One of the most important decisions you will make as a parent is who will be your child’s pediatrician. She is the one who will be there to help you care for your ill child, promote wellness and advise on prevention, safety issues and the many parenting concerns/issues that come with the ever-changing stages from newborn to young adult.

A pediatrician is a physician who has completed medical school and a three-year pediatrics residency. They are specially trained in caring for infants, children, teenagers and young adults. A pediatrician who is certified by the American Board of Pediatrics after 1988 must pass a stringent exam every 10 years. In addition to keeping up with the latest advances in pediatric care, she must participate in projects to improve her practice. To verify that a pediatrician is board certified, check the American Board of Pediatrics website at abp.org.

RECOMMENDATIONS: Chances are that your obstetrician has met many of the pediatricians in town so is in a favorable place to suggest a pediatrician or will have a list for you. Other sources are your family, friends, coworkers and healthcare workers, especially nursery and labor and delivery nurses. Before you narrow your list to 2-3 pediatricians who you would like to schedule a prenatal visit with, spend some time thinking about what is important to you.

SCHEDULE A PRENATAL OR PRE-ADOPTION VISIT: A good time to meet with a prospective pediatrician is at the beginning of the 3rd trimester. If you are adopting, check with your adoption agency regarding their timelines. They also may have a list of pediatricians who have a special interest in caring for infants and children who have been adopted.

Meeting a pediatrician before your baby is born gives the pediatrician a chance to review any medical problems during your pregnancy. If you are adopting, she can be prepared to handle medical issues that may be specific to a domestic or international adoption. Likewise, as a parent, you can obtain advice regarding medical decisions you will be making during the first few days of your baby’s life. Even though there will most likely be a designated nursery pediatrician for the hospital, your pediatrician will be in communication with him to allow for a seamless transition to home and follow-up care.

HOLD AN INTERVIEW: What sort of relationship would like with your pediatrician? Do you prefer a doctor who is informal and easygoing or one who is more formal and businesslike? Do you want a doctor who gives the impression of having all the answers and tells you exactly what to do, or one who is willing to admit, “I don’t know, but I will find out.” When possible, would you like the doctor to present to you an array of choices from which you will choose? Even in the best of doctor-patient relationships there may be points of difference; doctor-patient relationships are most likely to succeed if both parties agree on a majority of major issues. It is up to you to decide what these may be. Some examples are antibiotic use, immunizations, breastfeeding, circumcision, vegetarian diets and attachment parenting.

Other information you will obtain from the interview are office hours, how telephone calls/emergencies are handled, sick visit appointments, coverage arrangements and availability of house calls. There is a nationwide movement, especially among primary care physicians, to structure their practices to serve a limited number of patients so they can provide highly individualized additional services.  Some of the terms used are “membership medicine,” “direct care medicine” and “concierge medicine.” Arrangements for care at these practices vary, so check with the individual doctor to see what is provided for the membership fee.

MAKING YOUR CHOICE: In the end, your decision will most likely be made on how you feel about a particular pediatrician and her practice.

There is no such thing as a perfect doctor but if there seems to be more discord than harmony, try talking things out with the doctor. You may find that there is a misunderstanding that can be addressed to the satisfaction of all. If not, it may be time to move on to another pediatrician and, hopefully, have a pediatrician that is best for your family.

Dr. Gutierrez is the owner of Liberty Pediatrics in McAllen, TX…and yes, she does make house calls. See our ad in Healthy Valley Magazine.