Choosing a Pediatrician

The American Academy of Pediatrics (AAP) has developed this information to help you

• Choose a pediatrician.

• Prepare for office visits with your pediatrician.

• Know what to do if you have a question or an emergency health problem.

Why your child needs a pediatrician

Children's health care needs are different from adults'. Pediatricians are trained to prevent and manage health problems in newborns, infants, children, teens, and young adults. As children get older, they often find that they trust their pediatricians because they have known one another for so many years.

How to find a pediatrician

• Do your research. Ask other doctors, family members, friends, relatives, and coworkers for a referral. When someone suggests a pediatrician, ask them the following questions about the doctor:

  • Are your medical questions answered by the pediatrician or office nurses?

  • Do your children like that pediatrician?

  • Does the pediatrician talk with the children, and not just the parents?

  • Does the pediatrician seem to know about current advances in pediatric medicine?

  • How helpful and friendly is the office staff?

  • How well does the office manage your phone calls?

  • How does the office handle emergencies; can your child be seen as soon as possible?

  • Can sick children be seen on the same day?

  • What is the average time you wait before seeing the pediatrician for a scheduled office visit?

  • Is there anything about the pediatrician or the office that bothers you?

  • You may also find information on local pediatricians from a nearby hospital, medical school, or your county medical society. Even if your health insurance requires you to choose a pediatrician from their approved network of doctors, they may have additional information about them to help you choose.

  • Do not wait until your child is sick or needs a checkup to choose a pediatrician. Even if you have recently moved, are changing insurance, or are having a baby, it is best to find a pediatrician as soon as you can.

• Make a visit. After you have a list of names, you may want to visit each pediatrician's office. Check the waiting area to see if it is clean. (But realize that children have been in it all day long.) You can see if the office staff seems friendly and helpful. If staff members are not too busy, ask a few select questions.

  • What are the office hours? Are there evening and weekend hours?

  • Is emergency coverage available 24 hours a day, 7 days a week?

  • When is the best time to call with routine questions?

  • Is there an after-hours answering service?

  • When is payment due?

  • How does the office handle billing?

  • How are insurance claims handled?

  • Is this pediatrician accepting new patients with my insurance or managed care plan?

  • You may also want to ask about the pediatrician.

  • Does the doctor have a subspecialty or area of pediatric interest? If so, what is it?

  • To what hospital does the doctor admit patients?

  • Is the doctor board certified through the ABP?

  • Is the doctor a FAAP?

  • Who will care for my child if my pediatrician is not available? Are they on staff at the same hospital?

  • These are just sample questions. Ask other questions about things that are important to you.

• Follow your instincts. After your first visit with the pediatrician, ask yourself: Does this pediatrician listen, answer questions, and seem interested? Above all, ask yourself if you like and trust this person. If your instincts say "no," talk with the next pediatrician on your list.

Recommended health care visits

The AAP recommends regular health care visits at the following times:

• Before your baby is born (for first-time parents)

• Before your newborn leaves the hospital

• Within 3 to 5 days after birth

• Within 48 to 72 hours after leaving the hospital

• During the first year of life—visits by 4 weeks of age, and also at 2, 4, 6, 9, and 12 months of age

• In early childhood—visits at 15, 18, 24, and 30 months of age as well as yearly at 3 and 4 years of age

• In middle childhood—yearly visits from 5 through 10 years of age

• In adolescence and early adulthood—yearly visits from 11 through 21 years of age

(Your own pediatrician may recommend additional visits.)

Preparing for office visits

It is important that your child see the pediatrician on a regular basis. At each visit, the pediatrician will examine your child and make sure your child

• Is eating and growing well

• Has all the recommended immunizations

• Stays healthy and safe

Before each visit, write down any questions you have so that you do not forget to ask them. Keep up-to-date records on your child's growth and immunizations, and bring this information with you to each visit.

Also, remember to tell your child's doctor about all treatments your child is using. This includes home remedies, over-the-counter remedies, and dietary supplements such as vitamins or herbs. And tell your child's doctor if your child has seen any other health care professionals. Your child's health and well-being depend on open communication, trust, and respect among all health care professionals.

AAP pediatrician referral service

The AAP has an online pediatrician referral service for parents. For more information, please go to www.aap.org/referral .

When to call the doctor

Routine care. You should always feel free to call your pediatrician's office, even if it's for routine things like medicines, minor illnesses, injuries, behavior, or even parenting advice. Keep in mind, though, that your pediatrician may not be able to answer your questions without seeing your child first.

