Is Finding a Pediatrician Like Buying a New Car?

Written By Nelson Branco M.D., FAAP

Several weeks ago, a posting on The Huffington Post by Meredith Lopez titled “An Open Letter to Pediatricians” generated lots of commentary and discussion among pediatricians.  Ms. Lopez described her experiences with her son’s (former) pediatrician, who was apparently not available to answer her phone calls in the middle of the night or on a holiday, and was unable to diagnose and cure her son’s diaper rash despite several visits. When I read Ms. Lopez’s blog post, I see a relationship between a mother and pediatrician that just isn’t working because they aren’t communicating.As a practicing pediatrician, I know that not every visit leads to a definitive diagnosis and cure.  I also know that being available, professional, knowledgeable and compassionate are just as important as how quickly I can come to the correct diagnosis and recommended treatments. Communication is at the heart of all that we do in medicine.  If you can’t listen effectively and let the patient or parent know that they have been listened to, you have not really taken care of them.

I’ve practiced in cities, suburbs and rural areas.  Many times, patients, family and friends ask “Should I go into the city for this?”  For me, that city has been Boston, Providence, Albuquerque, Denver, San Francisco and Phoenix.   Which city doesn’t matter – what drives them is the desire to get their care from “the best” for whatever problem they are having.  My answer to them is always the same – the best doctor for your problem is the one you can communicate with, the one who is available to answer your questions and the one who makes you feel like they can take care of you and your problem.  Sometimes that person is right here in your own backyard, and sometimes that person is at the biggest hospital in the biggest city with the biggest reputation.  But you should do your homework to find out who that is, and part of that homework is calling your pediatrician.

Part of my job is to direct my patients to the right specialist.  In the days when HMO insurances were more popular, primary care doctors were the so-called ‘gatekeepers,’ and many patients felt that their doctor was trying to deny them access to specialists.  Now, with PPO and EPO insurance plans being the norm, primary care doctors are not necessarily involved in their patients decision to visit a specialist.  That isn’t good medicine or good care for your child.  My job as your primary care physician is to take care of all your problems – including getting help from a specialist when we need it.  I need to know where you are going for your care so that I can get information from the specialist, help you understand it and integrate it with any other issues or conditions you might have.  It’s also my responsibility to lead you in the right direction, and send you to the specialist who will help you get to the bottom of the problem.  Often, that means referring you to the person that fits your needs and personality; I know you and usually I know the specialists.  I may not be a professional matchmaker, but I usually have a good idea who you’ll work well with.

The other advantage to local care when it is appropriate is that it can be much easier to get.  All physicians know that a medication prescribed twice a day will be taken much more consistently than a medication prescribed three or four times a day.  So it is with visits, tests and follow up visits that you can do close to home.   What about when those specialists aren’t available close to home?  Or if there is only one choice for a particular specialty?  That’s the time when it’s most important to have me working alongside the specialist.  When there is only one Child Neurologist, they will be busy and won’t be able to see you frequently.  Then it becomes my job to communicate with them about questions, concerns or issues that may come up.

The bottom line is that it is important to pick the right pediatrician for you and your child.  Their personality, communication style, office setup and availability are all important.  Ask your friends, your family and co-workers.  Check the practice website, call the office and see if they are set up to do a prenatal or ‘meet and greet’ visit and meet with the doctor if you can.  Most pediatricians are kind, caring and dedicated – you’ll find the right one for you, if you look.

Dr. Branco is a practicing pediatrician in the San Francisco Bay Area and is very active with the local chapter of the AAP.