My wife and I have a little Wolverine on the way due end of March and are in the process of looking into choosing a pediatrician. The question for the board is what do you guys look for in a good pediatrician? We would prefer a doctor who works exclusively with children, and has children of their own, but not sure what else we should be looking for. We both grew up in Michigan and currently live in the Bay Area.
OT: Picking a pediatrician, what to look for?
Awesome advice would be to keep the health of your children out of the hands of a sports blog forum.
Says the guy who is asking pediatrician advice from bloggers who have an almost nightly "What are you drinking?" thread.
The best is to look for referrals. Everything else is a poor indicator of a good doctor.
This is not a complaint about this being OT, but you will get much much better responses on a parenting board that has a Bay Area section. As stated above, you want referrals. If you don't know a lot of people with kids in the area, that's the best way to get referrals.
Really, if the pediatrician doesn't have DRM included, don't even bother. For all you know, you might be getting a pirated version of a doctor, and after all, Home Taping is Killing Medicine.
Referrals. Totally agree. Have any doctor friends? Ask them who is best or who they take their kids to. They have a fast communication network.
Also, I try to find out how "prescription happy" the doctor is when we start. Some seem to give antibiotics for everything. Kind of freaks me out.
My daughter had a UTI when she was only a few months old. Even though she exhibited all the signs of a UTI the DR insisted on a lab speciman. In a child that young that means a catheter since they can't deliver the specimen. It was so painful for my daughter that two of the nurses were crying.
I understand antibiotic overprescription, but that was uncalled for IMHO.
Anyway, I'd go with referrals if that is in any way an option. I'm not 100% a pediatrician is even required if you're comfortable with your family doctor and your child doesn't have any issues.
good luck. Being a parent is the best thankless/payless job in the world.
Around you. Pick a pediatrician who works only with kids. Our pediatrician graduated from UM, so that was good.
The OP said he's looking for a pediatrician but then opened up the possibility of a Family Practice doc. Not a bad option if you live in a small town but I have a feeling SF is rife with pediatricans.
If it's Bay City, I may be able to help; my wife works with health care providers in the Tri-Cities. If it's San Francisco, you're on your own.
The bad news is that I can't help. The good news I that you weren't hit by the meteor yesterday. So, glass half-full.
Find one that looks smart. And make sure you talk to her/him i'm person, you don't want to get catfished
with a lot of the pediatricians -- not just your OB/GYN. Also, your OB/GYN can be a great referral source.
Make sure you know what selection criteria are most important to you, and don't be afraid to ask questions. Do you care most about the MD's (or OD's) academic credentials, certifications, experience, size of practice, accessibility, proximity, etc. . . Also, you may want to pay for a couple visits to different pediatricians to "interview" them. You are likely going to be visiting them for years, so a small initial investment can be valuable in making sure you are happy with an important relationship for you and your child.
Also, you may want to choose a practice that uses Pediatric Nurse Practioners in addition to Pediatricians. The PNPs can likely take more time with you and your child when you make office visits.
It's not only where the pediatrician went to med school, but where did they do their training. Because a med school is well known, it doesn't automaticlly follow that they have a great pediatrics program.
You also need to see who else is in the practice and how they are credentialed. For well baby care, you will se your doc, but when your little one gets sick in the middle of the night, you typically get the doc covering call.
From my perspective, I'd also like someone who has been practicing for a while. Experience is a great teacher.
If you can find some other docs with young kids, ask who they use, as docs know these things.
Congrats on your new arrival.
The staff ethically cannot make recommendations. Now if you have personal friends who work at a hospital, they can help you. But staff should not be giving you that kind of guidance.
Everyone is saying referrals, so another suggestion: education. You can usually find their degrees through a simple web search (or their webpage, if they have one). While it's not a surefire indicator, it's always nice to see B.S. U of Chicago, M.D. Northwestern, instead of Eastern Illinois and USF.
Better for a "little Wolverine"
Once you get referrals, You should meet with prospective peds prior to having the baby to make sure you are comfortable with them and you like their practice, bedside manner, and views.
Perhaps I'm a little jaded by being in NYC, but some practices are just factories where you feel like a piece of cattle and others you rarely see the doctors and are mostly seeing nurses, so meeting them ahead of time will give you a feel for the practice.
Referrals are great, but you also want to make sure this person takes the time to answer questions. I have found we see my son's peditrician far more than I ever see my doctor, and his doctor takes the time to answer our questions without appearing to be in a hurry to run to another patient. In other words, he treats us like people rather than a paycheck.
