Help me pick my baby doctor!
November 12, 2013 8:38 AM   Subscribe

I'm currently 31 weeks pregnant, and this afternoon I'm heading into a "meet and greet" with a new pediatrician at a practice affiliated with the big multi-specialty doctor group in my town. At this point, we're thinking it's pretty likely that we'll either go with the pediatrics group or with the family practice group where my PCP practices, and I had set up this meet and greet to help try to make that decision. However, it's now 5 hours until we head over and I have no clue what to ask this doctor to help us make a decision. I am sure others have probably gone through this before--so help me figure out what to ask!

Just as a bit of further context: (1) both the family practice group and pediatrics group are pro-vaccine, so I don't think I need to ask too much about that; (2) I have heard glowing things about both groups in terms of their general competence at doctor-ing.

Given that we have about 30 minutes to meet with this pediatrician, what are the really great questions that will help us figure out whether this is the right doctor for our baby?
posted by iminurmefi to Health & Fitness (15 answers total) 10 users marked this as a favorite
I'd say, "What do you think we need to know?" You can get a pretty good read on a person by how they educate you. If the doctor opens up and discusses all sorts of interesting things with you, then this is the right person.

If the doctor doesn't engage, doesn't ask you questions, etc, then it's probably not a good fit.

You'll probably know within the first minute or two if the doctor is one you can work with.
posted by Ruthless Bunny at 8:42 AM on November 12, 2013

I would ask about communication w/both the doc and the clinic. For example, "if we have a follow up question or a check in, can we call? Email?" Can you get same-day appointments? Each clinic/provider has different policies and practices and I think it would be difficult to work with a provider who is hard to reach or who is cagey with follow-ups. Especially with pediatrics, when things change so fast. I'd want to feel comfortable calling a clinic and not feel ignored. Good luck.
posted by ShadePlant at 8:49 AM on November 12, 2013 [1 favorite]

Same day appointments would be my concern. When you're a new parent the various rashes and other ailments that turn up can be disconcerting. Our doctor is really open to seeing us when we want her opinion. It's been helpful and put me at ease, plus my son did need medication and/or treatment in some cases. Also yes, ask about communication. Being able to call or email easily is key.
posted by JenMarie at 8:54 AM on November 12, 2013 [1 favorite]

Best answer: Except for the age-appropriate well-baby visits, the main interaction I've had with the pediatrician's office is through phone calls after hours. (Kids always spike a fever at night or on weekends, when the office isn't open!) So ask about the voicemail/message-relay system and how quickly you can expect a call back from a doctor or nurse. Try to get a sense of whether they're a "Well, I really couldn't say because I haven't examined the baby in question", a "Take her to the ER just in case!!!!1!!" or a "Let's keep a calm eye on it and call me back if [worrisome symptom] gets to [certain point]", the first two of which are completely unhelpful to a freaked-out parent.
posted by Liesl at 8:57 AM on November 12, 2013 [2 favorites]

I met with several peds while I was pregnant, because we had some pretty specific concerns. Other than my specific concerns, I also had a hard time preparing for those meetings. Here's what I ended up asking:

I asked about what we could expect in the first few weeks. How many visits, what those visits would be like. I looked at their practice - one was incredibly loud, with nurses yelling across the office to one another. I couldn't imagine bringing a sleepy newborn into such a noisy place.

Do they have separate waiting rooms for sick kids as opposed to kids who are there for well visits? Or do they otherwise separate sick & well quickly (newborns are usually taken into the exam room straight-away so they aren't exposed to other kids)? How easy is it to get in same day? Does the doctor communicate via email (most don't, in my area)? Are you on-board with my birth plan (if you plan to skip Hep B or vitamin K in the hospital, for example). What is your typical advice if something happens over the weekend?

What it came down to for me was personality fit - did I like talking to the doctor? Did the doctor treat me as the educated person and concerned parent that I am, and answer my questions directly? Or were they superior and dismissive?

And here's the thing - even though I felt we'd found a good fit before the baby arrived, I ended up switching peds, not once, but a couple of times. This is a decision that you can always change later.

My first ped was a little too happy to suggest that we take our very newborn baby to the ER if we didn't want to wait until Monday to see him. He was being overly-cautious, but I wished he would have been more reassuring that our concerns could probably wait. He also wasn't as breast-feeding friendly as I'd hoped. And his nurse was not friendly at all, she was clearly and openly judging some of our parenting decisions, but I hadn't met her during our initial meeting.

My second ped was a little too far and could only get me in same-day at the end of the day - right in the middle of rush hour, which bled into dinner time. I ended up stuck in traffic with a crying hungry baby a couple of times. Plus she ended up being a bit dismissive; the vibe I got from her was that I was acting like an over-protective new mother. New mothers need reassurance, not derision.

My current ped is close to us, gets us in same day easily, and even though we don't see eye-to-eye on all issues, he is always respectful of our decisions as parents. We are paying him for his professional advice, and he gives it. He doesn't get offended if we don't take it.
posted by vignettist at 9:13 AM on November 12, 2013

Nthing same-day appointments. Also ask about policies for consultations/visits on weekends and over holidays.

Availability of breastfeeding support and advice, if you're planning to go that direction. Ideally they'd have an IBCLC (International Board Certified Lactation Consultant) on staff, or be able to refer to a trustworthy one.

