New Parents FAQ
One of the responsibilities of new parents is too find a pediatrician. Around the medical
landscape of a community hospital, there are many pediatricians. Choosing the right one
will require some research.
Resources for lists of doctors can be obtained by your local hospital, your OB, your midwife,
your birth center, or friends, neighbors and more frequently, internet searches. Most offices
will offer free 15min introductions so that new parents can meet the physician and staff. As
with all doctors’ offices, parents usually want to ask about office hours, appointments
(urgent, same day, walk-ins), after hours availability, vacation coverage, and insurance.
With insurances, you want to make sure that your physician is in your network provider
book. Choosing and in- versus out –of-network can make a difference in 50% of the office
cost. For HMO insurance, it is absolutely important to choose within the network because
the bill can be high if both parties find out after the fact. For Medi-cal and Healthy Families,
it is important to ask because some offices will not accept these insurances.
The most common concern of new parents that will decide who they choose involves a
controversial subject: vaccines and autism. Vaccines have proven to be an important part of
disease prevention in the first year of life. Older pediatricians still remember and talk about
the days of infants and children admitted into the hospital for meningitis. The older
established vaccines, for the general population, are time tested and not as controversial;
they are consequently usually required for school attendance. These vaccines are dTap,
IPV, Hemophilus influenza b, Hepatitis B. The newer vaccines include chickenpox,
pneumococcal, rotavirus, and respiratory influenza virus and MMR. The newest vaccines
protect against meningococcal and human papilloma virus and are given to
adolescents.
Most pediatricians are quite strict with regard to the vaccine schedule. Some will even
insist upon immunizing all their patients according to their schedule and if you do not follow
it, they will ask you to leave their practice. If you and your spouse are generally healthy and
have had good experiences within the standard practice of medicine and respond well to
medications, then it is not necessarily an issue. However, if within your family, there are
neurological disorders or other children with autism, there is usually a concern and it is
worth it to do some research. In such cases of a tendency towards allergy or idiosyncratic
responses to medication within the family, flexibility with the vaccine schedule may mean that
both parties will be compatible.
The new parents must decide if they want to know the sex of the child or whether they want
to leave it as a surprise. If circumcision is an issue or a concern, knowing the sex of the
child will certainly help. If it is a girl, there are no issues. If it is a boy, the decision should
probably be made early. The American Academy of Pediatrics does not recommend
circumcision as a necessary medical procedure. Insurances no longer pay for it. Most
pediatricians do not do it in the office. You will want to ask. Generally, the OB does the
circumcision in the hospital 1-2 days before the infant leaves. Circumcisions are usually
done before 1 month of age and before the baby weighs 10 lbs, thereafter, most physicians
will refuse to do it. The older they are, the more pain, bleeding and risks are involved. It
would then be considered a ‘surgical’ procedure requiring specialist, operating room, and
anesthesia.
From the ‘business end’ of an office, it does not matter if you love the doctor, office, or staff.
If you have to drive very far, pay cash, and consistently have to wait more than 1 hour every
time, the practice might be too full. A pediatric practice, reaches a critical mass when one
pediatrician sees approximately 40 patients a day, total. This number supports one
physician, one office manager/biller, one front office and one or two back office personnel.
Over this number, I feel that the increased volume of patients, decreases the time you have
for each visit. If the office is very busy, you need to ask how the volume is managed. Once
you’ve chosen the doctor, most parents ask what happens next? Nothing, until you actually
go into labor. When you are admitted to the hospital or birth center, the nursing staff will
ask (again) who is the pediatrician. [The question is usually first asked when you pre-
register.] It is very important to get the name correctly, better yet, give the nurse the doctor’s
office phone number. I recommend handing the nursing staff the doctor’s business card to
guarantee that no mistakes are made. Very often, names sound similar and when a call is
made, they may call the wrong person. Hospitals require that the pediatrician evaluate the
infant within the first 24 hours. If the baby is born in the morning most docs go during
lunchtime; if in the afternoon, the first exam is done after hours. And if the infant is born
during the early morning hours, we do the exam before office hours.
Ninety nine percent of normal pregnancies lead to deliveries that are uneventful and normal.
It is important to pick your pediatrician before hand on the slim chance that there are minor
immediate issues such as rooming in, respiratory issues, the nursing staff will contact the
doctor at home for orders. You don’t want them to call the wrong person. If your doctor is
not on-staff at the hospital or birth center, you may request a copy of the baby’s delivery
information/summary.
In the first year of life there are many well child visits to check growth, development and
vaccines. These preventative visits usually occur at a few days of age, 2wks, 1month, 2, 4,
6, 9, 12, 15, 18 months and 2yrs. Common medical issues in the first month include
jaundice, feeding, constipation, colic, and rashes. Parents generally want to stay with the
same doctor if the infant has a rare but real medical condition that needs to be tracked over
time.
