Saturday, May 29, 2010

Paging Dr. Perfect

So, how exactly does one go about finding the perfect doctor?  Or even, one that is as close to ideal as is reasonably possible?

When I was pregnant, I found a to-do list for expecting mamas (there are many out there).  One item was "interview prospective pediatricians".  I admit I was a little surprised at this idea.  "Interview" a doctor?  Why can't you just pick one close to where your apartment is, or the one your coworker takes her daughter to?

I now realize the importance of this step.  Finding a doctor whose views are similar to your own is pretty important.

I did the interviewing.  I asked around and got recommendations from lots of folks.  Working with a bunch of nurses was good in this situation.  I visited websites, drove past offices, Googled.  I narrowed my list to three to make appointments with.  Some offices will charge you a co-pay for this visit.  I saw two doctors individually and neither charged me a co-pay (although one office had some difficulty with the "father" conversation).  The third office had a monthly "expectant parents" meeting, which allowed parents to interview a doctor and ask questions about the practice in a group.

I loved the doctor that did the group meeting.  He was well versed in primary research (my background) and the practice worked closely with Cincinnati Children's on research protocols.  He had good information both as a physician and a father, and he answered one of my key questions with a slam-dunk answer.  He's the doctor that recommended The Happiest Baby on the Block DVD to the group, which was my lifesaver through colic.

The next doctor I wasn't too thrilled with.  He was recommended by a fellow faculty member (one of those nurses mentioned above) and was very supportive of breastfeeding (important to me in a doctor).  But I just didn't connect with him much.

The last doctor I met with was part of a new practice started by two women who were mothers as well as pediatricians.  The doctor I met with was close to my age, hadn't been out of residency long, and had a young child.  I loved their new medical office - they truly had separated "sick" and "well" child waiting rooms.  In fact, from the outside you enter a closet-sized entryway with three doors, one labeled "Employees Only" one labeled "Sick" and the other labeled "Well".  I've been in doctor's offices where "sick" and "well" waiting areas are just opposite ends of the waiting room.  These were truly separate, a big plus.

I went back and forth in my mind about the two practices that topped my list, and finally decided on the first.  It was a larger practice, so you may be less likely to see "your" doctor when sick, but I went with my gut.  And I was SO glad I did.

I chose the doctor that had led the group session as "our" doctor, since I liked him so well.  However, he was not the doctor from the practice that was on call the weekend that Wee One was born.  Instead, we got another amazing doctor from the practice that we later called "Dr. McDreamy" and had a bit of a stalker-esque relationship with because we loved him so much too.

Oh, I hated leaving that practice when we moved.  We saw a total of 4 doctors from that practice in the 4 months she was a patient there, and we adored 3 of them.  They were informed, patient, accommodating, and they took great care of my Wee One.

That was the worst thing about moving.

I didn't like making the pediatrician decision the first time around, and now I have to do it again.  We started asking people who they went to, and everyone said a different practice.  Everyone said their doctor was "great" but noone was particularly enthusiastic about their pediatrician.  Finally we ran into one mother at a consignment sale and she raved about a particular doctor.  It was the most "gushing" I'd heard anyone around here do about their kid's doc, so I paid attention.

Later, when reading about vaccines on the Dr. Sears site, I came across the same physician's name on their vaccine-friendly registry.  At the time, I had Wee One on the regular (accelerated) vaccine schedule, so I wasn't doing delayed vaccination, but I wanted a physician who might be open to an alternative schedule.

I "interviewed" him, and he seemed okay.  Didn't have a stellar answer to my big question, but everything else he said sounded fine.  The practice has separate "sick" and "well" waiting rooms, and he's the only doc in the practice, so until he got a nurse practitioner, we wouldn't see anyone else for sick or well visits, which was a plus.

He's fine.  But ... he's ... just fine.  He did let me delay her one-year vaccines because she had a sinus infection at the time.  He laughs at Wee One every time he examines her because she always tries to play with his stethoscope.  He asked her to stick out her tongue once and she just looked at him.  He said "she's so smart, it's easy to forget she's not quite mature enough for that yet" which made my heart swell up. 

