Help us choose between pediatricians.
December 14, 2018 11:41 AM Subscribe
Mr. Millipede and I toured two pediatric offices for the twins we are expecting in early 2019. Please help us choose between them.
Very relevant preliminary background fact:
We live in Manhattan. We do not have a car, do not drive, and are very cowed by the idea of hailing a cab, installing two(!) carseats, and squishing everyone in, and would thus like to avoid it.
Now, the practices we are considering:
Pediatric office #1 is two blocks from our apartment, which is its main selling point. It's part of a well-known chain of pediatrics offices in NYC, but a small outposting of said chain, not one of the main offices.
Pediatric office #1 lacks two things I care about. They are: 1) separate sick and well waiting rooms, and 2) a policy banning anti-vaxxers from their practice.
Three pediatricians work there, and we only met with one. She was nice and seemed competent, but she was rather new to the practice and could not answer one of my main questions, which was "what percentage of your patient population chooses to remain unvaccinated?" My feeling is that we don't live in a particularly anti-vaxxy neighborhood (lower upper east side) but I wanted to quantify the issue so I could make an informed decision. She couldn't give me even a range.
The office itself was bright and cheerful and quirky; the exam rooms looked very warm and calming and kid-friendly. And I remind you that this office is two blocks from our apartment.
Pediatric office #2 is about 20 blocks from our apartment. Alas, we liked it SO MUCH BETTER than office 1. Three pediatricians practice there, and we met all three and liked all three, and all three have been working there for a long time, which we read as a good sign.
Pediatric office #2 has separate sick and well waiting rooms, and they don't accept anti-vaxxing families. Their office was spacious and well-organized, and they had many more exam rooms than practice #1. The exam rooms themselves were more medical-looking--just like regular doctors' office exam rooms, not quirky or warm or especially kid-friendly, but I feel okay about that.
This office, being 20 blocks away, would be a nice stroll in the summertime, but a mess to get to in the winter, especially because non-folded strollers are not permitted on NYCT buses. Originally I had the idea that we could get the stroller on a bus, take a quick ride uptown, and it would be fine. But removing two infants from their stroller, managing to fold it up, and then reopen it and get them back in... sounds extremely daunting, even if Mr. Millipede and I both attend every single appointment, which would be ideal but may not be realistic.
A few other relevant comparisons between the practices:
-Office #1 has an online portal and #2 does not. We do like an online portal.
-Office #2 has Saturday morning hours. Office #1 does not.
-Office #1 has an after hours hotline but it goes to the main office of their chain, not our actual doctors we'll know. Office #2 has one and it goes directly to the doctors we know--it's not a chain.
-Office #2 is higher rated on the internet than Office #1.
What do we do! If getting there were not an issue, Office #2 would easily be our choice, but getting there is going to be so hard with two tiny infants--unless you have some ideas about that, which I'll happily listen to. ("Get a car and learn to drive it" is not a good idea for this.)
Very relevant preliminary background fact:
We live in Manhattan. We do not have a car, do not drive, and are very cowed by the idea of hailing a cab, installing two(!) carseats, and squishing everyone in, and would thus like to avoid it.
Now, the practices we are considering:
Pediatric office #1 is two blocks from our apartment, which is its main selling point. It's part of a well-known chain of pediatrics offices in NYC, but a small outposting of said chain, not one of the main offices.
Pediatric office #1 lacks two things I care about. They are: 1) separate sick and well waiting rooms, and 2) a policy banning anti-vaxxers from their practice.
Three pediatricians work there, and we only met with one. She was nice and seemed competent, but she was rather new to the practice and could not answer one of my main questions, which was "what percentage of your patient population chooses to remain unvaccinated?" My feeling is that we don't live in a particularly anti-vaxxy neighborhood (lower upper east side) but I wanted to quantify the issue so I could make an informed decision. She couldn't give me even a range.
The office itself was bright and cheerful and quirky; the exam rooms looked very warm and calming and kid-friendly. And I remind you that this office is two blocks from our apartment.
