Conference moira::parenting_v3

    You might want to look in PARENTING_V2.  I'm sure there was at
    least one note on this topic.
    
    Carol

    When I went through the search for my daughter (now almost 9 months
    old) I thought it would be important to feel comfortable not only with
    the Doctor, but with his nurse(s) and/or receptionist as well - so I
    called the offices and spoke with the nurses and receptionist to get a
    feeling for how they related to parents' questions and concerns.  In
    retrospect, I've found that it is VERY important to find a Doctor who's
    staff is helpful and easy to deal with - because I have called the
    office many times just to get the nurse's advise (first time mother
    questions on all sorts of things!) and I think it's important to be
    able to ask the Doctor/Nurse anything at all you are questioning about
    your child.
    
    Good Luck with the Pedi and Best Wishes for an easy delivery,
    Diana
    
    

    Bev,
    
    Things I've asked....
    
    In emergency situations, do they meet you at the hospital or do you see
    the doctors there?
    
    What hospital are they associated with? (You may not like it)
    
    Do they have Saturday hours for immediate situations? Do they make
    house calls if it it really warranted? Some doctors are open for a few
    hours on Saturday mornings to handle situations that arise over night
    and cannot wait until Monday morning.
    
    Do they have an answering service?
    
    Who are the doctors which cover for them while they are on vacation?
    
    Do they have seperate well-rooms and sick rooms so your little one in
    for its 6 weeks check-up isn't sitting next to a kids with chicken pox?
    Do they at least have sick hours and well hours so the kids aren't
    mixed?
    
    How much time does the doctor actually spend with the child? Should you
    hold questions for him/her or direct them to the nurses?
    
    Will the doctor look at developmental issues other than just physical
    growth? Things like speech, crawling, walking, etc. I found this most
    important to me. I wanted to know how my child was doing all around not
    just whether he was growing okay and putting on enough weight. I wanted
    to hear things like "he is growing very well and he seems to have very
    strong legs. Has he started attempting to walk? Does he use a walker? 
    Maybe it will help him? I'd like to see him take a few steps now" or 
    "how many words can he say?". I wanted the doctor to watch my child
    take those steps and not just ask if he had started to walk.
    
    Does the doctor/office have set opinions about things like when bottles 
    should stop, when foods are introduced, advocate pacifiers, etc? You
    want to make sure that your opinion matters and the doctor/office isn't
    going to make you feel "bad" if you oppose their view.
    
    If you are going to be working, do they have late hours or can you
    schedule early morning hours? 
    
    What is there pay schedule like? Most require that you pay in full
    immediately and you handle your own insurance company. If you have a
    problem with this, they can usually arrange a payment plan. You might
    ask the receptionist this and not the doctor. 
    
    I think through talking with the doctor you will come to understand his
    bedside manner. Do stick around for a little while to see how the
    office operates - watch the nurses in action as well.
    
    Never be afraid to ask any question. During on "sick" visit the doctor
    promptly announced that my son had "peri-orbital cellulitis". Well, I
    had no idea what he was talking about so I just said "English
    translation please?" and he explained the whole thing to me. They can
    get caught up in their "medical" jargon so don't be intimidated.
    
    A suggestion when you go on you first visits - definitely bring a
    blanket with you. You have to strip down the baby and you will often
    have to wait until the doctor comes in, leaving the baby to lay there
    on the table. You never know the temperature of the rooms. Dress the
    baby in easily removeable clothes because everything will come off
    (except the diaper).  
    
    Good luck for a quick delivery and congratualtions on the things to
    come!!
    
    Andrea
                                                                     

    It was recommended to me during our birthing classes to have the pedi
    selected a few weeks before your delivery date.  This is in case you
    end up with a c-section.  The pediatrician has to be present during
    a c-section and if one hasn't been picked then I assume they would 
    just get one who is on call.  It is much more reassuring and relaxing
    to have someone who you've talked to and met be looking at and checking
    out your newborn than some stranger.  I know and was very glad that I
    had mine selected.
    
    I also agree that getting along with the whole staff is very important.
    They probably all say "Call  anytime with any questions and we'll be
    glad to answer them and help you any way we can."  But in reality that
    may not be the case.  A friend of mine was disappointed with at least
    a couple of situations.  She got no suggestions and little support
    with one problem she was having.  Another time she wanted to reschedule
    a so-many-month appointment and couldn't get another one for several
    months.  It would have been like almost skipping a checkup!  She
    changed her pedi at that point to mine who gave her an appointment that
    week.  So, how full they book their appointments is another factor, as
    well as how long you usually have to wait once you get to the office.
    Ask other parents who happen to be waiting when you're in the office
    for the interview.
    
