Overview

A pediatrician is the primary care provider for your child from birth through early adulthood. They offer crucial support in monitoring growth, administering immunizations, and diagnosing illnesses. A pediatrician also provides guidance on health and development and will assist you in navigating caring for your child. There are many factors to consider when choosing a pediatrician who is the right fit for your family. Some basic things to look for are proximity, insurance coverage, and qualifications. You should also consider their philosophy on topics like breastfeeding, parenting, and vaccines. This episode walks you through how to find the best pediatrician who will be the perfect fit to care for your baby and help you navigate raising a healthy human.

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Your Child’s Primary Care Provider

A pediatrician is a doctor who specializes in children’s health from birth through early adulthood. In addition to undergraduate and medical school, a pediatrician must complete three years of pediatric residency training. Your child’s primary care provider may also be a family physician or general practitioner. This article discusses what to look for in a pediatrician, but everything discussed will apply if you work with a family doctor or general practitioner.

The Role of a Pediatrician

A pediatrician is your trusted partner in ensuring your baby is healthy and developing normally. They monitor your child’s growth and development, administer immunizations, and diagnose and treat common illnesses. Most importantly, they assist you in navigating caring for your baby and can answer questions about their care, health, and development.

Pediatric Appointments

Most of your appointments with a pediatrician are preventative care, meaning you take your baby to the doctor before they are sick. This is a good opportunity to see how they are growing and developing. Your pediatrician will take weight, height, head circumference, and blood pressure measurements. They will examine senses like hearing and vision. A pediatrician monitors developmental milestones. As children grow, they will also observe development, including social, behavioral, and mental health.

The American Academy of Pediatrics has guidelines for when well-child visits should occur. Certainly, vaccination schedules play some part in this timeline, but it is good to check in even if you opt out of vaccines. Each appointment allows you to ask questions and build a relationship with your child’s pediatrician. If you want to see some topics that may be addressed at each appointment, click the link below.

American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care:

• 3-5 days after birth

• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old
• 2 ½ years old
• 3 years old and annually after that

When to Start Looking for a Pediatrician?

You have a lot going on in your pregnancy, and finding the right pediatrician is one item on a long list of to-dos. You can start as early as you like, but as you educate yourself, your priorities may change regarding what type of provider you are looking for. Around week 30 is a good ballpark to start. If you want to interview potential doctors in person, you need time to schedule and attend appointments. I recommend having everything wrapped up by week 36 so you can enjoy the last month of your pregnancy and be ready if your baby comes early.

Identifying Potential Pediatricians

The first step is to identify potential pediatricians so you know what your options are.

Ask for Referrals

Getting a referral is almost always better than selecting a random name from a list online. If you have friends or family who have babies or young children, ask them if they would recommend their pediatrician. Referrals can also come from your doctor, midwife, hospital, or birth center.

Your Health Insurance Coverage

Your health insurance will likely affect your options for a pediatrician. You can go through your health insurance company and find out what pediatricians are covered in your area. If you find potential pediatricians another way you should verify that your insurance covers them.

The American Academy of Pediatrics

The American Academy of Pediatrics is an organization that develops guidelines and recommendations for pediatric healthcare practices, publishes scientific research and journals, advocates for policies that benefit children’s health, and provides resources and support for parents and caregivers. If a pediatrician is certified by the American Board of Pediatrics, they will have FAAP (Fellow of the American Academy of Pediatrics) after their name. Membership with the AAP is not required to be a practicing pediatrician, although most pediatricians belong to the AAP. You can search for FAAP pediatricians here.

What to Look for in Your Initial Search

If you search through your insurance or the APP website, you will see education and training, gender, the languages a doctor speaks, and contact information. In the initial stage, the two main things you are looking for are that they are located near you and your health insurance covers them. Although some medical schools are more prestigious than others, just because someone graduated from Harvard Medical School doesn’t mean they are great doctors.

Comparing Your Options

When you’ve narrowed your choices to a few doctors, you’re ready to get specific questions answered. Many of your questions, like what the office hours are, can be answered with a Google search. Other questions will need to be answered by the pediatrician or a staff member. You can call and ask questions over the phone. The best way to get a feel for whether a pediatrician is the right fit is to meet with them in person. To request an initial consult, you can call or email to say you are expecting a baby, are looking for a pediatrician, and would like to come into the office for a short introductory meeting.

Questions to Ask

Let’s review some questions you can ask potential pediatricians as you compare your options. You do not need to ask all of these questions; you can select the ones that apply to you and your baby.

Qualifications

• What medical school did you attend, and where did you undergo postgraduate and residency training?
• How long have you been in practice? If a doctor is around retirement age, do they plan to continue practicing for the foreseeable future?
• Do you have children? It could be important for you to work with a doctor with first-hand experience raising a child. However, many excellent pediatricians do not have children.
• Do you have a subspecialty or an area of interest? This is particularly important to know if you think your child will have special medical needs.

