Who Is Your Child's Doctor?

Every day families bring their kids into the Emergency Department with non-emergencies- runny noses, fevers, rashes, diarrhea.  Many of those times mom is a little embarrassed, and says "I called my doctor and they were booked, and they told me to come here."  Or worse, the mom might say "My child does not have a doctor." Having a good doctor for your kid is important.  Then you have a doctor who cares, and listens. That doctor knows your child, and has the child's past history at her fingertips.  You have a place to go for check-ups,  school physicals, shots, and questions.  If you go to the Emergency Department or a quick care clinic, good luck.  Maybe the doctor there will care or listen, maybe not.  Maybe they know kids, maybe not.  They certainly won't know your child as well. What if you are a new parent, or new in town?  What if you want to change doctors?  Here is some help to find a good doctor for your kid: 1.  The doctor is "board-certified" in Pediatrics or Family Medicine.  The national boards only certify those who show by testing and credentials that they are keeping up-to-date. 2.  Full-time practice.  It is important that your doctor and his covering partners are available when you need.  The best practices have evening and weekend hours for working parents.  Such practices have doctors with around-the-clock phone availability in case of emergencies. 3.  Competent over-the-phone advice.  Medical advice should be handled by doctors and nurses.  The scheduling secretary should not be giving you advice on the phone.  She is not trained for that. 4.  Reputation: having people recommend a doctor is nice, but one bad comment doesn't mean the doctor is bad.  Even the best doctor can't please everyone all of the time.  However, see if you can get a doctor's recommendation on where to go.  Doctors work with each other all of the time, and know who are the hot shots and who are the slackers. 5.  Fellow of the American Academy of Pediatrics (FAAP, as in Scott Hamilton, MD, FAAP) or American Academy of Family Physicians.  This means that the doctor is a member of the national professional organization that provides him the most up-to-date information. Given the blitz of advertising of doctor, clinics, and hospitals, these are hints that can help you find a good medical home for your child. When you settle on a doctor for your child, then you really learn if they seem good or not.  The first thing you should notice is that your doctor is a good listener.  Listening to a child's medical history is important.  As the father of modern medicine, William Osler, said, "Listen to your patient, he is telling you the diagnosis."  85% of diagnoses are made from the history alone.  The physical exam and labs and xrays usually only help to confirm the diagnosis.   Listening is a kindness, and other kindnesses should be apparent.  Nice and helpful secretaries and nurses are important.  It makes your experience better, and having them care about you and your child is just plain good medicine too.  These are people who get back to you in a timely fashion with appointments and lab results. Many times I have heard parents say they are changing practices not because of the doctor, but because of the "people in front." A kind and listening doctor is good, but the doctor who is also a thinker is even better.  Consider this: you are paying your doctor to carefully consider your child's case.  Your doctor is not just a vending machine for antibiotics and steroids.  You want your doctor to take the time to explore a problem, answer your questions and consider your opinions, and give comprehensive and thoughtful advice.  Now, these things are hard for a doctor to pull off, in this era of doctor shortages, shrinking payments, full practices, and thus reduced times allowed for each office visit.  Your doctor should at least seem to make the effort! So who is your child's doctor?  Someone board certified?  Has good phone access and good people in the office?  Has hours that fit your work schedule?  Good!  Then you shouldn't have to come see me.  Unless it is an emergency!