Urgent care. Sometimes it's hard to tell how sick your child is. However, urgent care or a trip to the hospital is usually not needed for a simple cold or cough, mild diarrhea, constipation, temper tantrums, or sleep problems. However, if your child has any of the following, call to find out if he needs to be seen:

• Vomiting and diarrhea that last for more than a few hours in a child of any age

• Rash, especially if there is also a fever

• Any cough or cold that does not get better in several days, or a cold that gets worse and is accompanied by a fever

• Cuts that might need stitches

• Limping or is not able to move an arm or leg

• Ear pain with fever, is unable to sleep or drink, is vomiting, has diarrhea, or is acting ill

• Drainage from an ear

• Severe sore throat or problems swallowing

• Sharp or persistent pains in the abdomen or stomach

• Pain that gets worse or does not go away after several hours

• A rectal temperature of 100.4°F (38°C) or higher in a baby younger than 2 months

• Fever and repeated vomiting at the same time

• Blood in the urine

• Bloody diarrhea or diarrhea that will not go away

• Not drinking for more than 12 hours

Emergency care. Call 911 (or your emergency number) for any severely ill or injured child or if your infant or child has any of the following:

• Bleeding that does not stop with direct pressure over the wound

• Suspected poisoning (Call the Poison Help line at 1-800-222-1222.)

• Seizures (rhythmic jerking and loss of consciousness)

• Trouble breathing

• Skin or lips that look blue, purple, or gray

• Neck stiffness or rash with fever

• Head injury with loss of consciousness, confusion, vomiting, or poor skin color

• Sudden lack of energy or is not able to move

• Unconsciousness or lack of response

• Acting strangely or becoming more withdrawn and less alert

• A cut or burn that is large, deep, or involves the head, chest, abdomen, hands, groin, or face

Be prepared

During a scheduled checkup, ask your pediatrician what you should do and where you should go if your child needs emergency care. Learn basic first aid, including CPR. Keep emergency and Poison Help line (1-800-222-1222) numbers posted by your telephone.

Tips before and during a call to the doctor

Your pediatrician may prefer that you call with general questions during office hours. Some offices even have special "phone-in" times. Before you call, have a pen and paper ready to write down any instructions and questions. It's easy to forget things, especially if you are worried about your child. During the call make sure your child is near the phone, if possible, in case you need to answer any questions.

Also, be prepared to provide information about your child's health (see below).

• Fever. If you think your child has a fever, take your child's temperature before you call. If your child does have a fever, write down the temperature and time you took it.

• Medical problems. Remind the doctor about past medical problems (such as asthma, seizures, or other conditions). He or she cares for many children each day and may not remember your child's health history.

• Medicines. Be sure to mention if your child is taking any medicines, including prescription or nonprescription drugs, inhalers, supplements, vitamins, herbal products, or home remedies.

• Immunizations. Keep immunization records at hand. These are especially helpful if your child has an injury that may require a tetanus shot or if pertussis (whooping cough) is in your community.

• Pharmacy. Have the phone number of your pharmacy ready.

If the doctor needs to return your call, make sure you are available for a callback. Unblock your phone "call block," and keep phone lines open so that your pediatrician can return your call in a timely manner. Do not leave pager numbers. If you leave a cell phone number, be sure that you have your cell phone on and will be in an area where you can receive calls.

Immunizations and your child's health

Many childhood diseases can be prevented with regular health care visits and up-to-date immunizations. The following are important vaccines that your children need to help protect them from certain diseases:

• Diphtheria, tetanus, pertussis (whooping cough)

• Measles, mumps, rubella (German measles)

• Polio

• Hepatitis A

• Hepatitis B

• Haemophilus influenzae type b (Hib)

• Varicella (chickenpox)

• Influenza (flu)

• Pneumococcal

• Rotavirus

• Meningococcal infection

• Human papillomavirus (HPV)

Be sure your child receives vaccinations on schedule. It is the only way to protect your child against many serious diseases.

Your pediatrician can give you the latest information about any new vaccines as they become available. At each checkup, ask your pediatrician if your child is fully immunized. Information is also available from the AAP Childhood Immunization Support Program Web site at www.cispimmunize.org .

Please note: Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this publication. Phone numbers and Web site addresses are as current as possible, but may change at any time.