Ask lots of questions during your interview with him/her. Should also ask if they have an area of subspeciality (diabetes, etc.). Find out what they think about the things that matter to you and your wife and make sure you are all like minded.
One other for instance: my wife and I weren't fans of giving our son 5 immunization shots in one session. He was very understanding and said he had no problem doing whatever we wanted to do. I think we ended up spreading it out over a period of months, which was his suggestion in the end.
Hope this helps. Good luck with your little Wolverine. Go Blue.
In addition to getting referrals as others have mentioned, ask those who provide referrals about the entire practice, not just one doctor. Doctors have days off, and when junior needs to be seen right away, he might just be seen by another doctor in the practice. Also, even the best doctor with a crappy nurse or receptionist can make visits less than pleasant.
One thing that has always been helpful for us - and one of the reasons we really like our pediatrician in Ann Arbor - is a friendly office staff that responds in a timely manner and good availability, including Saturday hours, as our kids have a tendency to present bugs at awkward times of the day and night. Ours even has a paging service that is 24/7, so if we needed to do so, we could at least talk to someone. I would ask about things like this as well.
The easiest thing to do (depending if you have time of course) is to interview them. Talk to the OB's, ask where they send their kids. Then interview the pediatricians and see who you like. Some people want a male/female doc based on if they have a boy/girl. It makes a difference in terms of comfortability with your child but may not matter if you have more than one kid and one of each gender. Also, parenting style is a huge thing. If you are against vaccines find a pediatrician who's okay with that. If you want to space out vaccines find someone who is okay with that. You want to breast feed until your kid is 13, it'll be tough but find a doc who's not going to give you a hard time about it. It's not an easy task but a very important one, a little time now will save you a ton of headache later.
/pediatric resident in detroit.
Edit: also ask if they have residents/medical students. It may not matter to you but it certainly matters to some parents and can definitely add time to most visits if they are present.
Hopefully these are not the attendings in your training program!
I'm all for freedom of choice but there is this thing called herd immunity.
/M.D. who only works with big 'uns
None of the attendings I work with are against vaccines as far as I know. I have seen one "excuse" a family from their practice for refusal to vaccinate which is why I brought it up. If a parent is against vaccines and has no interest in hearing the benefits etc then they are not going to have a good relationship with their doc and that's no good. Like I said, I'll avoid the arguments regarding vaccines (despite the bait further down the thread) and just say I'm 100% for vaccines and the vast majority of docs I know are as well...but it is certainly an issue that can cause friction.
- Check their reviews - Google is your best friend.
- Referrals -
- Big group vs individual - definitely go with big group (i.e, other doctors can help you if your primary doctor is not there - he/she can not work 24 hours a day)
- After hours visit (say 6 pm ~ 8 pm, Saturdays, Sundays)- absolutely needed for first few years
- Way after hours consultation: you may need 24/7 consultation available over the phone if something happens, especially if this is your first child.
It's funny everyone is mentioning referrals from friends. When my daughter was born, she wasn't gaining weight the first few weeks and we were getting very concerned. Our pediatrician (highly recommended by friends of ours) was absolutely terrible at supporting our concerns or taking us seriously. Their response was, "oh she'll be fine! Sure your wife is having terrible problems nursing, but she'll be fine!" We thankfully thought better and switched pediatricians immediately and were given amazing support and a workable plan from our now current pediatrician.
Lesson learned: everyone thinks their doctor is the best. Your experience may differ! I work in a Children's hospital now, and frankly it is kinda terrifying how bad half the doctors really are. Their patients really don't know any better.
posts suggesting referrals are not suggesting referrals from friends, but referrals from other heathcare professionals who are in a position to form an educated opinion.
The referral was from our friend who is a pediatric cardiologist.
If you trust your ob that would be the first person to ask (for specific doctors). You should look for someone who takes what the parents say seriously. Some doctors think they are above you and know what is best for your child. Also someone who communicates well with you.
This is good advice. We would have ended up at the right doctor in the first place if we had listened to the OB recommendation in the first place.
I second this advice. Our pediatrician (whom my husband went to high school with) can be somewhat condescending, and makes me feel stupid for having any concerns at all. I know they listen to nervous parents all day long, but that's why they're doctors - to listen to people's concerns, which actually may be legitimate. So, find someone who you feel listens to you. Doctors don't know everything, and they should listen to parents, who know their kids best.