Hopefully, you now have enough information to help you make a few of the most important
informed decisions for your new baby.
landscape of a community hospital, there are many pediatricians. Choosing the right one
will require some research.
Resources for lists of doctors can be obtained by your local hospital, your OB, your midwife,
your birth center, or friends, neighbors and more frequently, internet searches. Most offices
will offer free 15min introductions so that new parents can meet the physician and staff. As
with all doctors’ offices, parents usually want to ask about office hours, appointments
(urgent, same day, walk-ins), after hours availability, vacation coverage, and insurance.
With insurances, you want to make sure that your physician is in your network provider
book. Choosing and in- versus out –of-network can make a difference in 50% of the office
cost. For HMO insurance, it is absolutely important to choose within the network because
the bill can be high if both parties find out after the fact. For Medi-cal and Healthy Families,
it is important to ask because some offices will not accept these insurances.
The most common concern of new parents that will decide who they choose involves a
controversial subject: vaccines and autism. Vaccines have proven to be an important part of
disease prevention in the first year of life. Older pediatricians still remember and talk about
the days of infants and children admitted into the hospital for meningitis. The older
established vaccines, for the general population, are time tested and not as controversial;
they are consequently usually required for school attendance. These vaccines are dTap,
IPV, Hemophilus influenza b, Hepatitis B. The newer vaccines include chickenpox,
pneumococcal, rotavirus, and respiratory influenza virus and MMR. The newest vaccines
protect against meningococcal and human papilloma virus and are given to
adolescents.
Most pediatricians are quite strict with regard to the vaccine schedule. Some will even
insist upon immunizing all their patients according to their schedule and if you do not follow
it, they will ask you to leave their practice. If you and your spouse are generally healthy and
have had good experiences within the standard practice of medicine and respond well to
medications, then it is not necessarily an issue. However, if within your family, there are
neurological disorders or other children with autism, there is usually a concern and it is
worth it to do some research. In such cases of a tendency towards allergy or idiosyncratic
responses to medication within the family, flexibility with the vaccine schedule may mean that
both parties will be compatible.
The new parents must decide if they want to know the sex of the child or whether they want
to leave it as a surprise. If circumcision is an issue or a concern, knowing the sex of the
child will certainly help. If it is a girl, there are no issues. If it is a boy, the decision should
probably be made early. The American Academy of Pediatrics does not recommend
circumcision as a necessary medical procedure. Insurances no longer pay for it. Most
pediatricians do not do it in the office. You will want to ask. Generally, the OB does the
circumcision in the hospital 1-2 days before the infant leaves. Circumcisions are usually
done before 1 month of age and before the baby weighs 10 lbs, thereafter, most physicians
will refuse to do it. The older they are, the more pain, bleeding and risks are involved. It
would then be considered a ‘surgical’ procedure requiring specialist, operating room, and
anesthesia.
From the ‘business end’ of an office, it does not matter if you love the doctor, office, or staff.
If you have to drive very far, pay cash, and consistently have to wait more than 1 hour every
time, the practice might be too full. A pediatric practice, reaches a critical mass when one
pediatrician sees approximately 40 patients a day, total. This number supports one
physician, one office manager/biller, one front office and one or two back office personnel.
Over this number, I feel that the increased volume of patients, decreases the time you have
for each visit. If the office is very busy, you need to ask how the volume is managed. Once
you’ve chosen the doctor, most parents ask what happens next? Nothing, until you actually
go into labor. When you are admitted to the hospital or birth center, the nursing staff will
ask (again) who is the pediatrician. [The question is usually first asked when you pre-
register.] It is very important to get the name correctly, better yet, give the nurse the doctor’s
office phone number. I recommend handing the nursing staff the doctor’s business card to
guarantee that no mistakes are made. Very often, names sound similar and when a call is
made, they may call the wrong person. Hospitals require that the pediatrician evaluate the
infant within the first 24 hours. If the baby is born in the morning most docs go during
lunchtime; if in the afternoon, the first exam is done after hours. And if the infant is born
during the early morning hours, we do the exam before office hours.
Ninety nine percent of normal pregnancies lead to deliveries that are uneventful and normal.
It is important to pick your pediatrician before hand on the slim chance that there are minor
immediate issues such as rooming in, respiratory issues, the nursing staff will contact the
doctor at home for orders. You don’t want them to call the wrong person. If your doctor is
not on-staff at the hospital or birth center, you may request a copy of the baby’s delivery
information/summary.
In the first year of life there are many well child visits to check growth, development and
vaccines. These preventative visits usually occur at a few days of age, 2wks, 1month, 2, 4,
6, 9, 12, 15, 18 months and 2yrs. Common medical issues in the first month include
jaundice, feeding, constipation, colic, and rashes. Parents generally want to stay with the
same doctor if the infant has a rare but real medical condition that needs to be tracked over
time.
Hopefully, you now have enough information to help you make a few of the most important
informed decisions for your new baby.
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