Pediatric office #2 is about 20 blocks from our apartment. Alas, we liked it SO MUCH BETTER than office 1. Three pediatricians practice there, and we met all three and liked all three, and all three have been working there for a long time, which we read as a good sign.
Pediatric office #2 has separate sick and well waiting rooms, and they don't accept anti-vaxxing families. Their office was spacious and well-organized, and they had many more exam rooms than practice #1. The exam rooms themselves were more medical-looking--just like regular doctors' office exam rooms, not quirky or warm or especially kid-friendly, but I feel okay about that.
This office, being 20 blocks away, would be a nice stroll in the summertime, but a mess to get to in the winter, especially because non-folded strollers are not permitted on NYCT buses. Originally I had the idea that we could get the stroller on a bus, take a quick ride uptown, and it would be fine. But removing two infants from their stroller, managing to fold it up, and then reopen it and get them back in... sounds extremely daunting, even if Mr. Millipede and I both attend every single appointment, which would be ideal but may not be realistic.
A few other relevant comparisons between the practices:
-Office #1 has an online portal and #2 does not. We do like an online portal.
-Office #2 has Saturday morning hours. Office #1 does not.
-Office #1 has an after hours hotline but it goes to the main office of their chain, not our actual doctors we'll know. Office #2 has one and it goes directly to the doctors we know--it's not a chain.
-Office #2 is higher rated on the internet than Office #1.
What do we do! If getting there were not an issue, Office #2 would easily be our choice, but getting there is going to be so hard with two tiny infants--unless you have some ideas about that, which I'll happily listen to. ("Get a car and learn to drive it" is not a good idea for this.)
For infants at least, installing car seats is a snap: bucket seats can be secured with a regular seat belt (so no base needed) and takes less than thirty seconds each, if that changes the equation at all. I am admittedly not sure what you would do when they outgrow the bucket seats and are into convertibles.
posted by anderjen at 11:49 AM on December 14, 2018 [1 favorite]
posted by anderjen at 11:49 AM on December 14, 2018 [1 favorite]
I think you should go with the one you like more for the following reasons:
- this is a long-term partnership (between you and your doctors) and it really helps if you find one you really trust and are comfortable with
- it's very hard to contain your child after the infant stage; being in a well waiting room has given me some peace of mind while we are in the "everything in the mouth" stage
- when you need to go to the doctor with your child either it's something you can plan in advance or it's sudden. And when it's sudden there is always something inconvenient about it; there's not much you can do about it.
- you are going to become a pro at get your two kids places very quickly
I have one more suggestion: do they each have a nurses hotline? If so, can you call it and try it out? You want nurses who (a) answer the phone and (b) give you a sense of confidence in their answers. I use the nurses hotline ALL THE TIME. We rarely go into the office.
posted by CMcG at 12:03 PM on December 14, 2018 [8 favorites]
- this is a long-term partnership (between you and your doctors) and it really helps if you find one you really trust and are comfortable with
- it's very hard to contain your child after the infant stage; being in a well waiting room has given me some peace of mind while we are in the "everything in the mouth" stage
- when you need to go to the doctor with your child either it's something you can plan in advance or it's sudden. And when it's sudden there is always something inconvenient about it; there's not much you can do about it.
- you are going to become a pro at get your two kids places very quickly
I have one more suggestion: do they each have a nurses hotline? If so, can you call it and try it out? You want nurses who (a) answer the phone and (b) give you a sense of confidence in their answers. I use the nurses hotline ALL THE TIME. We rarely go into the office.
posted by CMcG at 12:03 PM on December 14, 2018 [8 favorites]
We ended up switching pediatricians at 4 months because our primary doctor left the practice. I say this because you can always switch if distance is a factor. We primarily used walk-in hours over the first year so I would say that whoever has better walk-in times/days is something to consider. Separate sick and well waiting rooms are really important to me as well, though I've always asked immediately for a private room (particularly with my newborn) and they always let me go into a room immediately -- so I wouldn't make that your final arbiter. It sounds like 2 has much better walk-in hours, though.