    Personal Recommendations from other parents and my obstetrician was
    a big part of my decision.  My OB's kids, and my friend's little one
    are going to the pedi I picked and it's also convenient to get to.
    
    Lots of offices have pamphlets with their policies and procedures all
    written up that answer many of the questions that were in the previous
    replies.  Then you don't have to ask so many questions during the
    interview.  By the way, some offices charge for interviews!
    
    I just thought of this.  You don't really know how a doctor acts with
    kids till you see it.  So if you have a friend with a baby, whose pedi
    you are considering, maybe you could go to a checkup with them and see
    him in action.  Then you could really see his examining-room manner
    and thoroughness.
    
    Good Luck
    
    Mimi Overman
    

    re: .4

    I think what you're saying about having someone you "know" there
    at the delivery may hold true for individual or small practices.
    However, I believe that with some group practices and HMOs, even if
    you've selected your pedi, you may get the pedi on call *from that
    practice*.   Or was my experience out of the ordinary???

    Carol

>   The pediatrician has to be present during
>   a c-section and if one hasn't been picked then I assume they would 
>   just get one who is on call.


Not always the case.  We'd picked a family practicioner as our pedi, and we
thought he'd said he'd be there if C-sec.  It was a c-sec, but as soon as
my ob asked who it was so he/she could be called, he said: so sorry, but
this hospital doesn't allow family practicioners in the surgery rooms.
Needless to say we were confused and disappointed, but on to the solution.

When the ob saw we didn't have anyone else in mind, he offered the name of
one he highly recommends, saying if his kids were still young that's who
he'd want them to see.  We agreed and that pedi was there within 15
minutes.

As it turns out it was the best thing to happen.  We were so impressed with
him that we switched permanently to that pedi when our son was 1 month old.

    Other things to consider/ask:
    How supportive of breast fedding or bottle feeding? Your choice,
    wichever it may be, should be supported by your dr., even if it may not
    be the one he/she may recommend.
    How does he/she feel about feeding on schedule vs. demand...or is his a
    mixed approach (feed on demand as long as its not more often than X
    number of hours).
    If you get a differrent doctor in the practice, say during a sick baby
    visit, and you are uncomfortable with his opinion, do you have the
    option of requiring him to check with your own dr.
    
    You will get whoever is "on" in an HMO or large group practice, same as
    you get whatever OB is on in a similar situation. 
    --dave--

    Another thing a previous note sparked in my mind is that if you are
    selecting a pedi prior to the delivery and expect him to do the
    hospital visits, make sure he will. I live(d) in Methuen but delivered
    in Concord. Our selected pedi would not travel the distance to do the
    hospital exams. I thought that was totally understandable since it was
    not the hospital he was affiliated with. I selected a second pedi to
    handle the hospital visits who was recommended to me by one of my OB
    nurse practitioners (it was her kids' pedi and he was very well known
    from all I could find out about him).
    
    Do select a pedi close to home. You don't want to be travelling with a
    sick kid and  (God forbid) if anything lands the child in the hospital,
    you'll want to be close to home.
    
    Andrea

    For your own sanity (and I hope you don't have to go through this),
    find out your pedi's opinions on Infant Colic!  When my son began his
    bout with it, his pedi was on vacation and I was referred to her
    replacement.  I was EXTREMELY disappointed with his response to my
    frantic call to DO SOMETHING FOR HIM!  His response was "It's just
    colic".  When my pedi came back, she examined him, made several helpful 
    suggestions, and in general treated it as a 'condition'. 

    
    
    One thing you may want to check on is whether the staff will ask the
    pediatriacian when you call for advice.  I made the mistake of taking the
    advice of the receptionist when I called the pediatriacian.  My son had
    a terrible case of colic.  There was no way on God's green earth that
    this woman let the doctor know what was going on with my son.  
    
    I ended up trying cereal with my son way too early and it only
    complicated his situation.  There is this poor child writhing in pain, 
    now not only with the gas but with constipation to boot.  This is a
    little child about three months and under who if he slept more than 20
    minutes during the day, I was sure something was wrong with him.  Many
    times, he could only sleep against my body--probably because the warmth
    provided some comfort.  The problem ended up being some of the food I
    was eating.  I was nursing.  Even after seven years, it is something I
    still feel a bit guilty about.
    
    Please be sure that the staff is conferring with the pediatrician before
    you follow the advice.    
    
    
    					Darlene

    My pedi's office hands out a "Parents Survivial Guide" at the initial
    visit, plus a neat bag full of goodies for new parents like a Sitter's
    Information bulletin board (the kind you write important numbers on) a
    sample pack of pampers, literature on formula and breast feeding and
    some powder.   
    
