Expectant moms sometimes call our clinic and ask when they should schedule an appointment to interview their future pediatrician. I say it’s something you can’t do soon enough. If you deliver early, you may miss the chance to sit down and meet the person who will be treating your child all the way into college.
It’s always nice to see future moms come in with their list of recommendations they get online or from talking to other moms about what they should ask the pediatrician. By the way, dads are welcome too.
So when the parents come in for that initial visit, we first go over some basics. I introduce myself. We talk about the sex of the baby and the due date. Then I usually launch into my spiel.
The main thing I go over at the interview is not to panic about breastfeeding right after the birth of your baby. I explain to moms to watch for certain interested cues and if the nurse makes you wake the baby up to feed the baby, it’s probably not going to work and if it doesn’t work, don’t worry. During those first couple of days, mom get your rest. The nursing will happen. Your baby isn’t going to starve and only requires the colostrum (early milk rich in antibodies to help the baby’s immunity) in the first three or four days.
I let mom know I will be at the hospital every day that the baby is in the hospital. Usually it’s two days for regular vaginal delivery and usually a C-section requires a little longer stay. We have everyone back in the office two days after you go home to check the baby for jaundice. Then when your baby is 2 weeks of age, you come back to make sure he or she has gained back the birth weight.
We go over the checkup schedule – 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months and then again when the child is 2 years old. From that point on, barring sickness or injury, I will see you once a year. Often times, I see the child through college.
I like to go over the behavioral aspects of raising kids and how much they change in that first two years because 18 month olds are very different than 2 year olds, 18 month olds are very different than 9 month olds and 9 month olds are very different than 4 month olds. Part of my job is to help prepare parents for those changes and one of the things is to prepare them for the behavioral things.
I then go over our office schedule. We are from 8:30 a.m. to 5 p.m. and open on weekends. We are closed Thanksgiving, Christmas, New Year’s Day, Easter Sunday and Fourth of July. Then we discuss when to call our office and our after-hours, nurse triage phone line.
If after hours, I beg and plead for parents only to call if it is a serious issue and you really think there is cause for concern. If it’s something like cold symptoms or rash that’s not really bothering your kid, I ask parents to wait. It’s Ok to call, just wait until the next day.
But if parents think it’s serious or bordering on emergent, they need to call and the triage nurses will call back. The nurse will then give you home care instructions or recommend that you call the office in the morning. However, if the child sounds like he or she is seriously dehydrated the nurse will recommend going to the Cook Children’s Emergency Department.
Then it’s time for questions. Usually, I’m asked about our waiting room situation. Do we have a room for the sick kids and one for the well kids? They’ve actually done studies to show that doesn’t really help. We usually separate our well ones and our sick ones by time. We see well ones early in the morning and early in the afternoon and sick ones later in the morning and later in the afternoon and that’s how we try to keep them separate.
But all bets are off when it comes to our toddlers. They are crawling on the floor and chewing everything.
Some people ask about antibiotic use. I treat bacterial infections with antibiotics. If the baby looks real sick, I get a blood count at our office. If I find a high white blood count and I can’t identify a source then sometimes I start them on antibiotics. I communicate with the parents what it is I’m treating. Really I’m treating the white blood cell count.
I’m often asked about immunizations. I can’t overstate the importance of immunizations and how passionate I am about taking care of your child. If I thought for a second that immunizations harmed your child, I would not recommend them. But I do believe in immunizations and believe they are crucial in keeping your child, and all other children, healthy.
We give a little booklet that goes over what the immunizations are for and how often they should be administered. Occasionally, a parent expresses concern about immunizations. I try to talk to them about how there is no evidence that immunizations do anything but save lives right and left, but if they are adamant that they aren’t ever going to give their baby immunizations I say, “you know what I may not be the doctor for you.” If I get someone that wants a different schedule or that sort of thing I’ll work with them but if they don’t want to get any at all, I can’t in good conscience take care of your child. You are putting every other child in our clinic and at their school in danger.
I care about all of the kids I see and I want what’s best for every child. I don’t want to take responsibility for treating a child who has not been immunized. Plus, children who have not received their vaccinations place my other patients at risk for getting illnesses that are preventable with immunization.
I can’t in good faith do that for children. So it’s not out of arrogance, but out of caring that I expect parents to take my advice. Sometimes I have parents who don’t listen to me and they still come in for their visits. I wonder why. They may get their healthy kid stamp of approval, but they don’t get any of the other benefits I think I can give whether it’s behavioral issues, sleeping issues or eating issues. Parents should trust their pediatrician enough to take their advice, otherwise it’s frustrating and a waste of time for everyone involved.
You are paying for the advice. You might as well take it.
All the questions and information parents receive is important in choosing a pediatrician, but usually it comes down to the physician’s personality. It’s really important to take time to meet the person who, if chosen, will be taking care of your child into his or her teens.