I am starting to interview pediatricians for the new baby. I think it is important to have a relationship with a doctor. What kind of questions would you ask? How would you ask them? Any suggestions on how I can get a feel for the doctor's philosophy. I want someone to work with us to maintain health.

I have heard very good things about the doc I am seeing Tuesday. This is his second career; his first being a cultural anthropologist in Africa. I here he is pretty "AP" friendly - but I'd like to find out for myself.

Here is my list so far:
• What are your office hours?
• Do you have a nurse hotline? Is it 24 hrs?
• Do you have other Drs in your practice? Nurse Practioners?
• Will they see me if you are not available?
• How quickly can I get an appointment if my baby falls ill?
• Tell me about how you treat ear infections?
• How often do you prescribe antibiotics?
• Are there any immunizations you do not recommend?
• If I choose to selectively vaccinate on my own schedule, will you still treat us?
• What do you think about homeopathics? chiropractry(sp)?
• Do you use different growth charts for exclusively breastfed infants?
• How long do you encourage mothers to breastfeed? *(I am not sure I want to go there - but I think life would be so much easier with a doctor that was supportive of extended nursing.)
• What role does nutrition play in wellness? Do you have a nutritionist I could work with?

THE RESPONSES:

• That sounds good to me. I don't think I would hesitate asking about the breastfeeding. I think it's important that you know in advance his/her reaction and beliefs on length of breastfeeding. I went through 2 pediatricians before I finally found a family doctor that was AP friendly, is reaspectful of my decision to not vax, and even advises herbals before meds (depending on the seriousness of the situation). I don't think you can be too "picky." There are doctors out there that will at "least" respect your views, and I would want to know if that was so ahead of time.

• I agree. Any question that makes you think "I shouldn't even go there" is precisely the one to ask! I guarantee that you want all breastfeeding issues covered first - the last thing you want happening is what happened to one of my friends, where you go in to get a sprained ankle checked out and are told to wean. (WTF do those have to do with each other?)

  Meet the nurses. Interview them if possible. In most pediatrician offices (especially if you're on a HMO) you will deal with the nurses much more than the doctors, and it won't matter how much you like the doctor if his head nurse is a snarky bitch. The nurse is usually a gatekeeper over the phone who determines your eligibility to get an appointment.

  Find out which hospitals they have privileges at. Ask how many doctors they share being "on call" with. Ask about their other associates - nurse practitioners or other doctors in the practice. Meet them if possible. Don't limit yourself to just pediatricians. I went the ped route with well-baby checks with my oldest and it was a big PITA all the way around. I instead found a very open-minded family physician we only see on occasion. (The baby hasn't gone yet even once though - hasn't needed it).

• Sounds good...and lol about the breastfeeding question! At my 3rd child's newborn check....my doc said "I really encourage moms to nurse as long as possible," and I said "no problem here, my last nursling weaned when she was 4 1/2 years old." His eyes got big as saucers and he said "WELL!! That's certainly a long time!" LOLOLOL!!!

• I'd ask about circing, how often s/he finds it "necessary" to circ later on, how s/he recommends caring for an uncirc'd penis, things like that.

• I agree with the nurses being the gate keepers. I would definitely ask if he returns phone calls if you specifically request it.

  Because of my 'unique' nursing situation, I wanted to be able to come in and use the SAME scale to weigh my babies whenever I wanted (of course I made sure it wasn't when the place was packed!) I didn't want to wait in a room with sick babies, so one of my important questions was whether they would 'hustle' us into a room when they were NB -- you may not need this 'feature' but it may be something to add.

  Some doctors allow you to send your question in via email, find out if he has one that he gives out to patients. And I would DEFINITELY ask the EN question.

  I'd ask how he would feel if your baby had an ear infection and you treated it with garlic ear oil and echinicea. I know you have that you are going to ask about his view on homeopathy etc. but it is worth asking him specifically his reaction to that.

• I also agree with the importance of knowing your calls will be returned promptly. I have NEVER had a problem with a doctor but I have had MANY problems with staff members who make it nearly impossible to reach them! I used to be a gatekeeper so I know they are doing their job by not putting them right through, but their jobs also include giving the doctor accurate and timely messages, and sadly it is rare that they do! I left our old pediatrician because my daughter was very ill and slipping through the cracks CONSTANTLY and every time the doctor FINALLY got the message it was too late. She actually urged me to change practices, as her staff was hired by the hospital she was affiliated with and she had no control over their actions (or inactions). Turned out she joined the group I now go to so I am VERY pleased!!!

  Also I do agree with asking SPECIFIC questions regarding homeopathics - in general most MDs will not pronounce themselves to support it, as it is in a sense handing over some of their control to you...but if you can come up with a specific example of how you might handle something at home you may be better able to find and gauge their true feelings on it.

• I'd ask when they encourage starting solids, and when they encourage weaning. Our ped (we'll switch when we move) is supportive of breastfeeding in that there is a lactation nurse on staff. However, they encourage introducing solids at 4 months (way to early, IMO!) and every visit they ask how she's eating, which was hardly relevant until around 15 months when my DD finally started eating more solids and nursing a tad less as a result. I'd also ask about what they think of family bedding and try to get a sense of whether they worry about when a baby is "sleeping through the night." Our ped also encourages bottle-weaning at a year, which seems totally irrelevant to me, but it makes me realize that they don't actively encourage EN. (Though I've never been criticized for nursing past a year, thank goodness - I would have left immediately.)

  My guess is that if you ask about the vaccinations and they're reasonable about wanting to delay or not give them, they'll probably be in line with you on family bed, nursing, and other issues. But if you're trying to get a full picture, these might be good tidbits to know. And, if you feel like going for the gold, ask how they feel about homebirth.

• You could always ask, "About when can I expect a baby to sleep through the night?" And just cross your fingers that they'll respond with something like, "It really doesn't matter, what I personally recommend is that you keep them in your bed, and you won't mind when they do wake up." Or at least, "I don't even ask, that's not really a medical concern."

• UPDATE: OMG! I got LUCKY! First of all, his son is intact and both his kids nursed until they were four! As if that didn't make up my mind RIGHT THEN, he is on-call 24 hrs a day (and has a nurse line for questions and non-emergencies) and he has a REAL RECEPTIONIST. Most practices have a voice-mail maze that makes sure you can't talk to a real human being.

  He does recommend all the vaxes, but he has a modified schedule & discourages the HepB until 4 months. He is comfortable with the vaccination schedule (or lack of) that you set. His comment on the MMR vax was "I am not sure the evidence bears it (the autism link), but if you want to skip that one - all those are fairly minor diseases." Wow!

• The only other question I'd ask is why Hep B at all. Even my ped who encourages all of the vaxes doesn't encourage hep b at all. That is because Hep B has a risk group of IV drug users, prostitutes and sexually promiscuous people and homosexuals --- all of which a 4 month old baby is not. The reason they vax babies is because the risk group won't come in for vaccination - even the CDC website says so.