I would go with #2, understanding that if you find it a pain to get to, you can always switch to #1.
posted by melodykramer at 12:21 PM on December 14, 2018
I would go with #2, understanding that if you find it a pain to get to, you can always switch to #1.
posted by melodykramer at 12:21 PM on December 14, 2018
do you plan on moving in the next couple of years? if not, go with the one that is closer to your home. getting two children into strollers and out of them and onto the bus and then doing the reverse (TWICE!) as a single individual adult sounds awful, especially if one or both are sick.
and 20 blocks is a long way to walk in the hot/humid nyc summers pushing a double stroller.
unless the docs at the office closest to you seemed significantly crappier go with the one that is closer.
posted by misanthropicsarah at 12:25 PM on December 14, 2018 [1 favorite]
and 20 blocks is a long way to walk in the hot/humid nyc summers pushing a double stroller.
unless the docs at the office closest to you seemed significantly crappier go with the one that is closer.
posted by misanthropicsarah at 12:25 PM on December 14, 2018 [1 favorite]
I'd choose #1. (I have a 2-year-old.) Here's why:
-LOCATION: We moved from DC, where we had a car and drove to the dr, to Brooklyn, where we do not drive and our pediatrician is a 10-minute walk. It's SO much better to walk. For the first year, they go in so many times for regular appointments, and then you take them in for sick visits too--I always hated the longer commute, and then if you do the thing where you and your partner both go to the visit and then one of you goes to work from there and the other brings the kids home--there's just one of you to get all the way home!
-WAITING ROOMS: We haven't been to any pediatricians that had separate waiting rooms, so I don't care too much about that. My kid is one of the mouthiest out there (and also most active) and I just kept him in the stroller or on my lap until it was time to go into the consulting room. Plus, I read somewhere that it doesn't matter about the waiting rooms, because they don't separate out the consultation rooms by sick vs. well. I suppose that depends on your practice.
-ANTI-VAXX: Again, I don't think it matters too much if they let these families into the practice because you just won't spend THAT much time there. (Vs, eg, your daycare/preschool.) As long as they support YOU in pursuing the standard schedule, I don't think you're going to notice it too much (our previous ped had no such policy and it just wasn't a problem).
The only thing that might tip me to #2 is the Saturday morning hours, but I think with the location I'd probably still choose #1.
posted by CiaoMela at 12:26 PM on December 14, 2018 [5 favorites]
-LOCATION: We moved from DC, where we had a car and drove to the dr, to Brooklyn, where we do not drive and our pediatrician is a 10-minute walk. It's SO much better to walk. For the first year, they go in so many times for regular appointments, and then you take them in for sick visits too--I always hated the longer commute, and then if you do the thing where you and your partner both go to the visit and then one of you goes to work from there and the other brings the kids home--there's just one of you to get all the way home!
-WAITING ROOMS: We haven't been to any pediatricians that had separate waiting rooms, so I don't care too much about that. My kid is one of the mouthiest out there (and also most active) and I just kept him in the stroller or on my lap until it was time to go into the consulting room. Plus, I read somewhere that it doesn't matter about the waiting rooms, because they don't separate out the consultation rooms by sick vs. well. I suppose that depends on your practice.
-ANTI-VAXX: Again, I don't think it matters too much if they let these families into the practice because you just won't spend THAT much time there. (Vs, eg, your daycare/preschool.) As long as they support YOU in pursuing the standard schedule, I don't think you're going to notice it too much (our previous ped had no such policy and it just wasn't a problem).
The only thing that might tip me to #2 is the Saturday morning hours, but I think with the location I'd probably still choose #1.
posted by CiaoMela at 12:26 PM on December 14, 2018 [5 favorites]
Adding: the anti-vax stuff was also really important to us, but we ended up going to a practice that doesn't forbid them. Their reasoning? They view it as an ethical issue to continue to educate, and also put them immediately in a room and sometimes make them come in at different times so they're not overlapping with newborns or immune-compromised patients. So they're in the practice, but we would never encounter them. That made me feel a lot better.
posted by melodykramer at 12:26 PM on December 14, 2018
posted by melodykramer at 12:26 PM on December 14, 2018
I have kids and I would choose #1.
