Posted in Parenting

What Makes A Good Pediatrician?

On Wednesday, Little Dude had his 6 month appointment at the pediatrician’s office.  This was our fourth well check since his birth and though I love the clinic and staff and rather like the woman, I found myself questioning whether I should stay with her or find another.  Not that I think she’s a bad doctor, only that perhaps I may be happier with her if some small things were different.  Perhaps an example would help make my point.

Yesterday’s appointment looked like this and is a good example of what typically happens:

We arrive at the clinic on time and register with the receptionist who smiles at my son and greets him telling him how handsome he is.

A nurse comes to fetch us and after exchanging civilities, asks me to undress my son so that she can weigh him.  She comments on the cloth diaper and shows him a stuffed animal as he is seated on the scale.  I then put the diaper back on and then my son length and head circumference are measured upon which time I am prompted to wrap him up in a blanket and go back into the waiting room.

We are then called in to the pediatrician’s office.  I am greeted with a warm smile and again we exchange civilities before getting down to business: “Hello, how are you doing?”, she asks.  “Oh we are doing pretty well, aren’t we Charles?  Except, we’ve been having some trouble with nighttime sleep this past week”, I answer.  “Good, good”, she answers while she looks through my son’s health booklet.  “I see you’re still breastfeeding”, she adds “do you have enough milk?”, she asks.  “Absolutely”, I answer.  After all, we get a plentifully wet diaper each time he nurses.  She nods.  “And how are solids going?”, she asks.  “We haven’t started yet.  We were actually going to start today at lunchtime”, I answer.  “Oh”, she replies as she looks back down upon her growth chart, “well that’s good, he just barely gained the acceptable amount of weight since his last appointment”, she adds.  I was floored.  Did she not understand that my son had been exclusively breastfed for six months.  Does her chart take into consideration that at the same age, most babies have already started solids around here?  I think not.  Doesn’t she know that typically, in breastfed babies who went through a rapid weight gain in the first months (as was the case with my son) that the weight gain slows down after a few months?

She gets up and gestures towards the examination table.  As I rise to bring my son there, she looks back down upon her file: “how’s his eczema?, she asks”.  “Oh, it has cleared up”, I reply.  Once my son is seated upon the table, she examines him (or tries to) as he attempts to grab everything to put it in his mouth – stethoscope, tongue depressor, that thing you use to check the ears – and so begins my monologue to my son, explaining what is happening and why.  She puts him on his back and presses his tummy, stretches and folds his legs, removes his diaper to check if everything is OK there.  “Everything looks good,” she says, “come back in three months”.

That was it.  In and out in five minutes.

As I was driving back home I couldn’t help but wonder.  Shouldn’t she at least be asking if he’s able to roll over?  Shouldn’t she be inquiring as to how we’re introducing solids?  Shouldn’t she be talking to him, at least a bit, as she’s examining him?  Shouldn’t she be taking into account that he had not had anything other than breast milk for 6 months before telling me that her standardized growth chart indicated that he’d just barely gained enough weight?

I don’t know, perhaps I am being overcritical.  I know that I’m doing a good job as a mom.  I know that I shouldn’t worry about the fact that his weight gain has slowed down (he gained 2.25kg between 2 weeks and 2 months, 1.43kg between 2 months and 4 months and .79kg between 4 and 6 months); my son is content after feedings and showing no signs of being undernourished.  I also concluded that our difficult week was due to a growth spurt/wonder week/ 3-2 nap transition.

What do you think?  What are your experiences with pediatricians?  What makes a good pediatrician?

Author:

Thirty-something year old discovering the joys and bumps of motherhood.

23 thoughts on “What Makes A Good Pediatrician?

  1. This is really interesting, and I always wonder about the growth charts and doctors looking purely at the growth chart to determine whether the child is putting on enough weight or not enough – I think, like you’ve said there are a lot of factors that influence this, and provided he is healthy and feeding as normal, you shouldn’t worry. It would have been nice if your pediatrician to have been a bit more thorough though.
    Hopefully your next appointment there will be some improvements with how helpful she is!

    1. It’s not an easy call. On the one hand, I know that doctors here are swamped and I imagine that if there were indeed something wrong with my son, that she would take more time with him. I figure that it’s a good thing that I read a lot, otherwise, I probably would have been worried about his weight. But then again, if I didn’t read a lot, I would have started him on rice cereal at 4 months like everyone else around here…

  2. Oh I understand how you feel. We are on our third pediatrician and I don’t look to her for behavioral guidance or about breastfeeding.co-sleeping etc. I thought about switching too but I’m not sure I can find a doc with the same child philosophies as me. It can be frustrating though!

    1. One of the reasons that I hesitate is that it’s hard to find a doctor here, period, let alone one that would share all of my philosophies. Plus, there’s the fact that I need a prescription (or referral, rather) for a pediatrician… I suppose I just have to have faith that if there’s something serious with my kiddo, she’ll know what to do and that she’ll actively listen if and when I have genuine concerns.

  3. The growth charts are a bunch of nonsense. If your child has wet diapers and is gaining weight, he is doing well. Your doctor does not necessarily sound bad, she just sounds like she does not care. To not even interact with your little one is just not right. That is your doctor’s job!

  4. Since our run in at NICU in her first weeks of life, my husband has become a pro at pushing doctors to giving us more attention by asking for recommendations or schools of thoughts on how we’re choosing to raise our daughter. Our pediatrician is pretty good, too. I know she looks more deeply into Baby Girl’s health because of the circumstances surrounding her birth, but the lesson I learned is to not be afraid to ask for recommendations in order to get a better picture of the doc’s philosophy.