Practice

• Are you part of a group practice? If they are, will your appointments be with other doctors, or will you see the same doctor each visit?
• How long is a typical appointment?
• How are appointments handled for children who are sick?
• Is there a separate waiting area for sick kids? Most appointments with your pediatrician are well-visits when your child is healthy. Since newborns and young children have sensitive immune systems, you want to avoid having your child around other people who are sick. Most practices will have a separate waiting area for children who are ill.
• What is your policy on calling or emailing with questions? Many offices will have a nurse on staff to answer questions or to interface between patients and the doctor.
• How do you reach the doctor if your child gets sick outside of open office hours? Are they available via phone? Some doctors refer patients to urgent care clinics, while others will meet you at the office outside regular business hours.
• How are emergencies handled? Can they make time for an immediate appointment? Where would they refer you for an emergency?

Observations

• Visiting an office in person allows you to observe things you cannot see online or hear over the phone.
• What is the overall vibe of the office?
• Is it cluttered and hectic or clean and organized?
• Is it a cold, sterile environment or warm and inviting?
• Is the staff warm and helpful?
• Are there a lot of people waiting?

Philosophy

You will work with your pediatrician to make critical decisions for your child. Doctors have medical expertise and can assist you in navigating challenging topics like breastfeeding, circumcision, and vaccines. Their attitudes towards these subjects will also influence their recommendations and how they resolve conflict if you do not see eye to eye on one of these subjects.

Many new mothers struggle with breastfeeding. If it is important to you to exclusively breastfeed your child, you may want to work with a pediatrician who prioritizes breastfeeding. If you run into issues, do they have any training in breastfeeding support or a lactation consultant to whom they can refer patients? Alternatively, if you plan not to breastfeed, will they support that decision?

The decision to circumcise your baby can be a very polarizing topic. If you are having a boy and plan to circumcise your baby, is this a procedure your pediatrician will perform?

If you want to utilize alternative medicine for your baby, will the pediatrician support that? This could include things like acupuncture and homeopathy.

The last thing you want is to feel shame or judgment from your child’s doctor. Ideally work with someone supportive of the decisions you make as a parent. You do not need to agree on every topic. You do need to be able to have productive and respectful conversations. Meeting with a pediatrician in person and discussing their philosophy around these topics will give you a good feel for the type of support you can expect.

Vaccines

Vaccines are another controversial topic. In the United States, every state has legislation regarding vaccines. States can enforce this by requiring proof of vaccines for your child to attend public or private daycare or school. Currently, 45 states and Washington D.C. grant religious exemptions. Fifteen states allow philosophical exemptions because of personal, moral, or other beliefs. See this link if you would like to see whether your state allows religious or philosophical exemptions.

All states allow exemptions for medical reasons. However, whether a pediatrician will write you a medical exemption is another story. In recent years, medical boards have given a lot of pushback to doctors for writing medical exemptions. In some cases, they even revoked medical licenses. As a result, many doctors may not be willing to issue a medical exemption. This could be relevant if you want to opt out of vaccines and live in a state (like California) that does not have a religious or philosophical exemption.

You will need to consider the laws of your state if you choose not to vaccinate your child. In some cases, the decision to not vaccinate would prohibit your child from attending public or private daycare or school. If you think you want to decline vaccines or deviate from the CDC vaccination schedule, you should ask a potential pediatrician what their position is and whether they would support your choice. Some pediatricians will not accept patients who choose not to vaccinate.

You can learn more about vaccines for your baby in the following episodes:

• Vaccines 0-24 Months, an Overview
• Vaccines 0-24 Months, Individual Vaccines

Your Baby’s First Appointment

If you have your baby at a hospital, the hospital will ask you for your doctor’s name when you check in, and many hospitals notify the doctor when your baby is born. Some doctors visit newborns in the hospital or send another doctor from the practice. Others may not see you until you bring your baby in for the first office visit. The hospital’s pediatrician will often take care of newborns until they are discharged. This can be either instead of or in addition to your selected pediatrician. If you have your baby at home or a birth center, call your pediatrician once your baby is born and make an appointment within the first 3-5 days.

Tips for Pediatric Appointments

Most of your appointments with a pediatrician are uneventful and routine. It can be helpful to know what is coming up at the next appointment so you know what to expect. Your baby will need to be undressed at every appointment, so skip those cute outfits that can be time-consuming to put on and take off and opt for something simple like a onesie. If you vaccinate your child according to the CDC schedule, they will receive a vaccine at nearly every appointment. You can also expect your doctor to weigh and measure your baby and review their growth chart to ensure your baby is healthy.

Every appointment is an opportunity for you to ask questions or address any concerns you have about your baby. Your pediatrician is an excellent resource for assisting you in navigating the care of your new baby. Keep a list of questions in between appointments and bring that list with you to each appointment. There is no such thing as a stupid question or an insignificant concern.

If possible, have your partner join you for appointments. This allows them to hear any advice from the doctor firsthand and ask any questions.

Changing Your Pediatrician

If you are unhappy with your pediatrician, you can always switch to a new doctor. Medical professionals vary significantly in the time and attention they give to patients. If you do not feel like you are receiving the level of care you want for your child or the support you need as a parent, please explore other options.

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