The best way to start looking for a pediatrician is by asking other parents you know and trust. They are likely to know you, your style and your needs. You also should consider asking your obstetrician for advice. They will know local pediatricians who are competent and respected within the medical community. If you're new to the community, you may decide to contact a nearby hospital, medical school, or county medical society for a list of local pediatricians. If you are a member of a managed care plan, you probably will be required to choose a pediatrician from among their approved network of doctors.
What to consider
Once you have the names of several pediatricians to consider, start by contacting and arranging a personal interview with each of them during the final months of your pregnancy. Many pediatricians are happy to fit such preliminary interviews into their busy schedules.
Before meeting with the pediatrician, the office staff should be able to answer some of your more basic questions:
Is the pediatrician accepting new patients with my insurance or managed care plan?
What are the office hours? Do they include weekends and holidays?
What is the best time to call with routine questions?
Do the doctors answer secure e-mail or other HIPAA compliant electronic communications?
Who answers the phone if my baby has an issue after the office has closed?
How does the office handle billing and insurance claims? Is payment due at the time of the visit?
Both parents should attend the interviews with pediatricians, if possible, to be sure you both agree with the pediatrician's policies and philosophy about child rearing. Don't be afraid or embarrassed to ask any questions.
Here are a few suggestions to get you started:
How soon after birth will the pediatrician see your baby?
Most hospitals ask for the name of your pediatrician when you're admitted to deliver your baby. The delivery nurse will then phone that pediatrician or her associate on call as soon as your baby is born. If you had any complications during your pregnancy or delivery, your baby should be examined at birth. This exam may be conducted by a staff pediatrician or neonatologist at the hospital if your pediatrician is not there at the time of delivery. Otherwise, the routine newborn examination can take place anytime during the first 24 hours after birth.
Ask the pediatrician if you can be present during that initial examination. This will give you an opportunity to learn more about your baby and get answers to any questions you may have. Your baby will undergo routine newborn tests that will screen for hearing and jaundice levels as well as thyroid and other metabolic disorders.
Other tests may be needed if your baby develops any problems after birth or to follow up on findings on your prenatal sonograms.
When will your baby's next exams take place?
Pediatricians routinely examine newborns and talk with parents before the babies are discharged from the hospital. Many pediatricians will check the baby daily in the hospital, and then conduct a thorough exam on the day of discharge. During these exams, the doctor identifies any problems, while also giving you a chance to ask questions. Your pediatrician also will let you know when to schedule the first office visit for your baby and how to reach them if a medical problem develops before then.
All babies also should begin their immunizations before leaving the hospital. The first and most important "immunization" is starting to breastfeed your baby as soon as possible after birth. This provides some early disease protection for your baby. The second recommended immunization is the first dose of the hepatitis B vaccine, which is given as a shot in the baby's thigh. Your baby will receive the next series of vaccinations when they are eight weeks old, including the second dose of hepatitis B.
When is the doctor available by phone? Email?
Some pediatricians have a specific call-in period each day for questions, while others will return calls as they come in. If office staff routinely answer these calls, consider asking what their training is. Also ask your pediatrician for guidelines to help you determine which questions can be resolved via phone and which require an office visit. Some pediatricians prefer using secure electronic messaging, usually through an online portal. You both may find this more convenient. It may also help foster a relationship with the doctor. Some doctors also offer electronic visits via telemedicine.
Which hospital does the doctor prefer to use?
Ask the pediatrician where to go if your child becomes seriously ill or is injured. If the hospital is a teaching hospital with interns and residents, find out who would actually care for your child if they were admitted.
What happens if there is an after-hours (nighttime or weekend) concern or emergency?
Find out if the pediatrician takes their own emergency calls at night. If not, how are such calls handled? Also, ask if the pediatrician takes office visits after hours, or if you must take your child to an emergency department or urgent care center. When possible, it's easier and more efficient to see the doctor in their office, because hospitals often require lengthy paperwork and extended waits. However, serious medical problems usually are better handled at the hospital, where staff and medical equipment are always available.
Who covers the practice when your pediatrician is unavailable?
If your physician is in a group practice, it's wise to meet the other doctors in the practice, since they may treat your child in your pediatrician's absence. If your pediatrician practices alone, they probably will have an arrangement for coverage with other doctors in the community. Usually your pediatrician's answering service will refer you to the doctor on call, but it's still a good idea to ask for the names and phone numbers of all the doctors who take these calls—just in case you have trouble getting through to your own physician.
If your child is seen by another doctor at night or on the weekend, you should check in by phone with your own pediatrician the next morning (or first thing Monday, after the weekend). Your doctor probably will already know the situation, but this contact will give you a chance to bring them up to date and let them reassure you that everything is being handled as they would recommend.
How often will the pediatrician see your baby for checkups and immunizations?
The American Academy of Pediatrics (AAP) recommends a checkup within 48 to 72 hours after your newborn is discharged from the hospital. This is especially important in breastfed babies to evaluate feeding, weight gain and any yellow discoloration of skin (jaundice). Your pediatrician may adjust this feeding schedule, particularly in the first weeks after birth, depending on how your newborn is doing.
During your baby's first year after birth, additional visits to your doctor's office should take place at about two to four weeks of age, and then at two, four, six, nine and 12 months of age as well. During your baby's second year of life, they should be seen by your pediatrician at ages 15, 18, and 24 and 30 months, followed by annual visits from three to five years of age. If the doctor routinely schedules examinations more or less frequently than the AAP's guidelines, discuss the differences with them. Additional appointments can be scheduled any time that you have a concern or if your child is ill.
What are the costs of care?
Your pediatrician should have a standard fee structure for hospital and office visits as well as after-hours visits and home visits (if they make them). Find out if the charges for routine visits include immunizations. Be sure to familiarize yourself with the scope of your insurance coverage before you actually need services.
After these interviews, ask yourself if you are comfortable with the pediatrician's philosophy, policies and practice. You must feel that you can trust them and that your questions will be answered, and your concerns handled compassionately. You also should feel comfortable with the staff and the general atmosphere of the office.
Once your baby arrives, the most important test of the pediatrician is how they care for your child and responds to your concerns. If you are unhappy with any aspect of the treatment you and your child are receiving, you should talk to the pediatrician directly about the problem. If the response does not address your concerns, or if the problem simply cannot be resolved, seek out another physician.