But ... you know there's a but ... I'm just not totally comfortable with him.  Wee One has been exclusively breastfed (except for that one night in the NICU).  I didn't start out to be militant about breastfeeding, I wanted to do it as long as it worked.  I never dreamed it would go that well for us, or we'd still be nursing at almost 14 months.  When I first met with him, I asked him about extended breastfeeding, and he gave me a pat answer about "normally" weaning at one year, but some parents breastfeed "longer".  At her one year appointment, we talked about moving her to cow's milk.  I asked about extended breastfeeding, and he said some parents nurse to 18 months or even 2 years.  But he continued to talk about the cow's milk.  My mom even asked about DHA (I have beent taking a DHA and EPA supplement the entire time I've been nursing) and he said all the essential fatty acids she needs are in cow's milk (which, technically, DHA isn't in cow's milk unless its added).  While he didn't specifically discourage me from continuing to nurse, pump, and give breast milk - he did talk alot about switching her from that to cow's milk.

At an appointment we made to discuss food issues, he again pushed the cow's milk.  Again, not specifically being discouraging, just not being encouraging of extended breastfeeding either.

But the thing the I would most prefer in a doctor's office, I have come to realize, is electronic medical records.  I don't know why this is so important to me, and I feel like it shouldn't be.  But it is.  Dr. McDreamy's office had electronic medical records.  Everything in their office was electronic.  The doc would enter her weight on his little tiny laptop and immediately show us her growth curve.  In color.  (The visual learner in me LOVED THAT.)  They could, at the touch of a button, print all her past height/weight/head circumference stats (complete with percentiles) so I could keep track.  If you talked to the doc on call after hours, he had his little laptop with him, and could view her entire record and history right then.  It was efficient and effective.

Our new doctor doesn't utilize EMR in his office.  During our visit about feeding, he had to plot her height and weight himself on the little growth chart graph paper to see where she was on the curve. 

I don't want to bounce around from practice to practice.  I don't want to go from a doctor that is "ok" to a doctor that's worse.  But I would like a doctor that is truly supportive of extended breastfeeding, a doctor that supports alternative vaccine schedules, a doctor that has EMR, and a doctor that doesn't think attachment parenting is wierd.

How does one go about finding that?

(She loves the baby in the mirror at the doctor's office.  So if they have that, that would be good too!)


Funky Mama Bird said...

I found both pediatricians we used through

You can look and see what other parents are saying, and a lot of them will mention things they are passionate about, like delayed vaccines, etc.

My big thing was finding a doctor who connected with my kid, but still listened to me. I think I found someone this time around, and he was helpful with pushing for the allergy testing.

Good luck with the hunt!

Laraf123 said...

I am still breastfeeding at 15 months. My OB/GYN is shocked. I didn't even mention it to the ped. and he didn't ask. I plan on weaning around 18 mo. unless my son wants to sooner. (He's losing interest) What about asking a local lactation consultant for a rec?

Billy said...

So different here! A doctor is for when the child is sick, child's growth centre for the rest (height, weight, vaccinations, skills, etc.). But, hmmmm... the nurses there have a really bad reputation (go strictly by the book, freak out new parents..), I wouldn't dream of consulting them.
Anyway, good luck with finding just the right doctor.

Without going into the issue of extended breast feeding, why cows milk? Isn't goat's milk much more healthy and much more easier for young kids to tolerate? [I suppose a question to your dr. not you..]

Sara said...

I think I just hit the jackpot. The pediatrician within walking distance of my house is rated first on, and is mentioned in the Green Parents group as being AP friendly. Now, if he takes my insurance AND new patients AND I like him, we are set.

MommieV said...

Lara - so glad to know you are still breastfeeding. My intent is also to go as long as she wants to - she is still as interested as ever, so we may go 18 mos or longer. We'll see.

Billy - cow's milk is the kind of milk most folks drink in the US. In fact, I find it interesting that "milk" is cow's milk, and if you want a different kind of milk, that is specified on the label. We just consider "milk" to be "from a cow" over here. I've seen soy milk in the regular grocery, but I'm not sure I've ever seen goat's milk. Most folks only try other kinds of milk if they have an allergy to cow's milk.

I'm fascinated by the cultural differences that I'm learning about through you!

MommieV said...

Ok, Sara, I have to know who your doctor is. I'll send you a message on Facebook. Most peds I have talked to are always taking new patients, since folks are always having babies! It's the insurance that I think will be the clincher!

Billy said...

Cow's milk is also the default here, and most people use that kind of milk. But goat's milk and goat's milk products are becoming more and more popular. Forgot about soy milk..