Choosing the right paediatrician for your child is sometimes a hit-and-miss affair. Some parents and kids get on with their paediatrician from Day 1. Others seem to keep hopping from one doctor to the next, unable to find one that they're happy with.
What should you look for in a paediatrician?
Some parents prefer an older doctor whom they feel is more knowledgeable and experienced. Others prefer a younger doctor who will discuss the treatment with them and whom they feel is less dictatorial.
Some may prefer a male doctor and others, a female doctor. Some want to see how the child reacts to the doctor before deciding.
Paediatrician Dr Yong Junina Fadzil advises parents to find a paediatrician they can interact with.
“It would help if the child doesn't scream every time he or she sees the paediatrician. Make sure that you've got a qualified paediatrician. I think you can go online to check and when you visit the doctor, don't be embarrassed to ask if he or she is the doctor whose name is displayed in the clinic. If you think the doctor looks a bit too young, just ask how long they have practised and where they graduated from. I don't think it's offensive for parents to ask because they would then get some peace of mind if the doctor can answer them,” she advises.
Whether parents choose a paediatrician in a private clinic or one in a hospital is entirely up to them.
Dr Yong says that while it depends on the patient's level of comfort, the child's medical problems is also a factor.
“If the parents are comfortable with the doctor in a particular hospital then they should return to that doctor. However, if a child has a heart or lung disease or if the child was born prematurely, then the child may need regular followup visits at a particular hospital. Basically, it depends on why the parent needs to bring the child to the hospital and what the child needs followup visits for.
“On the other hand, even if the child has a heart problem and they can find a good specialist outside who has ties with a hospital should the child require admission, then it is okay to follow up at that particular clinic. But, the parents should be aware of whether or not the doctor they are seeing is able to cater to the child's needs and what they should do in case of an emergency or if the child requires admission.
“The parents can actually ask the doctor, if they see one in a private clinic, what he or she would do should the child require further treatment in the hospital; would it be the same doctor? If not, where would the child be referred to and what would the procedures be,” she says.
Parents should never assume that the hospital doctor would be better than the private clinic doctor.
If the child has a medical condition, then parents may want to find a paediatrician who specialises in that field. It could be a paediatrician who is also a cardiologist, or a paediatrician who specialises in allergies.
Dr Yong explains that paediatricians with niche specialities may only be available in a hospital; not even all hospitals.
“If your child is born prematurely, for example at 28 weeks or weighs less than 1kg, then your child will need the care of a neonatologist until the child is more able. If the child has been discharged from hospital and is growing well and the parents choose not to go back to the hospital, then the parents will have to look for a doctor who is able to continue the care, and if possible, liaise with the first doctor who took care of the child. Or try to get the history from the first doctor so that there is continuity,” she explains.
If your child has special medical needs, you want to find a paediatrician who is comfortable treating the condition. It could be that the child is asthmatic or have an allergy or a heart condition.
Dr Yong explains that most paediatricians can handle cases like bronchial asthma. However, if the child has a complex heart disease then you may need to be followed up by a paediatric cardiologist at specific intervals. In between, if the child has cough and cold, you can just to stick to your regular paediatrician. In such instances, the child may have two followup visits – one for cough and cold, and the other with the paediatric cardiologist.
“If you're comfortable with a paediatrician and the paediatrician is able to refer you to the necessary specialists for the other problems then you don't have to keep going to different doctors. If your child has special needs like a heart problem, poorly-controlled asthma, metabolic problems, then it's important you get somebody suitably-qualified,” she says.
Dr Yong does not recommend parents hop from one doctor to the next for the obvious reason that the doctor will not have the child's complete medical history.
If it's because one clinic is closed and it's just a cough and cold, then it's okay. However, if it's because one medication is not working, then the parents should inform the second doctor what medication the child has been taking. Parents should also keep a list of medications that the child is allergic to or has had a reaction to and inform the new paediatrician of the name of that medication as well as what the child's reaction to it was.
Dr Yong explains that if the new doctor is updated on the child's previous medication then he or she can formulate the next level of management for the child's treatment.
If the child doesn't get better, it is not necessarily because the doctor is not good. It's not always the fault of the doctor or the medication. It may be that the child's symptoms are evolving over a period of time.
Dr Yong warns against changing doctors when it comes to the child's vaccinations.
“Supposing your child changes paediatricians each time they need to be immunised, then the records will not be complete. Come six years of age, and the child enters Year One in primary school, you may have a problem retrieving the records because they're essentially scattered all over the town.
“For vaccinations, parents should not leave all records with one doctor. They should make an effort to know what has been given to their child so that they can actually inform the next doctor rather than say they don't know what vaccinations their child has received,” says Dr Yong.
She adds that parents have every right to ask for more information about the vaccines – what is the brand, where it's from, etc.
She reminds parents that while relying on friends' and family recommendations for paediatricians is great for starters, they will still need to make up their own mind after that. Many a time one family may get along with the doctor but another family may not.
Dr Yong informs that these days, a number of doctors give out their mobile numbers in case of an emergency. This way, parents can just text the doctor symptoms of the problem, if it's something mild. This way, they need not go to the clinic unnecessarily.
However, if there is an emergency and it's after the clinic hours, the parents will still have to take the child into the hospital.
Dr Yong says that the best time to visit a paediatrician (assuming you can wait) is midweek when there are fewer patients. Paediatrician clinics tend to be fuller on Mondays and days after public holidays and on Saturdays when parents have time to take their kids in for vaccinations. Evenings tend to be busier than mornings because that's when parents come home and find that their kids are not well, as opposed to in the mornings, when parents go to work and the kids are off to school.
Tips for choosing a paediatrician:
1) Get recommendations from family and friends. However, keep in mind that a paediatrician who is given a glowing testimonial by a friend, may not necessarily be the best one for your family.
2) Ask the paediatrician about his or her background if you want to know if they have the right credentials to treat your child.
3) If your child has a specific medical condition, you may want to find a paediatrician who specialises in that illness.
4) Find a paediatrician you and your child are comfortable with and who will explain the problem and the treatment action plan to you.
5) Preferably don't switch doctors/clinics for vaccinations.
6) Keep your own records of medication that your child has had a reaction to and what the reaction was.
7) Keep track of the immunisation jabs that your child has gone for as well as where the jab was given.
8) Ask your paediatrician for his or her mobile number. If he or she gives it to you, use it sparringly. Do not keep calling your paediatrician every two days.
9) Ask your paediatrician what is the action plan if there is a medical emergency during and after clinic hours – should you bring your child to the clinic or go straight to the hospital.
10) Check out the location of the clinic, how long it takes to get there and the parking situation before deciding.