    My pedi is part of a group practice, however the only downfall I found
    was that they will not allow you to change doctors within the group
    once established with one.  I discovered shortly after AJ's birth
    another woman doctor (My pedi is a woman with young children) who had a 
    much nicer bedside manner.  My own pedi was "talking down" as if I didn't 
    know how to get out of my own way, but we talked that one through and now 
    have a mutual respect.  They do have evening and weekend hours, I find
    the nurses as full of help as the doctors.  Many times I can ask for
    advise, prescriptions or just dumb questions without bothering the
    doctor.  If I need to see a pedi beside my own, and have had a bad
    experience with someone in the group, they respect this request and
    will schedule me with someone else if my own isn't available.
    
    I find that this group makes a routine practice of not seeing the newborn 
    until a day or two after delivery.
    
    RE .4  I would suggest it NOT a good idea to accompany a friend into an
    exam room.  There is a "Patient Confidentiality Law" in MA which
    forbids discusing medical conditions  with anyone but the patient or
    their representative (parent etc).  Not to Rathole this but it's very 
    likely that as a non family member you would be asked to wait in the
    waiting room during an exam and discussion.
    
    Wishing you a short and wonderful labor!!
    Lyn
    

    
    
    	When is the best time to consult a pediatrician to take
    	care of your newborn??  
    
    	/Kim

    I take my son to U-Mass Residency Program in Fitchburg.  I called
    them about a month before he was born and they told me to call as
    soon as he was born to set up an appointment for his two week visit.
    I called from the hospital when he was two days old to set it up.
    
    Lori B.

    
    
    	RE: Lori
    	
    	Thanks... My doctor suggested a group practice in the
    	Leominster Medical Building (Krumholtz, Feldman, Dugan,
    	Knight, Kelly and MacKaul)...
    
    	Do you know if the Residency Program in Fitchburg are
    	members of CMHC?
    
    	/kim

    re: .14
    
    I'm not sure, but their phone # is 343-3041, you could call and
    ask them.
    
    Lori B.

    
    I am in the process of looking for a new pediatrician and am looking
    to compile a list of questions to ask on an initial consultation.
    I've looked thru the file, and the archives, but came up empty.
    What kinds of things do you ask when interviewing a doctor?
    
    Here's my dilemma.  The pediatrician I presently have is wonderful,
    but far from home (I live in Sterling, he's in Waltham).  I also
    have a child who is a bit of a challenge, she has epilepsy and is
    developmentally delayed about 1 year. (she's 3yrs old).  I've asked
    several reliable sources for recommendations and have a couple of
    consultations set up for this week.  One doctor came VERY highly
    recommended from my daughter's neurologist (his children go to
    her!), but some friends on mine have worked with the pediatrician and
    absolutely hate her because she misdiagnosed their son's epilepsy
    for diabetes!  Another doctor comes highly from my daughter's 
    physical therapist, but doesn't communicate well with the neurologist,
    which has been a problem I've been having lately with the doctor we
    have.
    
    SO.....
    
    
    What kinds of questions do you ask when trying to determine fit with
    a physician?  How do you assess skill?  
    
    HELP!
    
    - Lynne

    You could start with these from the _v2 file:
    
   433  JAIMES::CUTTING      21-APR-1988    13  Interviewing pediatricians...help!
  1084     TPS::GOLIKERI     21-MAR-1989     9  Qualifying a pedi
  2044    BCSE::ZEEB         15-MAR-1990     8  Choosing a Pediatrician!!

    Moderator please move if there is an appropriate note for this topic.
    
    Well my head is already spinning with the anxiety of wanting to do
    a good job when interviewing pediatricians.  My OB, who has also been
    my Gyn for 17 years highly recommended one by my house.  Well in
    talking to two of my friends they said "Don't go to him".  They
    indicated that it was a three doctor office and that they were so busy
    and not very responsive.  So I asked them for there pedi (same one for
    both) and called her office.  I spoke with the nurse and asked her
    what she thought of this doctor my OB recommended and she said that
    they have an excellent practice and maybe my friend just had a
    pesonality conflict.  Sorry so many confusing details, but here is
    the bottom line....I am going to start setting up appointments to
    meet with pedi's in our area.  Being a first time mom and wanting to
    ask all the right questions, I'm asking for your experience and advice
    before I start this adventure.
    
    I realize that you can only determine so much during a first meeting
    and the real story will be told when I see the pedi in action with
    my child...or call him 10 times in one night at two in the morning!
    
    Thanks in advance for your help.
    
    ..Lori

    Where do you live?  
    
    Being on an HMO, I knew what practice I would end up going to for my
    daughter (I'm also a first time mom).  I asked my midwife for a
    reference and so far have been very happy with my pedi.  I also
    inquired about other doctors in the practice and the ones that were
    recommended (whom I've seen and like) were nearing retirement age and I
    wanted a doctor that would be around for a while.  This is something
    you might want to consider; however, I do not think it should be a
    deciding factor.
    
