory. You might also be asked to pay for an initial interview, and this cost may not be covered by your health plan.
Here are some issues to consider when interviewing doctors:
Purely Practical Factors:
These considerations take into account the practicalities and logistics of the practice. They may not seem as important as other issues, but you will be visiting your doctor at least a dozen times in your baby's first year of life. So, you'll want to make sure your travel and office visit experiences are pleasant.
- Is the doctor taking new patients?
- Is the doctor part of your health plan?
- Is there convenient parking or public transportation near the office, and how long is the commute? A thirty-minute trip, for example, may not seem long for a regular checkup, but it can seem like an eternity with a crying, sick baby.
- Does the doctor have hospital access after you deliver your baby? If not, what do you need to do to get that access?
- Does the doctor's office have weekend or evening call hours?
- What is the average wait time for an appointment?
- What kind of support does the doctor have at the office in case of emergency? (Are there other doctors in the practice? Nurse practitioners?)
- How does the office respond to call-in questions?
- How is the practice organized? Will you see the same doctor at each visit? Or, is the practice large with pediatricians who rotate patients? A larger practice can make it more difficult to see the same doctor each time, and thus develop a relationship, but the practice may also offer a broader range of expertise.