We used to live within walking distance of our pediatrician's office and, while we kept the pediatrician when we moved because he was absolutely outstanding, we were secretly relieved when he quit practicing entirely because we could in good conscience stop traipsing four towns over when our kids had an ear infection. Or strep. Our daughter had strep 8 times before she got her tonsils out at 4.
I've never been to an office that had a separate sick kid waiting room, but I understand that it is a thing. In an ideal world I would love that, but in the practical world unless you have an immunocompromised child it's not going to make much of a difference.
If you lived in an area with a high percentage of anti-vaxxers I would make finding a practice that banned them a priority, but that might not be crucial if you live in a sensible part of the country and will absolutely vaccinate on schedule. (I live in Greater Boston and it was never a huge concern).
The only thing that would give me pause is Saturday hours, because most illnesses happen over the damn (usually holiday) weekend because germs are stupid evil things that know when offices are closed.
posted by lydhre at 12:34 PM on December 14, 2018 [4 favorites]
We used to live within walking distance of our pediatrician's office and, while we kept the pediatrician when we moved because he was absolutely outstanding, we were secretly relieved when he quit practicing entirely because we could in good conscience stop traipsing four towns over when our kids had an ear infection. Or strep. Our daughter had strep 8 times before she got her tonsils out at 4.
I've never been to an office that had a separate sick kid waiting room, but I understand that it is a thing. In an ideal world I would love that, but in the practical world unless you have an immunocompromised child it's not going to make much of a difference.
If you lived in an area with a high percentage of anti-vaxxers I would make finding a practice that banned them a priority, but that might not be crucial if you live in a sensible part of the country and will absolutely vaccinate on schedule. (I live in Greater Boston and it was never a huge concern).
The only thing that would give me pause is Saturday hours, because most illnesses happen over the damn (usually holiday) weekend because germs are stupid evil things that know when offices are closed.
posted by lydhre at 12:34 PM on December 14, 2018 [4 favorites]
The anti-vax issue will be most relevant for only a few vaccines when your babies are very little, like the measles and pertussis vaccines, which are not normally given to tiny infants under 6 months. If you could arrange for first-patients-of-the-day well visits for your newborns, you could probably manage to avoid sick kids in the waiting room. All the exam rooms and office surfaces will have been cleaned after the previous day's office hours, too.
My daughter's pediatrician has adopted a no-waiting policy, where patients are scheduled only by email, are scheduled to the minute, and there is never another family waiting when they arrive. It presents a scheduling problem occasionally when she is running late, but it does minimize exposure. This is also an urban practice with minimal office space, and where the majority of patients walk or take public transit.
posted by citygirl at 12:43 PM on December 14, 2018
My daughter's pediatrician has adopted a no-waiting policy, where patients are scheduled only by email, are scheduled to the minute, and there is never another family waiting when they arrive. It presents a scheduling problem occasionally when she is running late, but it does minimize exposure. This is also an urban practice with minimal office space, and where the majority of patients walk or take public transit.
posted by citygirl at 12:43 PM on December 14, 2018
I was very anxious about the anti-vax thing too, but I wound up at a practice that didn't ban them. At least until your babies are vaccinated, make sure you book the first appointment of the day to reduce the number of other kids you'll encounter. (Re your choice here, I think for you it's at best a wash, if to get the babies to the place that bans unvaccinated kids you have to put them on a city bus.)
Smaller is better, overall, for us. Fewer other kids total. Our ped recently joined a much larger practice group and I hate going there now. So loud.
I'd take the one that's closest. Two blocks away? That's a gift right there.
posted by fingersandtoes at 12:57 PM on December 14, 2018 [1 favorite]
Smaller is better, overall, for us. Fewer other kids total. Our ped recently joined a much larger practice group and I hate going there now. So loud.