As you make the trip there, keep an eye on the logistics, as well. Is the drive manageable and not too trafficky? Parking easy and convenient? Walk to the office uncomplicated, without stairs and hills and other stroller/carrier-unfriendly features? Waiting room comfy, with two separate spaces for sick and well kids? All these things sound tiny, but they have the potential to become major annoyances when you have to visit the place 4-6 times per year with screaming and/or sick kids in tow.
posted by Bardolph at 9:14 AM on November 12, 2013

Best answer: After-hours modes of contact and access, definitely. There are a lot of things that are not worrying for a grown person who can communicate that are very serious for little ones who can't, and the line is sometimes vague for a non-medical professional. (An example from our house: Toddler gets stung by 5 yellowjackets when standing too close to a nest on a Friday after business hours. Dr. Internet says "bring them to a hospital if there are many stings or if the child is young." Dr. ActualDoctor says "'Many' means 'I can't count them all', give him a treat for being a trooper and call if XYZ happens.") Having access to on-call medical professionals has turned out to be more important than I would have expected.

If you're planning to nurse, ask about lactation consultants and their qualifications. This was the main reason we switched from our family practice to a dedicated pedicatrics office in our son's first week--the family practice doctor was supportive but had several actively detrimental pieces of information about nursing and newborn behavior; the ped's office was VASTLY superior.
posted by tchemgrrl at 9:21 AM on November 12, 2013

Some things you should probably know about:

- How many well baby visits they like to have, and also figure out how many are covered by your insurance. My insurance gives us something like 6 well baby visits in the first year, so our pedi actually let us bring him in for some of his checkups billed under something else (like "feeding questions" or whatever) so the insurance would cover it. Good to know how they handle these and how flexible they can be.

- Make sure someone other than the doctor is administering vaccines/shots. The baby will figure out that the person doing it = pain, and it's better if your kid doesn't learn to fear the actual doctor.

- Talk about vaccines in general and make sure they are willing to work with you about whatever your personal feelings are there. Some people like to stagger them, or want some and not others, etc. If you're anti-vax, probably good to disclose that to the doc.

- Will the doctor be able to visit you at the hospital you are delivering? It's ideal if your pedi can be the one to administer the first exam.

- Get detailed information about office hours and what the doctor expects you to do if you have a question or issue outside of those hours.

- If you're planning to breastfeed, mention that and ask what resources their practice has available to help you be successful. Some work with lactation consultants and will try really hard to help you make it work; others will just push formula on you at the first sign of trouble. Good to be philosophically aligned ahead of time.

You can always switch later if you want, but in the first couple of weeks you'll be so busy and exhausted you will not want to deal with finding a new doctor. So prioritize finding someone you feel confident will be good for at least those first few weeks of newborn care when you are going to need help the most — responsive, good hours, willing to take lots of phone calls, etc.
posted by annekate at 9:24 AM on November 12, 2013

Nth-ing after-hourse nurse advice line and same-day appointments.

Other things that were important to us: philosophy about vaccines, cosleeping, and breastfeeding; bedside manner.

But like 90% of the usefulness of our pediatrician's office has been responsive after-hours advice. Kids always get worryingly sick at midnight.
posted by rabbitrabbit at 9:33 AM on November 12, 2013

Oh, the advice above about waiting rooms and minimizing exposure to other kids is very good. Just as a data point, our pedi schedules newborns in the morning before other kids can come in, so the waiting room was always empty and completely silent when we brought him in. Our son did not get sick even once until he was about 8 months old, and I attribute at least some of that to this practice that kept him away from germy kids.
posted by annekate at 9:38 AM on November 12, 2013

I'm not big on giving kids antibiotics for everything that comes up. I was relieved to find that my pediatrician was respectful of that and was willing to work with me on it when it came up. I didn't realize ahead of time how important that would be for me.
posted by ThatCanadianGirl at 9:40 AM on November 12, 2013

Even if your practice is pro-vaccine, ask if every one of their patients is vaccinated - and if not, what measures they put in place to make sure that their unvaxxed patients don't infect others. I just interviewed a pediatrician and she reassured me that her unvaxxed patients, of which she has very very few, only are allowed make appointments at the end of the day when there are no other patients around and the rooms can be cleaned afterward.
posted by sestaaak at 9:53 AM on November 12, 2013 [5 favorites]

Best answer: Lots of good advice here. I'd also ask the dr's assistant, not the dr directly (if you can), what is the normal waiting time between calling in with a question and being able to speak with the doctor. Sometimes you want to speak with him within the hour, not get a call back at the end of the work day when its too late to go out to the pharmacy or whatever.
posted by CrazyLemonade at 10:16 AM on November 12, 2013

I don't have specific questions for you but here's what I love about our pediatrician. It might give you a good sense of what to look for when you go in.

- He is generally always in a good mood.
- Once the exam is over, he sits down and explains what's going on. Like he'll go into as much medical detail as I want him to.
- He was able to talk me through giving my first a bottle of formula every night while still really encouraging me to breastfeed.
- It's a big practice with 5-6 doctors and they have all been nice. (We don't always get to see "our" doctor.)
- They have Saturday appts and walk-in hours on Sundays.
- The staff is very friendly (I think this a big thing. If they are treated well by the doctors, they'll be happy. If not, you'll know it.)

Good luck!
posted by dawkins_7 at 11:28 AM on November 12, 2013

If you can't pick easily, I'd go with the pediatricians. Their training was entirely focused on children, as opposed to being split between pediatrics, adult medicine, and obstetrics, and their continuing education will also focus on children. That's a huge plus to me.
posted by the young rope-rider at 4:36 PM on November 12, 2013 [1 favorite]

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