As a pediatrician I come across lists of “what to ask the pediatrician” and routinely meet with inquiring parents who are in search of a pediatrician. Occasionally they come with a list of questions but most often they are not sure what they should be asking. I always tell my new parents that the interview visits can tell you if I’m a normal person and if you can get booked into my schedule but ultimately tell you nothing about whether I’m good at what I do.
Here are the questions that cannot be gleaned from the practice website that I think will give you a better sense of the type of care you might receive and the provider’s style.
How many patients per hour do you see?
In pediatrics, the general standard for a wellness visit or new problem visit is 15 to 20 minutes. Acute same day concerns are generally seen every 10 to 20 minutes. This boils down to typically a pace of 4 to 6 per hour. Anything more than that and your time with the physician drops or your wait time increases. A pace of 8 per hour, for example, gives you 7.5 minutes face time with the physician. I would be cautious of a pediatrician who routinely books more than 6 patients per hour.
What is the no-show policy?
At first glance, a generous no-show policy that allows you to arrive very late to routine appointments may appear enticing. However, one thing to consider is what your tolerance is for a long wait time in an exam room with a sick or hyperactive child. A generous no-show policy comes at a cost. The physician may have to see additional patients in a shorter time period which can result in either a longer wait time or shorter clinic visit. Imagine coming on time to your appointment, waiting 45 minutes to be seen and then only getting 10 minutes with the doctor because another parent came late and had to be worked into the schedule. If you routinely run late to appointments look for a physician or clinic with a generous no show policy (>15 minutes) if you generally run on time then a stricter policy or a physician who routinely runs on time may be more your style.
Does the physician respond to phone calls or will you primarily be speaking only with the nurses?
Most clinics have their nursing staff as the front line in responding to patient concerns. This is normal practice and for 90 percent of the concerns a nurse is more than capable of handling them by phone. Occasionally you’ll need or want to talk to the physician over the phone, and this is something that every physician should make time to do. If you expect for every phone call to be answered by the physician, you will likely be unhappy at most clinics. As long as the physician is open to responding to their phone calls personally when requested, you should be fine here.
What is their general view regarding immunizations? Do they accept delayed or non-vaccinating patients?
Parents who are seeking to delay or avoid vaccinations entirely tend to cluster around a few physicians within a community who support the practice. Some of those physicians cater to these populations either from being like-minded or as a business model. You can quickly attract a very loyal patient base by advertising on forums about being open to non-vaccinating parents and other treatment modalities such as chiropractic care and supplements. For the rest of you who are more inclined to follow a standard vaccine schedule, you can find great insight from this question.
Pediatricians that accept delayed or non-vaccinating parents but mention that they discuss vaccines at each visit are commendable and are showing a willingness to have difficult conversations even if it makes them unpopular.
If the pediatrician answers this question however with a response built around giving you whatever you want without offering discussion about the benefits of vaccines, then I would be concerned. Vaccines are a basic tenet of pediatrics and medicine in general. A pediatrician who is focused on the idea of giving you what you think you want will also tend to give antibiotics when you think you need them as opposed to when your child actually needs them. In my experience, they over treat with medications and expose your child to unnecessary antibiotics because their focus is on making you happy as opposed to an honest and open discussion about options.
Does your physician offer same day sick visits or will this be with a physician assistant (PA) or nurse practitioner (NP)?
If your sick visits will primarily be with the PA or NP, then meeting them is crucial as is understanding that you will not be seeing the pediatrician for those visits. Your primary doctor will never be able to see you for all visits, so an occasional visit with an NP, PA or other physician is understandable. However, seeing your primary physician only for wellness visits and never for the other visits is unacceptable.
When is the next available well visit?
A few weeks out for the next wellness visit is understandable. More than six weeks out however can present a scheduling problem for many parents.
When is the next available sick visit?
Typically within 24 hours but ideally, the same day is preferable. Anything more than this can mean costly Emergency room visits or Urgent care visits.
This is not an all-inclusive list but will hopefully fill the holes that other lists leave. Ultimately I hope you find a practice where you enjoy trust and mutual respect and have someone who truly cares for your child.
Jeremy J. Granger is a pediatrician.
Image credit: Shutterstock.com