Pediatricians? « Back to Group Discussions

[babytoes]

Hiya Ladies...

This is the newest subject around these parts, and I am going to come and ask for everyone's professional opinion. Professional, meaning "moms who know".

So I need to find a Pedi. I live in a totally different part of the state from when my boys where babies, and in a larger city. I had the most wonderful Pedi for them, he was really a family doctor and was very pro nursing and co-sleeping/APing, and he had no problems with not doing immunizations (I was never badgered or made to feel like a bad mom when going to appointments). The best part was I just "found" him on accident. He was a new doctor and my 20 year old DS's Pedi was retiring so I went to the "new" doctor in town. He ended up being fabulous. He also is no longer practicing with children and has narrowed his clientele down to the elderly.

This gives me even more anxiety about finding a new Pedi, because I am nervous I won't find anyone to fill his shoes. I have been compiling a list of things I want to ask when I do the interview, but I would also like to open this up to new moms looking for a Pedi, or moms that have moved, etc. I believe a good Pedi, that is open to our "crunchy" ways, is key for a good doctor - client relationship, which in turn will make parents more trusting when something major happens. 

Questions to ask;

 1. How long have you been a doctor?

2. Are you a pediatric generalist, or do you have a subspecialty?

3. What is your philosophy on 

•  breastfeeding, 
• immunization,
• co-sleeping          

​4. What is your policy on the use of antibiotics?

5. How are emergency calls handled by your office? 

So, from here, I would like to know what else I should be asking, or looking for. What are some key questions that I might be missing?

Also, are any other mamas looking for a Pedi as well, and what are you doing about interviews? 

Success stories?

Thanks Ladies!!

[Melany]

When I was pregnant with my son, we asked if the ped had any opinions on circumcision or was familiar with an intact little boy. The one that sold me was the ped that answered her son was also intact and told me that about 50% of the babies she saw were. (This was when we lived in North Seattle).

Being in a small town, there is 1 pediatrician in town. Some things I wish they had that are making us move the kids to a GP was how hard it is to get the kids in when they are sick. I've been told to take the kids to the ER on more than one occasion because there are no open appointments. Our GP has Saturday walk-in hours, which our ped in North Seattle had. This makes a HUGE difference financially for what should be non-ER visits. Our ped has "flu shot clinics" during school hours. We do the flu shot because my nephew is immune-system compromised and we cannot get him sick. But, why would you hold a walk-in clinic for the flu shot during school hours? In my opinion the kids shouldn't "have" to be taken out of school unless they are sick. The GP did it on a Saturday and allowed us to have the preservative-free shot, were they ped would not give that to the kids unless they were under a year.

[cabbitdancer]

We got lucky. I procrastinated so long that we found our Ped in the hospital where my daughter was born. She was one who came in to take a look and we've been with her ever since. She's very pro-crunchy, no pressure on anything, and she is great with the kids, though the practice in which she works decidedly does not follow the same philosophy, so we have to be careful to whom we speak. I love her, though. I just found out at my daughter's last annual that we were actually her first or second set of patients, she was that new. I will, more than likely, be bringing this one to her, too. :D

[withlittlelungs]

We are going to be looking for a pedi, too. My parenting has changed a lot since having DS, and I really want to find a crunchy doctor for us. I have seen a few recommendations online for good doctors, but they are all quite far. There is an awesome one that makes house calls, but we can't afford her. 
 

[mariee]

Honestly, I think #1,2,and 5 are the most important.  I'm not sure I would even ask #4 because I don't think any dr. would really say he or she has a "policy".  You might ask if they are familiar with alternatives to antibiotics or something like that....  

As for BFing and co-sleeping, I feel like it would be nice if I could discuss those things with our ped, but I don't really need to and I don't plan to.  Not because I don't think it is important, but more so because I view trips to the dr as a purely medical reason.  Anything beyond medicine, I don't really ask for input on because I'm not certain she is the best resource, you know?

[Melany]

Mariee: I'm going to have to disagree on the breastfeeding issue. Having a pediatrician that is supportive can make or break a "hard" breastfeeding situation. If it works, it really doesn't matter, so I can see your point, but it is important when it doesn't work. We had significant issues with feeding when my son was born and the pediatrician being supportive is why we were able to continue. She gave me the name of a lactation consultant, suggested fenugreek and even domperidom. My son didn't latch on until he was 6 weeks old and those first 6 weeks were the hardest 6 weeks of my life. My sister had a completely different experience with her ped. She also had feeding issues, different than mine, but still frustrating. Her pediatrician told her to give it up and switch to formula. It actually was a really good thing that she switched peds, instead, and found someone who was BF supportive because of the later diagnosis her son had with a genetic disorder. The symptoms show up when breastfeeding ends and it would have been life threatening had he been an infant when the symptoms occurred.

[Melany]

Mariee: PS, sorry I sound so alarmist. I was trying to politely disagree, but I'm not sure if came across that way.

[akind1]

#3 - #5 are the biggies for me, personally, I don't know #1 or #2 are deal breakers. nice to know, of course, but meh. I don't care how long they have been practicing, or if they have a subspecialty.

