Tips on choosing a Pediatrician
When and How to Start Looking
Begin your search for a health care provider before your baby's due date. Babies often come early and you'll want to be sure you've found a health professional whose style and personality work with your own.
If you're in a managed health care plan, your choice of participating doctors who provide primary care for children may be limited, so be sure to check the plan's online list (paper lists get outdated quickly).
If you have questions about whether a provider participates in your plan or if you're interested in a doctor who isn't on the list, call the health plan directly. Also call if your child has any special medical needs that would require an out-of-network doctor.
Your Options
There are three types of qualified health care providers for children: pediatricians, family physicians, and pediatric nurse practitioners.
Pediatricians: a medical doctor specializing in the medical specialty fully focused on the physical, emotional, and social health of children from birth through adolescence. The primary focus of pediatrics is on preventive health care. Some pediatricians have additional training in a subspecialty area such as cardiology, critical care or emergency medicine, or hematology.
Family Physicians: Family medicine residents train in pediatrics and several other areas such as internal medicine, orthopedics, and obstetrics and gynecology. They usually spend several months training in each area. Afterwards, they're eligible to take the certifying examination of the American Board of Family Medicine. Because they train in many areas, family physicians are qualified to care for patients of all ages. This means your child would be able to see the same doctor from birth through adulthood. It also means that all members of your family can receive their primary care from the same doctor. If this sounds best for you and your family, be sure to ask a family physcian and/or a family medicine practice, about age policies - some see only a few kids or don't see children younger than a certain age.
Pediatric Nurse Practitioner, PNP: A pediatric nurse practitioner generally have earned a master's degree in nursing and have special training in obtaining medical histories, performing physical examinations on children, making medical diagnoses, and providing counseling and treatment. Like pediatricians, PNPs may specialize in a particular area, such as neurology or endocrinology. PNPs work closely with doctors in hospitals, clinics, and private practices.
Questions to ask
- What are the office hours? Flexibility of the doctor's schedule may be a concern, especially if you work outside the home; you may prefer a doctor who offers weekend and evening hours.
- Is this a solo or group practice? If it's a solo practice, what are the coverage arrangements? If it's a group practice, ask about the qualifications of the other doctors in the office. Who will see your child if your doctor is on vacation or otherwise unavailable?
- Does a PNP work in the office? How does he or she fit into the practice arrangement?
- Which hospitals is your doctor affiliated with? Will your doctor come to the hospital when you deliver to examine the baby? If your baby needs to be hospitalized, who will provide care there?
- How does the office handle phone inquiries during and after hours? Are special times set aside for parents to call in with questions or is there an open advice line (usually staffed by a "phone nurse") during working hours? How are after-hours calls handled? How quickly can you expect a call back from the doctor on call after you've contacted the answering service? Are after-hours calls routed to a "nurse-on-call" system? This is a service that employs a staff of nurses to give parents advice about how to handle most common childhood illnesses. If your child's illness is thought to be serious, the nurse will transfer the call to your child's doctor or a covering physician, or advise you to go directly to the emergency room. Otherwise, a record of the call will be relayed to your doctor the next day.
- Is email an option for communicating with your doctor?
- Will the doctor handle emergencies or will your child be referred to an emergency room or urgent care center? Are these facilities equipped to handle pediatric emergencies?
- Are lab tests done in the office? Most offices can perform basic tests, such as complete blood counts, urine testing, and rapid strep tests rather than send samples out to a laboratory.
- What are the payment policies? This is especially important if you do not have prepaid health coverage. What are the fees for services? Must they be paid in full at the time of the visit or can payment plans be arranged?
- What are the policies regarding referrals to specialists in the event your child needs additional care? Is the doctor financially penalized by your health plan for referring patients to specialists, and if so, will this influence the doctor's referral practices? If you are in a health management organization (HMO), it's important to ask how your doctor handles out-of-network referrals.