    If you live in the area of Concord, MA send me mail offline and I'll
    give you more information on the practice I take my daughter (20
    months) to.
    
    Mary

    Hi Mary,
    
    I live in Laguna Hills, California.  
    
    ..Lori

    I live in New Hampshire so I don't know much about CA. But with my
    first child we had no idea which pedi to choose. All were just names in
    our HMO book. So we asked our OB and he suggested the pedi that he
    uses. We talked to one of the 3 in the clinic and liked her very much,
    But another Dr. was on duty when my daughter was born. Since he had
    seen her we decided to keep him as the pedi of choice. He seemed very
    calm and caring, which he was. But he did not have that "touch" in
    dealing with small children. For some reason the "warmth" never flowed
    from him (am I making sense?). There never seemed to be a
    "relationship" between the pedi and my baby.
    
    After talking to a lot of other parents we found another pedi and she
    is oneof the best that we could find. She has such a manner with kids,
    such tolerance (my daughter starts screaming and crying as soon as she
    sees the nurse) and patience.
    
    I guess what I am trying to say is in addition to interviewing the pedi
    yourself ask around. Word of mouth is the best way that I have found in
    situations like these.
    
    Shaila

re: .18

Regarding the experience with the reference, you will just about never get a 
negative reference on one doctor by another doctor (or doctor's office).

What I'd recommend is trying to set up an interview with the doctor your 
Ob/Gyn suggested.  You may have a personality conflict.  You may have 
difficulty getting in to see him or feel rushed when you do.  Those would all 
be points of information.  Get more information from your friends about 
specific incidents.  For example, I've known doctors who were themselves very 
responsive, but got a bad rep because of a non-responsive nurse or 
receptionist.

Then go with your gut.  We used, until he left the area, a pedi about whom we 
were told by the DECNurse at my facility, "I wouldn't let him touch my child."

Clay

    Lori,
    
    Give me a call (DTN 525-4444) and I'll give you info on a few peds
    in the Irvine area.  
    
    Jodi-

    I had a similar experience looking for a new pedi when we moved.  Both my
    then-present pedi and my OB recommended the same pediatrician.  But several
    parents I spoke with recommended against this pedi because whe was very
    brusque.  I interveiwed her and decided I wasn't comfortable with her
    bed-side manner.  

    In my situation, I suspect the pedi in question was an exceptional
    medical doctor - which is why two doctors recommended her.  But her manner
    was more brusque than most parents were comfortable with.

    I agree with the noter who advised you to intervew the pediatrician.  If
    you find out why the doctor is getting mixed reviews you can then identify
    what strengths are important to you and which aren't

    Please don't get anxious about making a wrong decision.  You can always
    change pedis pretty easily.  A baby does not know the difference.  Just
    sign the release form to get your file and bring it to the new doctor. 
    (I recommend picking the file up because some offices are very slow
    about mailing them.)
    
    In the book, What to Expect the First Year, you will find guidelines to
    selecting a pedi.  You will also find a schedule generally used for
    administering vaccinations (they should never be given early),
    development milestones, and lots of information about handling medical
    problems.  If you are better informed, you will be more confident in
    dealing with the pedi and determining if your child is getting good
    treatment.
    
    By the way, we all see the same group of family practitioners, and are
    doing fine.
    
    
    Laura

    This conference is such a blessing of support and knowledge.  After
    reading this note and researching all other related ones on the topic,
    I felt a lot more secure in going on my first interview with a pedi.
    
    I had phoned the pedi's office on Tuesday and scheduled for Thursday
    evening.  On Wednesday, I received in the mail a package containing 
    her credentials, well baby visit schedule and pricing, hours/after
    hours, affiliated hospitals, etc.  I was pretty impressed with the
    responsiveness from her office.  Although, I kept in mind that the
    real test would be told when I see her in action with our baby.
    
    I was a little on the anxious side when I was waiting in the office,
    but that all left me immediately and something new took over.  There
    were three small children waiting for appoinments with their mothers.
    It suddendly struck me that I was in a pedi's office.  So much of this
    pregnancy has still felt like a dream come true (it is!).  I can think
    of the years we were trying and being in stores and touching baby
    clothes...going to childrens parties and dreaming of the day we would
    have our own.....and all of sudden I realized I was in a pedi's office
    and going to have a baby!  
    
    I know, probably sounds a little crazy...the tears welled up in my eyes
    and I was so filled with joy about this little gift from heaven growing
    inside of me that there was no room for anxiety overy interviewing the
    pedi!
    
    The interview went great and I have two more scheduled in the first 
    week of March.  Once the decision is made its on to the next
    adventure.... DAYCARE!
    
    Thanks for all your advice.
    
    ..Lori