I'm sure there are boards in the Bay Area that would be better places to get info.
That said, find folks that have similar values and philosophies about medical treatment. Our initial pediatrician was recommended to us by everyone, but had far too many patients. He was hard to to get in touch with and always seemed rushed. Most people love him. He actually recommended our current pediatrician. We had an honest talk with him and he pointed us in the right direction.
It's all about what you want. Our current pediatrician respects our views, but provides us with her expect opinion. She likes to space out vaccines and we can come in and get them without copays between visits. We feel really involved in the decision making and she spends a lot of time with us during our visits.
We have other friends that go to large practices where they see a different doctor every time. They love that practice based on the hours they are open and the ease of getting appointments.
I don't think I answered your question at all.
In all honestly, it is about finding a good fit. It's a relationship that is going to span nearly two decades.
Some pediatricians have their waiting room divided into 2 sections - one for the sick kids and one for the healthy ones (since you bring your child in under both circumstances). This IS NOT more important than the points made by others on referrals; alignment with your philosophy on tests and shots; or competence of office and staff. But it is something that we have always appreciated when our pediatrician as had it. Also, avoid places that loop the same 14 year old episode of Barney in the waiting room. On occassion it has lead to unfortunate episodes of violence.
Our ped has healthy kid hours and sick kid hours, and they sanitize in between. Not the most important thing, but it's a point in the plus column.
Look for someone that stayed at a holiday inn express last night, that should take care of qualifications.
Ask the nurses in the maternity ward for referrals. Nurses observe how pediatricians interact with a wide range patients on a daily basis and can be more objective than parents.
My wife is due with our little Wolverine at the end of March as well. We just asked our OB for a recommendation.
My wife is due with kid two on February 26th. I feel like I'm always on call and not participating in the drinking threads as much.
I'm going to second the Pediatric Nurse Practitioner (PNP) idea somebody mentioned earlier. Disclaimer: I'm slightly biased because I'm an RN. However, being "on the inside" both in school and at work has shown me the education/training of PNPs aligns much better with the usual needs in a primary care setting. Lord willing your child will only have the "typical" healthcare needs - vaccinations if you swing that way, common colds/illnesses...you know, nothing needing hospitalization - but even so, there are still a variety of issues and concerns parents bring to the table. Nurses and nurse practitioners are trained in a very holistic way, and accordingly are more inclined to take the time to address those concerns. There is also a growing amount of research showing the care given by NPs is just as effective as that given by MDs, and patients are just as - if not more - satisfied.
This is certainly not to belittle or disrespect the physicians that are my fellow MGoBloggers...I just feel that in general, the medical community trains to "diagnose and cure" problems, and the focus on the patient is sometimes lost. Hopefully, you're less likely to see this in pediatricians since they work with kids, but needless to say a practice where MDs and PNPs collaborate would offer you the best of both worlds, especially in case your needs become more complex.
1) Avoid those listed on the sexual predator website.
2) go with a female
Because they prevent life threatening illnesses?
Read for yourself: http://www.cdc.gov/vaccinesafety/00_pdf/CDCStudiesonVaccinesandAutism.pdf
which vaccines do yo rec. people NOT get?
I'm just gonna say that all this you just said boils down to the following statement:
multiple anecdotes != data
mercury has been in vaccines for decades up until the last 15-20 years when it has been phased out b/c non-mercury-based preservatives have been developed.
There have been several scientific studies that have demonstrated no causal connection b/t thiomersal and autism. The original study published in 1998 that opened the door to the jenny mccarthy autism scare in the mid 2000's was not reproducable and was subsequently redacted from the peer-reviewed journal in which it was originally published.
there are always risks of alergic reactions to almost any injection. those risks do NOT outway the alternatives, the DATA about one of which is listed below from the CDC website.
Whooping couch (pertussis)
Since the early 1980s, reported pertussis cases have been increasing, with peaks every 3-5 years; however, the number of reported cases remains much lower than levels seen in the pre-vaccine era. Compared with pertussis cases in other age groups, infants who are 6 months old or younger with pertussis experience the highest rate of hospitalization, pneumonia, seizures, encephalopathy (a degenerative disease of the brain) and death. From 2000 through 2008, 181 persons died from pertussis; 166 of these were less than six months old.
