10 questions to ask when choosing a pediatrician

Many parents-to-be have discovered it's a good idea to interview possible baby doctors before the baby is born. And though today's health care plans have perhaps severely limited your choice of doctors, most plans still do have some choices. Physicians usually welcome these appointments and do not charge for prenatal interviews, but occasionally some do.

Ask if there will be a fee when you call to make the appointment. Also, ask how much time you'll have with the physician, so that you can pace your questions. Have your questions written down, and take someone with you -- your partner or a friend. One of you needs to take notes. When grandparents live nearby, some parents-to-be bring along their mom or dad, especially if this person will be seeing a lot of the grandchild.

Here's a list of common questions. Ask what is most important to you first.

1. What is your philosophy about child rearing? Do your homework and know your issues before you have this conversation. For example: Do many of the mothers in your practice breastfeed their babies successfully? Do you think children should be fed on a schedule? Sleep in the same bed with their parents? Wean at a particular time? What is your usual recommendation for babies who cry when they're put to sleep at night? What is your philosophy about antibiotics or other medication for children who have colds or other ailments? What is your opinion about infant vaccinations or circumcision?

   You'll think of other questions over time as your baby grows up, but it's important to get some sense in advance of how much a baby doctor and you agree on child rearing. Otherwise, if you disagree often, you'll probably change baby doctors later anyway, or you'll avoid discussing those issues on which you disagree and you won't get the benefit of a professional opinion sometime when you'd like to have it.

Does a pediatric nurse practitioner (PNP) work in your office? A PNP is a nurse, often already with a masters degree, who with additional training becomes the pediatric equivalent of the certified nurse midwife in an obstetrician's office. (American Nurses Association News Release, 11 July 1995, p.2) A PNP can handle "well-child" checks and minor illnesses, and consults with the pediatrician as needed. Many parents like to work with PNPs, as they often spend more time with them, and their fees are lower than a doctor's.

Do you charge for phone calls? Most physicians do not charge for these calls, but some do. Typically, most parents of firstborn children call frequently.

Do you return every call? Some doctors make every callback. Others have office personnel return the calls. Occasionally, the nurse who hand les your phone call may not have the same attitude about the issue in question (breastfeeding or sleeping habits, for example) that you or your doctor have. If you find that the person who's handling your phone call is not on your wavelength, request that the doctor call you back instead.

What is the scheduled length of your appointments? The closer her appointments are (10 to 15 minutes apart, rather than 20 or 30 minutes, for instance), the more likely it is you'll do some waiting, as well as be rushed through your appointment when you do see your health care provider.

How often do you want to see the baby in the first year? Why? Pediatricians more than family practitioners will schedule several "well-child" visits for your child. Pediatricians believe this to be a form of preventive care and an opportunity for parent education. Feel free to discuss in advance with your doctor or nurse the purpose of these "well-child" visits, so that you can decide what's appropriate for your child's care. We all need encouragement as parents, but you decide if it's always worth an office-visit fee to find out how much your baby, especially if it's not your first child, weighs and the fact that your doctor thinks your baby is doing well.

Do you have a "sick-child" waiting room? Some doctors try to avoid mixing the well children and the sick children in the same reception area. Young children are very susceptible to contagious diseases.

If you share a practice, will I always see you? Not likely. If you are scheduling an exam well in advance, it's easy to ask for a day that your doctor will be in the office. However, if you have a sick child, you'll get whomever is in the office or on call. If it's important to you, arrange to meet all the doctors who might cover for your baby's doctor in an emergency, or when you're in the hospital.

Do you have evening or Saturday hours? Although daytime hours are still the rule, a growing number of doctors are accommodating working parents.