I'd take the one that's closest. Two blocks away? That's a gift right there.
posted by fingersandtoes at 12:57 PM on December 14, 2018 [1 favorite]
Location matters a lot, but if #1 is tribeca pediatrics, we weren't fans.
posted by JPD at 12:58 PM on December 14, 2018
posted by JPD at 12:58 PM on December 14, 2018
I would choose #2; 20 blocks isn’t THAT far (I traveled farther than that when we were in Manhattan)- you could always hop in a cab, car seats are not required in them.
posted by ThePinkSuperhero at 1:34 PM on December 14, 2018
posted by ThePinkSuperhero at 1:34 PM on December 14, 2018
The normal infant checkup schedule requires 7 visits between birth and 12 months. Plus you'll have to consider all the potential sick visits (x2 with twins). I have two kids and would LEAP for a 2-block commute to the pediatrician.
posted by galvanized unicorn at 2:02 PM on December 14, 2018 [3 favorites]
posted by galvanized unicorn at 2:02 PM on December 14, 2018 [3 favorites]
I’m from Manhattan, now in LA. We did a slow vaccination schedule and my son is now 7 yrs old. I would not hesitate to choose pediatrician #1 that is 2 blocks from home. I would wait with the kids in the stroller or outside if it was a crowded waiting room, but really, I wouldn’t worry if the kids were strapped in and unable to touch stuff in the waiting room + it wasn’t crowded. It’s not that I don’t care about germs, it’s that I watched vaccinated kids at our preschool get chicken pox when my son didn’t. He started varicella vax just after the outbreak (3.5 yrs old, I think?) and.... My son never had colds, flu, etc. He was only sick a handful of times and only for a day or overnight. It’s possible my son has an incredibly strong immune system, but I’m pretty sure 99% of his good health was handwashing and not allowing him to body hug his friends when they were sick, keeping him in environments that were appropriately looked after and sanitized. Our preschool was really good about germs. Preschhool you do every day, and there’s loads of kids that can’t blow their own noses or wash without help. The doctor’s office is not someplace you go every day.
I would ask how often the waiting room is wiped down and disinfected.
I think walking in the open air is likely safer if you are worried about contagious illness than a cab, bus, or uber in terms of cleanliness.
I totally understand your concerns. You are very lucky if the closer office had good competent people working there. I would definitely be more concerned about public transport than the doctor’s office if I had the option to wait outside and keep the children safely contained in their stroller.
That’s my math. Congratulations! Whatever you decide will be right!
posted by jbenben at 2:18 PM on December 14, 2018
I would ask how often the waiting room is wiped down and disinfected.
I think walking in the open air is likely safer if you are worried about contagious illness than a cab, bus, or uber in terms of cleanliness.
I totally understand your concerns. You are very lucky if the closer office had good competent people working there. I would definitely be more concerned about public transport than the doctor’s office if I had the option to wait outside and keep the children safely contained in their stroller.
That’s my math. Congratulations! Whatever you decide will be right!
posted by jbenben at 2:18 PM on December 14, 2018
Ok, I have a different viewpoint. My oldest son is not vaccinated. He is not vaccinated because he has CVID, and his body does make antibodies. My younger son is vaccinated. So for your stance, we would fall under your "non-vaxxer" family. We rely on herd immunity to protect him (and IgA infusions every six weeks), because he cannot get vaccinated.
That said, I would pick Ped Office #1 because it is closer. It sucks schlepping to the ped office, esp. when they are little, and if your child ends up having a weird illness which makes it so you are going to the office every few weeks, it gets tiresome, super fast. And you will have twins. You can always switch ped offices, but I would go for the one closer right now.