Haha I'm glad you're assuming my reasoning and think I support your "toxicity" theory. Not even close but thanks for playing.
Also, vaccines don't cause autism, at all. Read the research (and if you think it's a government conspiracy it must be worldwide because the research from every country agrees with ours)
this is an incredibly dangerous comment to make in a large public forum. the scientific literacy of the media and the general public is terrible.
Slow down on vaccines if you wish. There is probably no need to vaccinate against 5-7 diseases at the same appointment, other than convienience.
but lets be clear about four things: vaccines DO NOT cause more disease than they prevent. In addition, Global climate change exits and is caused by man made greenhouse gases added to the atmosphere over the past 150 years. Finally, the theories of gravity and evolution by natural selection are absoulutely among the strongest (that means the most supported by objective, verifyable and repeatable evidence) theories ever proposed my mankind.
This is an incredibly ignorant comment. I'm partially sad I missed this thread when it was new and partially glad I didn't engage what would inevitably be a very misinformed and shortsighted argument.
-look for full board certification; you will also find most training info as well as possible board actions/disciplines.
-definitely ask the OBs, they would have a handle on that, as well as the nurses.
-don't fault a doctor for being busy, that is a good sign. Personally, I like smaller groups as the service tends to be more personalized. Also, many doctors are under a lot of pressure from the recent changes (and further coming changes coming) to the health care system, please keep that in mind (no political content intended).
- beware, the "Top Doctor" awards are a misnomer- kind of like the USA Today Coaches poll in football. In my area I know a doctor who was disciplined by the state medical board for self-prescribing narcotics, but still received a "top doc" award.
-interview the physician if possible; sometimes they can be a great doc, but not a good fit for you.
-nothing wrong with a Nurse Practioner; not quite the same training as a physician, but many are very/extremely good and you may prefer them. Please ignore the stereotype of doctors vs nurses; people are people and especially pediatricians tend to be the caring type vs other specialties (sorry, Wolverine Quaker).
-discuss vaccinations with you pediatrician; there seems to be a trend toward limiting or not vaccinating, but I understand (I am not a ped so I can't immediately cite a source) there has also been a significant increase in the diseases that vaccinations try to prevent.
-congrats on your soon-to-arrive addition to your family! Teach him/her to say "Go Blue!" as soon as they start talking!
As a pediatrician I'm definitely for vaccines. That said I'm not one for 5 shots a visit. I have no problem with spacing them out as long as they all get done. I won't get into the whole argument but that's my stance on the issue
I'm not a pediatrician... But I totally agree with you on this one.
No need for an apology MMB 82...in fact, I apologize. I was trying really hard to advocate for my position without treading on anybody's toes. Perhaps I tried too hard, I'd hate to give into that stereotype myself (I work with a lot of good docs). ::handshake::
I suggest one that has multiple pediatric specialties and does labs in the office. That makes things easier if your kid needs to see a specialist. Also, one that has walkin sick hours, so you don't have to wait a couple of days for an appointment when your kid is sick
I also suggest one that has at least day where they are open late. That way you can schedule routine stuff wothout talking off from work. Te other benefit with a larger practice is that you get multiple viewpoints for your baby.
Good luck and get all vaccines. Google or. The research that said they are linked to autism was fabricated. The guy admitted so a few years back.
As a pediatric subspecialist I would add the following:
I agree with the above - a prenatal interview is the most important.
You should also be comfortable with the whole practice, as if your kid gets sick, they' may not see their regular doctor as an add-on
I would not use internet reviews - those things could be done by anybody, the doctor themselves, their mother, or roll damn tide
Besides the vaccine advice mentioned above (and I do encourage reading up on this as much as possible to make an informed decision - the US government doesn't know everything and is affected by lobbying etc...), I would aim for a smaller practice.
We started out in a larger practice and experienced long waits in the waiting room for appointments (not easy with babies), long long delays in people calling us back when we had questions and seeing different doctors each visit.
We switched to a practice that had 2 pediatricians and experienced short waits, super fast responses when we had questions and saw 1 of 2 doctors every time.
Must keep in mind that if you fail to vaccinate your children, you're putting my children at risk, too! (see Ann Arbor measles outbreak of 2 years ago)
Fwiw some doctors might advise a different vaccine schedule; in other words be supportive of vaccines but have different opinions about timing given their experience or your kids context.
