Picking a Pediatrician

Questions to ask when looking for a pediatrician, by parents and for parents

(Courtesy of the online Dear Dr. Christina community)

The last time I chimed in on the topic of how to select a pediatrician was about 8 years ago when I did a video for the Discovery Health Channel, which I don’t think exists anymore. (!) My youngest was about one year old at the time and I had not a single grey hair. The video definitely looks like a much younger and more earnest version of me (sigh), weighing in on the issue of whether a large practice or small one might work best for one person or another. I knew intellectually at the time that this isn’t a ‘one size fits all’ type of situation; that it’s all about finding the right fit, but now that I’m further along in both my career and the parenting gig I have even more of a widened viewpoint on the topic. As a pediatric emergency physician I get a front row seat to witnessing which practices in my community are easy to communicate and follow up with, who is open on the weekends, and even what various practices’ overarching practice styles and philosophies are.

So recently a friend and nurse practitioner colleague suggested that I write something up about this very subject, since she has a friend,a parent-to-be, who recently asked. I certainly could have dug up my previous content, but I thought I’d do this person one better and ask the #smartmommas and #smartdads of the very groovy DEARDRCHRISTINA online community, and boy did they deliver. You already know this if you’ve followed my social media this week, but in case you haven’t, I thought I’d collate the helpful comments made and turn them into a practical list of questions that anyone on the pediatrician search might find handy and helpful. So thanks, those of you who commented; we wrote this blog together.

Insurance

Does this practice accept your insurance?

This is a present reality for many that narrows the choices right off the bat. Before you even start your search, make sure that you obtain a list of in-network pediatricians that will fit your plan and your wallet . I’m here to report that the overwhelming majority of pediatricians I’ve ever met are pretty great people, so chances are good that you’ll find one in-network that will meet your needs.

Hours and Geography

Does this practice have weekend and evening hours? Who answers the phone/on-call service after hours?

Is the practice located near me?

These questions all have to do with physical accessibility and continuity of care. While it’s nearly always best to see the pediatrician/group who know(s) your child the best, for some people, there are good pediatric urgent care options nearby in case of acute care needs so they are comfortable driving a further distance to see their pediatrician for routine well and semi-urgent sick visits. It’s important to know what’s in your medical neighborhood, not just your medical home, so that you know where you can go when, and for what reasons. Similarly, who answers the phone at night for the practice? Is it a nurse advice line or do you get to speak to the pediatrician staff?

A few parents identified separate waiting rooms for sick vs well as an important feature. It’s no secret that medical office waiting areas can have plenty of germs, so keeping sick away from well can be of benefit. It should be noted that most practices will keep newborns out of the waiting areas altogether due to their less developed immune systems.

Size

How many clinicians are in the practice? Are there only doctors, or are physician assistants and nurse practitioners part of the staff as well?

There are pros and cons to different sized practices. Large practices with many clinicians usually are easier to access for last minute appointments or walk-ins, but the downside is that many people report that they see a different person every time. So many parents commented about the importance of humanity, having a good connection, bedside manner, being a good listener, patience, and being “professional but laid-back” that if you’re joining a larger practice you probably want to meet several of the pediatricians so that you’ll have a sense of what more than one personality is like. Some people have strong feelings as well about specific degree and level of training, so just make sure you know the facts about the staffing mix. Finally, if you wish for your child to see a specific gender pediatrician, or a younger/older one, of course you need to determine the distribution of those in the practice.

Several comments supported seeing just one person, the same every time. This is the case in a small practice of course, but it’s reasonable to ask how that could work even in a bigger practice. Many offices will assign a “primary provider” for each child and will do their best to schedule even sick visits with that individual.

Provider Experience/Expertise

Do I need a pediatrician with expertise with a specific diagnosis, or with experience caring for special needs children?

A few parents commented that they wanted to know where their pediatrician trained, but a more popular comment was about experience for those whose children have specific needs. If your child has a chronic condition, especially an unusual one, while you will likely have subspecialty support, having a primary care team who is familiar with the issues related to that condition is important.

Philosophy

Does this practice allow patients whose parents refuse vaccines? What is the philosophy on alternative health practices?

Several parents commented that they would not take their child to a practice that allowed families who refused vaccines. If you are looking for a pediatrician and have firm beliefs about non-traditional healing, it is wise to understand the climate of the pediatric office to be sure that the partnership in health between professional and patient is firm and aligned.

Front Desk Staff/Access/Digital access

Is the front desk staff helpful and kind? Is it easy to access clinical advice when calling? Is there a digital portal for communication and lab results?

This was brought up by parents several times, and I’ll admit I didn’t expect it to come up more than once. I hope this speaks to any pediatrician reading this about the importance of the quality of their administrative staff. Respect, efficiency, and plain ol’ being nice matter. This team is an ambassador of the practice and are key players in the business aspect, so having a good relationship with them is a real factor to take into account.

Connection

Do I have a connection with the people in this practice?

At the end of the day, nearly everyone on the thread commented about trust and connection. Honestly, I think that’s a gut feeling. You know when you know. When you have it, sign up, show up, and benefit. It’s a relationship you’ll never forget, and can be life changing and life saving along the journey of raising kids. I wish you an excellent connection, be it in a big practice or small one, with a male or female, an NP or  MD, at night, and on weekends.