Do you have any crunchy mama friends? that's how I found our current pediatrician. Or do you see a chiropractor? often they have recs for crunchy-friendly recomendations. You may be better off asking more specifically about ear infections, rather than antibiotics in general, as that's the main reason babies/todders seem to get put on abx. Our ped mostly takes a wait and see approach with most illnesses - which lines up with our philosophy rather well. We like to give our kids immune system a chance to fight off an illness before short circuiting it.

As for vaxes - we don't - and she's fine with that. She has a spiel - most do - but trusts we've done our research and aren't just jenny mcarthy brainwashed idiots (our first ped was a little more like that) - and leaves us alone after the first visit.

IDK if you are having a boy or not, but drmomma.org has a list of foreskin friendly doctors on their website, if that's at all an issue for you.

[Bena]

I agree that 1 and 2 are interesting to know, but don't tell much about the quality of the care and relationship you'll get.  My personnal biggie for a family dr and ped is how confortable with them. 

#5 is a biggie for me too, though. And I would ask what kind of emergency he/she deals with.  ie.  could they handle a few stitches or would that warrant a trip to the ER?    That way, you know how to react to emergencies and don't loose time trying to find the proper care.

DD broke her foot last fall, and we first brought her to her doctor who sent us to the children's hospital ER.  Not a biggie, but it would've been nice to know ahead that she (Dr.) wouldn't be able to take care of things (maybe this is obvious for some, but we didn't know then that only the children's hospital would x-ray a toddler and only a pediatric radiologist would be able to confirm a break).    It never crossed my mind to go to the ER right away!

We now have a clear list from her clinic of what the clinic can handle (yes to stitches) and what warrants a trip to the ER.

[mariee]

No, Melany, I get it and you are right! I had very few problems with BFing so it was never something that needed talking about at the peds.  I can see how it would have been very different if I had difficulty.  In fact, my current ped has containers of Similac and Enfamil sitting on the counter in EVERY flipping exam room at her office..... so I can guess what her response would have been if I told her I was having problems BFing!

I think #5 is a big one, and I like akindl's suggestion about inquiring on ear infections.  Good luck!

[scruffy too]

I have question on behalf of the first time moms to be:

When do you start looking for a Pediatrician?  While still pregnant?

There's such a shortage of doctors here, I think I just have to accept whomever I'm "lucky" enough to get in with...  But I hadn't thought much about it until I read this thread for the THIRD time... (The first two times, I was like: this doesn't apply to me, but it's nice to see what everyone else thinks...  Then today I'm like: Ummm.... yeah!!!)

[Melany]

We started prior to being pregnant with #1. I "might" over-analyze things on a regular basis... maybe, just a little. :)

But, it helped to have a plan in place and then when baby is born, this is who the hospital calls to come check on baby to let you go home. Or this is who you call after baby is born to get the first check-up. I've had bad luck with doctors in the past, so I was scared to pick someone randomly out of the phone book. 

[Bena]

Originally Posted by scruffy too 

I have question on behalf of the first time moms to be:

When do you start looking for a Pediatrician?  While still pregnant?

There's such a shortage of doctors here, I think I just have to accept whomever I'm "lucky" enough to get in with...  But I hadn't thought much about it until I read this thread for the THIRD time... (The first two times, I was like: this doesn't apply to me, but it's nice to see what everyone else thinks...  Then today I'm like: Ummm.... yeah!!!)

Well, most peds will want to see the baby within 48 hours of birth, unless you have a midwife who can take over baby care for the first 6 weeks.  I was lucky because my family dr. doesn't take new patients but does take children of patients, so DD (and this baby) automatically became her patient.  We don't have a pediatrician per say  The nice thing about having a family dr as opposed to a ped is that when they turn 18, you don't need to find a new doctor! (assuming my family doc practices for another 20 years!!

[akind1]

I get asked at prenatal visits. I asked the midwife (hospital CNM) if any of the peds on her list did she know were comfortable with delay/selective vaxing - that's a biggie for us, and helps to point us towards more "crunchy" friendly doctors. one of the ones she indicated we have (non crunchy) friends that work there . . . so, we used them for #1. They were ok, but we found a practice we liked better with #2, after asking around to some of our more crunchy friends.

[scruffy too]

My midwife will see the baby for 6 weeks afterwards.  I completely forgot to discuss peds when she was here Friday night... I think I'm going to see if my Midwife's doctor is accepting new patients, since my MW speaks fairly highly of her.

[spughy]

Scruffy, I don't think peds here work quite the same way as peds in the States.  I don't know anyone here OR in Whse who takes their child to a ped as a regular thing - peds are for severe childhood illness & injury, family docs (GPs) take care of everything else - well-baby visits, infections, weird rashes, that sort of thing.  There are a couple of good GPs up there (and some bad ones too no doubt).  But I doubt anyone who does child-specific general practice.  The hospital might have a ped on staff.

