Question: I will be giving birth in two months and a friend suggested that I check out some local pediatric offices so that I can make an informed decision about who to choose for my baby. What are some questions that I should be asking at that visit and what should I be looking for?
1. The Doctors
The most important choice when searching for any new doctor is recommendations, recommendations, recommendations. I am not talking about the Castle Connolly America’s top doctor ads on the back page of the NY Times. I am talking about recommendations from anyone whom you know and trust—friends, neighbors and family who have lived in the area and who have used their practice for a while and are happy. You want to make sure the doctors are not only smart and experienced but that they truly care about their patients. I have worked in different types of practices over the last 20 years and unfortunately, some offices have become more like factories, trying to get as many patients in and out as quickly as they can so the bills can be paid. This is not appropriate for any field of medicine but certainly not for pediatrics where we should expect young patients to need a little extra TLC and parents to come in with lots of questions. No practice is immune to the new realities of medicine, but it is crucial to ensure enough time is given to all patient in order make them comfortable, hear all of their questions and do a thorough exam. Please make sure that the recommendations you get reflect this.
2. The Front Desk and Nursing Staff
This may seem unimportant but if you have ever dealt with a surly front-desk person or a cranky nurse, you know exactly what I am talking about. You want to know if the front desk is professional and appropriately responsive. The last thing you want when you have been up all night with a sick 6-month old (and you are pulling your hair out and ready to cry yourself) is someone barking at you on the phone. Sure, we all can have a bad day here and there (especially in a busy office dealing with many different personalities) but on a regular basis, does the phone get answered? Are you being listened to? Is your doctor getting your messages and returning your calls? (Which usually happens during our lunch break or after work depending on how busy it is.) Are emergencies dealt with immediately? Are labs being checked and follow-up phone calls being made by either doctors or staff?
3. Hours
Please check the office schedule and make sure it works for you. The majority of offices these days have evening and weekend hours. You want to be sure that the practice does checkups as well as sick visits during evening hours. This can be critical for working parents and important for school-age kids who benefit from not missing class time. (It is hard to imagine, especially if you are expecting your first, but the days of juggling doctor visits, soccer, piano lessons, mishmar carpools and SAT tutors are right around the corner.) You also want to ask how easy it is to get same day sick visits. Most practices will leave slots open for those who call in the AM for a same day appointment.
4. After Hours
How are after-hours phone calls handled? Most practices have a service that fields calls and arranges callbacks. It is important to know who you can expect to speak with. Do you always get to speak to a doctor or are you sometimes put through to a triage nurse? This is fine for some parents, but if you always want to speak with a doctor it is important you look into the policy of your potential practice. If you are looking at a practice with a solo practitioner, who will cover emergency visits and phone calls when he or she is on vacation?
5. Location, Location, Location
You want to make sure that the office is conveniently located for you. The closer you are the better. If you are going back to work at some point after giving birth, you may hire a babysitter who does not drive and many of our patients’ babysitters walk over with the kids when necessary. As a working mom of three children I can tell you that there is nothing more miserable than rushing home from a full day of work (after being up all night with a sick baby—sorry new parents, I don’t mean to scare you about being up all night again) and having to go to the doctor. Not fun. Not everyone can be within walking distance of a practice but proximity is definitely something to consider. In the first year of life you are seen for checkups very frequently (first every few days then every month or two) and you may not want to spend an excessive amount of time commuting with a newborn in your back seat.
6. Practice Policy on Vaccinating
I left this one for last because it has become such a controversial issue. I am not going to go into my feelings on vaccinating (pro, pro, pro—one of the most important and potentially lifesaving things you can do for your child) because that is an entire column (or three) all its own. I just want to mention it here because it is one of the most important things you need to consider when choosing a practice. Please ask at the prenatal visit whether the practice requires that its patients be fully vaccinated. You need to do this for two reasons. If you are anti-vaccine, as soon as you refuse vaccines, you will be asked to leave the practice and have to start the practice search all over again (much harder when you are lugging a baby in a car seat with you everywhere). If you are pro-vaccine you may feel uncomfortable having your baby in a waiting room with kids who are potentially not vaccinated. Vaccine schedules may vary from practice to practice so make sure you discuss what vaccines are given when and decide whether that is comfortable for you.
There is so much more to cover at the prenatal visit but I appear to be running out of space. The most important thing to remember is that if something is on your mind, don’t hesitate to ask. No question is too trivial or too embarrassing. A good pediatrician not only provides answers but an environment in which parents feel comfortable asking.
By Nina Epstein
Nina Epstein is a pediatrician at Metropolitan Pediatrics at 704 Palisade Ave. in Teaneck who loves to answer questions. She is hoping that this will become a regular column with topics selected from questions submitted by readers. To submit a potential pediatric question for the column please email [email protected].
