Shopping for a Pediatrician

How do you choose a pediatrician? Interview the candidates, says the current wisdom on parenting. You are choosing — hiring, you could say — a person who will be critical to the health and well being of your child. You will want to interview, check references and assess the fit between each candidate and your family, before making a choice.

“I know,” says Laura Winnett of Concord. “I’ve read those books and articles. But who has time? Frankly, I don’t know anyone who has done that, and I’ve talked with a lot of parents.” Most new parents, she believes, talk with friends and make the choice based on recommendations from those who are satisfied with their pediatricians. She notes that the choice may be limited to the provider network of one’s insurance plan.

Winnett didn’t give the matter much thought until the eighth month of her first pregnancy, in 1998. Her midwife suggested that it was time to choose a pediatrician. “I had friends with small children,” she remembers, “so I asked them about their doctors. My midwife was from the Dartmouth-Hitchcock Clinic. It made sense to have a pediatrician from the clinic as well. My husband Steve and I liked the idea of having other services in the same system. We like the broad coverage, the after-hours phone service.”

Winnett makes a point that is a factor for many parents. There is a feeling of security in choosing a doctor who is part of a large practice. “I also asked three midwives for recommendations,” she says. “They each gave me two or three names. Dr. William Storo’s name was on everyone’s list. He’s the one we chose.” Dr. Storo works with a pediatric nurse practitioner, Bonnie Proulx. Winnett, who now has two children, likes their team approach. “They both know my children well. They have young children themselves so they know what it’s like in the trenches.”

For P.J. and Andy Cooke of Troy, the first decision was whether to choose a pediatrician in Peterborough or Keene. P.J.’s obstetrician is located in Peterborough. Delivery was at Monadnock Community Hospital. But the Cookes chose the Dartmouth-Hitchcock Clinic in Keene for pediatric care, primarily because it is closer. They also liked the range of services in one complex.

Then she and her husband asked themselves, “Would we prefer an older pediatrician with years of experience — one who has ‘seen everything,’ or a young doctor, perhaps more aware of the newest in pediatric medicine?” They chose the doctor with the most experience, Dr. Arthur Simington. “When we talked to the referral coordinator about our choice, we were told that Dr. Simington planned to retire in a year. We felt that the first year of a baby’s life was the most critical and we were willing to change doctors when the time came.” Their daughter is now 4 years old. Dr. Simington’s replacement, a young woman, is out on maternity leave. Still, the Cookes are satisfied with the pediatric care they have received, though they have had to adjust to different styles.

“I know we were supposed to interview,” Laura Winnett says, “but the ‘mommy grapevine’ works. People talk. I could name two pediatricians in Concord that I wouldn’t choose because of what I hear from friends.”

For P.J. Cooke and her husband, the first visit served as an interview. “We found that we could talk easily with Dr. Simington. My husband asks a lot of questions but he wasn’t threatened. He answered our questions comfortably.”

Suggestions for interviewing a pediatrician are useful in thinking about your choice, whether or not a formal interview is conducted. Here are a few points to consider, from Dr. Daniel Neuspiel, writing for the Personal Health Zone Web site.

Education: Is the pediatrician board-certified in pediatric medicine?

Philosophy: How does he or she respond to parent needs? Laura Winnett likes the family-centered approach of her team. “They pay attention to the needs of the family, as well as the child,” she says. “They recognized that my sleep is important to the baby’s well being, that the new baby has to fit into a family which includes another child.”

Office: Is the office neat and clean? Are there separate areas in the waiting room for sick children and well children?

Support Staff: Is support staff pleasant and helpful? Will they make reasonable accommodation to your schedule? Is it difficult to get through on the phone?

Backup: What is the plan for covering evenings and weekends? If one’s child needs tests or has to be hospitalized, how active will the pediatrician be in that process?

Treatment Team: Will others, a physician’s assistant or pediatric nurse, for example, be involved with your child?

Special Needs: If your child has a condition that needs special attention, (childhood asthma, for example) is the pediatrician qualified to provide what is needed? If not, is she defensive about this? The Cookes’ daughter had a condition that could be corrected by a minor surgical procedure. Dr. Simington does not do the procedure and believes that the condition is usually self-correcting in time. He did not attempt to dissuade them, however, and referred them to another physician for the procedure.

Family Beliefs: If you have religious practices related to child care, or preferences for alternative treatments, ask the pediatrician about her views on the matter. To what degree will she honor your beliefs?

Gender: Some parents do have a preference. Pre-adolescent girls may feel more comfortable with a female physician.

The pediatrician is an important person in the life of your family. Whether you interview or seek recommendations from others, the choice should be made with attention to what works best for you and your family.