However, from the post it seems like your mind is made up for Ped Office #2. I just wanted to point out that you might have an unconscious bias there against people who do not vaccinate.
posted by alathia at 2:21 PM on December 14, 2018 [2 favorites]
That said, I would pick Ped Office #1 because it is closer. It sucks schlepping to the ped office, esp. when they are little, and if your child ends up having a weird illness which makes it so you are going to the office every few weeks, it gets tiresome, super fast. And you will have twins. You can always switch ped offices, but I would go for the one closer right now.
However, from the post it seems like your mind is made up for Ped Office #2. I just wanted to point out that you might have an unconscious bias there against people who do not vaccinate.
posted by alathia at 2:21 PM on December 14, 2018 [2 favorites]
You're going to want to go other places with your little ones, no? You're going to have to solve the transportation problem.
posted by amtho at 3:14 PM on December 14, 2018 [1 favorite]
posted by amtho at 3:14 PM on December 14, 2018 [1 favorite]
I vote for # 2. 20 blocks is only a mile. Even in extreme weather, New Yorkers have a great ability to bundle up and get cosy. Doing that 7x a year is pretty minimal and a healthy amout of walking. For illnesses, the illness will outweigh and hassle of carseats and I bet you won’t even care about putting seats in the cab.
posted by MountainDaisy at 5:34 PM on December 14, 2018
posted by MountainDaisy at 5:34 PM on December 14, 2018
I live just across town from you on the west side. Our pediatrician who we loved was two blocks away. In the first year and a half of my oldest son’s life he had a serious congenital heart condition he’s since outgrown and we were in there like twice a month if not every week for weighings sometimes. Then our doc changed practices thirty blocks away and we loved her so much but it wasn’t going to work for our frequency and we switched to a practice that has an office across the street and another office on the upper east side. I HATE schlepping one sick kid let alone two across town through traffic to the farther office. Especially since it’s not anywhere near my work and it’s a huge chunk of a morning getting kids there and back home and then back to the office if I need. I LOVE just bundling a babe up and running across the street if needed. Then I go to CVS down half the block for a prescription and we’re back home lickety split. Minimal misery when you’re already stressed. #1!!!!
posted by sestaaak at 6:22 PM on December 14, 2018 [3 favorites]
posted by sestaaak at 6:22 PM on December 14, 2018 [3 favorites]
I'd go with the closer office. Twins are likely to be preemie which means extra visits that first year. Being that close is amazing.
My daughter was extremely premature and immunocompromised and we just asked for a private room immediately upon arriving at each appointment. It was no problem, and a joint sick/well room is going to be no worse than a city bus, especially when they are so young that they'll be in the stroller the whole time.
posted by peanut_mcgillicuty at 7:13 PM on December 14, 2018 [1 favorite]
My daughter was extremely premature and immunocompromised and we just asked for a private room immediately upon arriving at each appointment. It was no problem, and a joint sick/well room is going to be no worse than a city bus, especially when they are so young that they'll be in the stroller the whole time.
posted by peanut_mcgillicuty at 7:13 PM on December 14, 2018 [1 favorite]
I would go with the Doctors you like and trust more and deal with the inconvenience. I had three under the age of three at one point. I have taken 3 car seats onto a plane when the oldest was 2.5. Sure, it sucks, but peace of mind and faith in the doctor so outweighs the PITA of the logistic of travel. In NYC (I am in Westchester), I would get an Uber, let them know there will be two car seats and take my time. I could not imagine going to a practice I thought was subpar to another because of my convenience. I would put my kid's as the top priority. Having said that, I am sure either practice will work out fine.
posted by AugustWest at 8:13 PM on December 14, 2018
posted by AugustWest at 8:13 PM on December 14, 2018
I skimmed and didn’t see this mentioned - is there an urgent care near you? Having someplace closer that you can pop into for some of the “is this an ear infection” or “should we worry about this rash” visits would make it easier to go with #2.
posted by songs about trains at 5:31 AM on December 15, 2018
posted by songs about trains at 5:31 AM on December 15, 2018
This thread is closed to new comments.
posted by k8t at 11:48 AM on December 14, 2018 [1 favorite]