    1. Sound logic and definitely something I’ll keep in mind for the next visits. I’ve always been like that for myself, but with my son, it’s different. I guess I’m turning into the overprotective parent I swore to myself I wouldn’t turn into hehe.

  5. Our pediatrician was really concerned about my daughter’s weight gain for awhile because she wasn’t gaining anything, just holding steady and staying a petite little girl. I knew she was fine and just built like me (I have never weighed over 100lbs except when pregnant – just come from a family with very high metabolism) but it took several tests to confirm my own “diagnosis” with the dr. Sometimes doctors are just way too rigid with the growth chart (I should technically still be in a car seat according to some states and that’s crazy since I’m an old lady now). I also have a kid who is in the upper 90th% and practically as big as his sister who is 3 1/2 years older than him. Every kid is different. If you aren’t worried (you know your child the best so you would know if you needed to be) and he’s not losing weight, the dr. should be fine with that. My experience is that older doctors tend to be more laid back about things because they think they have seen it all, which can often come across as arrogant/non-caring, even though I hope they don’t actually feel that way, and younger doctors tend to be more anal about all of the rules (most likely because they are scared of law suits). There are pros and cons to both approaches, but sadly, not many other options. I now love the dr. that wanted my daughter to be tested for weight issues now that we have worked through that together and have always been “guided” with reminders about solids and asked questions about natural milestones like rolling over and sitting up though. Even if your child hasn’t done it yet (which is fine because again, every kid is on a different time table), they should still ask at the appropriate average time just to have that in the records. If you have concerns, don’t be afraid to ask the dr and make her spend time with you to address everything you might have questions about. Sometimes they are just in a hurry because we all know how backed up places can get but they should still take their time with you if you need it! Maybe you just caught her on a bad day? I hope so because it’s always nicer to have someone who interacts with your child, especially when they start getting older. 🙂

    1. (Hehe, adult booster seat – petite indeed!) I think you have a point about a doctor’s age. Our pediatrician is on the older side of the spectrum and perhaps he lack of care facade is just her way of expressing that she is not worried with my son’s health or development.

  6. You may want to keep an eye out on the rice cereal. It didn’t give our son any issues with feeding to speak of, but sometimes with babies it has been known to cause problems with constipation. Our doctor had us feed our son oatmeal instead, and eventually just told us not to give him cereal without combining it with a serving of one of the “p” fruits. (pears, peaches or prunes) which are best at keeping babies regular.

  7. Ugh! That does sound annoying yet horrible. I figure no pediatrician situation is going to be perfect….I have been fairly happy with ours so far – ours is a practice of 4 doctors – I really like two of them and am only so-so on the other two – you can request specific doctors but I don’t. I like that they are very available for calls and help over the phone when I have little questions (ok, freak outs!). We have been trying to slow down the immunization process (ie get only one at a time) and 2 docs gave us some push-back on that which was annoying (after all I figure it’s more money for them the more appts we have to make) Over all, they have been very attentive, you can get appts when you want them, and I have been impressed by the front desk staff (and yes that is partly because of their compliments of our little guy 🙂 )

    Great post! BTW, ours hasn’t been gaining as much lately either – they told me this is partly bc he is sleeping more…and we are sneaking up on solids – I put the high chair in our kitchen, eek! Thinking we’ll try something in the next few weeks…

    1. Interesting that you don’t have an appointed doctor for your son, but it must be really nice to be able to see different practice styles and various point of views. But you know, one of the things that I do like about the clinic is how cheerful and chatty the receptionists are with me and with my son. Congratulations on the upcoming solids (and longer nights ;)), we also began our introduction to solids with our son just joining us at mealtimes.

  8. Doesn’t sound like you have a winner there… our pediatrician would recognize us on the street! She plays with Kolby and talks to her while doing her checks, still asks me about her bowel movements and actually acknowledges my concerns (this time was naps & eating times) and offers explanations and recommendations and stays as long as I need her to, always asking if I have any other concerns before she goes.
    Seems like you have what I’d call a “wham bam thank you mam” type of doctor… ones that treat the patient like a number without any consideration to circumstances concerning their patient… all numbers, averages and met/not met expectations.
    My Kolby gained just a little weight since her 4 month appointment (she was at the 51st percentile and now is down to the 33rd) and even though we’d been doing some solid foods for 3 weeks (not much – only once a day), my pediatrician reassured me that although the % went down, she still gained and that this was OK because she’d been a breastfed baby and to just “keep it up”.
    She even agreed with me about skipping the rice cereal as she did the same with her babies.

    1. Sounds like you have an awesome pediatrician! And yes, I do feel like we just seem to be a number in her day. Then again, I suspect that if there were genuine cause for concern she would let me know and if I came with questions she would take the time to answer them.

  9. I’d probably find someone else. I like my ped who is SUPER laid back about things like I am, but he does spend time talking with both of us and checks up on motor/cognitive development regularly. Sometimes visits seems pretty quick, but when there isn’t anything wrong and we’re just making sure he’s on-track, I don’t fret about it too much. All of my questions are addressed, my ped is not judgmental, and doesn’t treat me like an idiot. He also has kids of his own so can speak from experience. I sort of stumbled upon this ped and am super happy with him. If he wasn’t living up to my expectations, I’d switch in a heartbeat after asking more questions about why certain things were/weren’t happening.

    1. Thanks for your comment. I actually would find another pediatrician if that were an option. ‘Round here, you need a referral from your GP or OBGYN for a pediatrician and if I wanted another one I’d need to move away pretty far to warrant a new doctor (pediatrician or other).

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