My kid is fully vaccinated now but thanks to my doctor's advice we declined one (which ended up being yanked off the market later, good call doc) and postponed varicella -- which was also useful because in the interim they changed their estimate of effectiveness and the vaccine protocol.
I'm sorry but this is a ridiculous topic to post on MGoBlog. Marking a post as "Off Topic" usually means the discussion will center on, say, the NHL lockout or NFL playoffs. What shall we discuss next, which refrigerator to buy? Does anyone know of a good private school in Tulsa? What type of fish is in fish tacos?
Really chief, do you really want a bunch of beer-guzzling college undergrads giving you advice? And what's all this hullaballoo about "selecting" a pediatrician? Just pick the one that is close to you. It's not like GPs (or GPs for little kids) really do anything anyways, they just take their cut and refer you on up the doctor pay scale. Helicopter parents drive me nuts.
This is an amazing reply. Now I see why you're an mgoblog legend.
Herm, you're the man. This is spot on.
I've been a nurse for 30 years. Get referrals from friends with young children but also make some appts with physicians. Any good doc will meet with you before you decide.
Not much else to say that hasn't been said... I'm also a pediatrician (UM '01), like several posters above. I think getting referrals from friends with kids is the place to start, and then meeting with and interviewing the prosepctive candidates. Unlike what someone said above, as far as I know, we all meet with prospective families for an interview for free.
Also good to know what happens when your kid gets sick, I mean sick enough to be admitted to the hospital. Does your pediatrician attend there or will you be meeting someone new who will be taking care of your child?
Hopefully it never comes up but it is worth considering.
Dr wright on California street in SF. She is awesome. If you want a male, i have heard good things about her partner Bernstein. We saw him once when our son was sick.
If you want specifics of why her I can tell later when not on my phone. If you aren't in SF, my recommendation obviously doesn't help you.
Join Golden Gate Mother's Group (just search the Internet). Can't remember if that is just for SF or more of the Bay Are (so again if you aren't in SF this might not help, but I think there is an east bay mothers group and something in the South Bay- has a Spanish name that I am drawing a blank on now). Tons of great advice on there, lots of forums with every question you'll have already asked and answered or if you ask one lots of people will respond.
We used one through the UNC system - I don't know how it works in Cailfornia and obviously it won't be UNC out there, but the university systems are generally good. If you don't like them you can always switch. I shop doctors, not for ones who give me pills, cause I don't take any, but for those who don't immediately triage everything with the lowest common denominator easy button. If I'm sick I want to know what the root cause is, not be given a pill to shut up. I'm the same way with my kids peds.
Gratuitous double post
... but I don't know where in the Bay Area you're looking. So, yes, one with multiple pediatric specialties including any family history might lead you to think will be important (I have asthma, for example); doctors you like and can work with, hours that are flexible since kids don't get sick at convenient times, coverage for off hours, and later a support staff that can crank out school forms in their sleep.
Congratulations and good luck!
A diploma from Michigan's med school up on the wall certainly couldn't hurt
Go to a local playground. Talk to new mommies. They love to tell labor and delivery stories. Try to look interested. You'll get referrals.
After that, go to Refrigerators 'R Us. The one in Tulsa next to Taco Del Mar. Tell em Herm sent ya.
It depends what kind of pediatrician you are looking for - for general health - most pediatricians are good - board certification is good - but remember the most important is someone you can trust and have a good relationship with. If yo went to one school vs another - some of the best doctors didn't go to Harvard or UCSF.
If your child will have some special needs - university hospitals have some of the better doctors with pediatric subspecialties such in eye, ENT, gastroenterology, nephrology, oncology, neurology, etc. So if you know a pediatrician affiliated with a university setting it may be easier to get a referral or see some very well known doctors - on the othe side - you may see a resident or fellow prior to seeing the attending doctor.
Usually vaccination schedule are determined not by the doctor but recommended guidelines set by the CDC guidelines.
You want the doctor who is also more current on the updated medical llterature.
I love having a family practice doc. Guy sees our whole family, has context for everything going on. He has been seeing my son since he was a zygote since I never had to bother finding an ob-gyn either. My doc has been able handle all of our routine medical needs and a fair number of the non-routine ones.
Still don't know what part of the bay area you're in. If it's the east bay, we LOVED Ben King at Berkeley Pediatrics. Even if you're not in the east bay, I would also look into the Berkeley Parents Network. They have a lot of recommendations. While it's focused on the Berkeley area, I think I remember there being some from other bay area locations as well.