When DD was born I was "between doctors" - my GP had quit and I was able to get in with DH's doc but I really didn't like him so I was looking for a new one.  Then when I had huge problems breastfeeding my midwife referred me to a GP who had IBCLC certification for breastfeeding help and we hit it off and when I begged to be taken on as a regular patient (with DD in tow) she said ok - she was coming off a couple years of mat leave and wasn't working full-time so if I needed a doctor right now this minute I'd have to take whoever else was at her clinic, but if I could make appointments in advance I'd get her.  It worked out well, she's since changed practices and I've been really happy with her.  She's very hands-off and reluctant to medicate unnecessarily, but she's really up on her research and chatty and always happy to talk about stuff totally in-depth and doesn't dumb things down for me at all.  Best doctor I've ever had and I'm glad DD is with her too - and the new baby will no doubt meet her at some point!  Aside from the breastfeeding though DD hasn't exactly been a burden on the health care system - the only other thing I've taken her in for is a consult with a... oh damn can't remember the name of the specialty - she was walking on her toes a lot, I was worried because I know it CAN be a symptom of some kind of structural anomaly.  The guy was great, checked all of DD's other movements and alignment and said it was classic idiopathic toe-walking and I should just chill and ignore it.  (Well, you know, he used more reassuring language and all, but that was the gist of it.)  Aside from that DD's had one dr visit a year since babyhood.  She's never had anything more serious than a cold.

So, anyway - if you're in Canada, you probably don't want a ped for your kids unless they have some chronic, serious health issues.  You want a good GP and you want the same one for yourself.  A good GP is worth her weight in whatever precious substance you want to fling around.

[scruffy too]

Thanks Spughy!!!!  Before getting pregnant I was just going to a walk-in clinic whenever I needed birth control, so I haven't had a "family doctor" or GP since I left home.  I'll just look for a GP whom I like.  Sometimes I forget that all health care systems are different (USA vs. Canada), thanks for the tug into reality!!!

[babytoes]

Unfortunately I don't have any crunchy friends, I haven't really made many friends in this city yet.  I am going to ask my midwives though, and they did give me a contact sheet with peds on it. Maybe they can help me narrow it down. DP said the other night, that one of his co workers (whom he been pretty good friends with for at least 5-6 years) gave him the name of a ped they use. I am willing to give him an interview, but this co-worker is pretty far from crunchy, so I am not holding my breath that this is the right one for us. Of course DP thinks if his buddy likes the ped, than we most certainly will! I told him I would call and set up an interview, but I am not promising anything. 

I do agree that some things, like breastfeeding and co-sleeping, are not really important for me to be talking to my ped about. I think that it may set the pace, though, for how they feel about crunchy mama's in general. I personally never had any breastfeeding issues, and always co-sleep, so I am set in stone with these parenting ideas, I just figure if they are for it, than they will tend to be more crunchy friendly. I think I may be lucky though, I live in a state that is Crunchy-Tree Hugging Central, so I think most peds will be pretty flexible. 

We will see...

[BeantownBaby9]

check out a Holistic Moms Network meeting, they have boards and FB pages, also here on MDC the local tribe may be able to tell you what good Pedi's are out there.  

For me, 3-5 are more important than 1 and 2, though you do want someone with a little experience.  What I find is the newly minted docs are just repeating the AAP line on many issues, including cosleeping and shots, whereas someone who was a pediatrician in the 80s remembers the old shot schedule.  A more important question to ask is "How does your office handle non-vaxing or delay-vaxing patients?" (aka are you going to kick me out later?) and also "what would your infections disease protocol be for a child with symptoms of a VPD that needs to come into the office?"  For example, are there separate sick and well waiting areas?  Are sick appts mostly in the morning?  When DS developed severe chest congestion from Chicken Pox, they brought me in the back entrance, and fully fumigated, haha, the room after we left.  I am trying to be the most responsible non vaxing parent I can be and that helps me feel good they are watching out for us all.  Also, what is the office policy on treating ear infections?  My office will let you wait 3 days before they want you to do abx.  

[Chapsie]

For those of you still deciding on what ped to go to--- sometimes it is hard to know if they will be a good fit or not until you actually meet them.  Remember, you can always switch care givers.  My son is 4 and we've already had 3 different pediatric practices for him (not because of not liking them, but because we moved.)  There should never be any penalty for switching-- you really want to make sure that the doc is a good fit for you.  knowledgable and respectful.  

Also... location and hours are super important.  Our old ped was amazing, but it was a good 25 minute drive from our suburban home to downtown and it was a pain in the butt to drive out there for sick visits.  Our new ped is 5 minutes away and has early morning walk in hours and saturday appointment times.  I've also been able to call on the weekends and speak to the doc on call for medical advice.  I'm a nurse, and they will even sometimes prescribe meds over the phone based on my description.  

Whoever it is, you have to be able to communicate well with them (and they should be nice to your kids! haha.  I know many peds from work that my kids would probably be terrified of, haha.)

Some pediatric offices will now publicly post their vaccination policies on their websites... you can sometimes get a good feel for the practice just based on the websites.