Advice from one of our contributing pediatricians, Dr. Gilgoff:
Choosing a pediatrician is a very important decision.
The birthing process itself will be much less stressful if you know that your baby has someone waiting to help oversee his or her health and well-being starting at birth. I encourage expecting parents to come in and meet me for a prenatal consultation. It means a lot for parents to get the right energy or “vibe” from the doctor, the staff, and the office. You will need to know that you won’t have to wait too long, especially with your newborn, and that your phone calls will be returned quickly, whether it’s 3 p.m. or 3 a.m. And you won’t want to feel rushed, especially during those first few visits. I expect and encourage parents to bring a long list of questions.
Pediatrician Bedside Manner
With a cardiothoracic surgeon, perhaps bedside manner isn’t as important. But your pediatrician needs to be someone who is empathetic, nurturing, patient and kind. They need to understand that as a newborn parent, there is no such thing as a bad question, and they should be available for you by phone or in person when you are concerned.
Moreover, you want to make sure your pediatrician is well-versed in all of the “bread and butter” topics that will come up in childhood. From the very beginning you’ll need support in nursing, achieving that correct latch, checking for tongue-tie, and avoiding thrush. You’ll want to know that your pediatrician has read all the books out there, but that they also have seen thousands of newborns so that they can give you the “nitty-gritty”, and what actually works. You can really stress yourself out being a new Brooklyn parent nowadays! So you’ll want your pediatrician to help you keep everything in perspective, and yet to provide guidance and direction when needed for nutrition, starting solids, and of course, the all-important topic of sleep!
What Makes a Pediatrician?
While most children are indeed healthy, and get over their fevers or bruises, you do need someone who is there for you “just in case”. There are unfortunately both minor and major obstacles that you’ll face as a parent. In the beginning, you’ll likely see a little weight loss and a little jaundice in the newborn’s first week. You want the pediatrician to guide you, educate you and reassure you when possible. But you don’t want them to miss anything either. At some point, you are likely to encounter the first fever, and in that moment it seems like a true emergency. Your child is burning up, looking a bit lethargic and just not themselves at all. Each fever is a unique challenge, and while most are harmless but stubborn viruses, you don’t want to miss a urinary tract infection or appendicitis or Kawasaki’s disease.
So while we all aim to be “non-interventionists”, you need to know that when intervention is indeed necessary, you are in good hands. We all aim not to do unnecessary blood tests, or x-rays or antibiotics, but there are times where we do need to explore, or rule out diseases that could be serious. So whether it is a new rash, a mild heart murmur, or even something that has already come up on the prenatal sonogram, you need to make sure you are working with a seasoned balanced intelligent physician.
It is therefore crucial that, when choosing a pediatrician, you find out if the doctor is a well-trained, experienced, and hard-working professional. It is actually important where a doctor received their training, as a residency in a top academic institution allows for exposure to a true diversity in patients and diseases as well as guidance from top experts in the sub-specialty fields, including development, cardiology, dermatology etc.
And experience certainly matters. We all have to start out with our first job. But when it comes to giving advice on the bread and butter pediatric topics, as well as guiding an intervention or treatment for a sick child, you want someone who has a lot of experience under their belt. Each year I see around 5000 new “cases” or visits, and after 18 years, this is nearing 90,000 child/parent/doctor interactions. We are always learning, as each child is different. But the proper level of comfort often allows a doctor to achieve that balance, and not be overly aggressive, while making the correct diagnosis quickly and efficiently.
The Office and Staff
You want a friendly efficient office. When you do call, you want to make sure you can get an answer back the same day, and moreover that there are open slots for same day sick visits. Adults can sometimes wait – children often can’t! You want good extended weekday hours, and of course weekend hours are a huge plus. You want there to be a good plan for after-hours care, and you want to know where to go just in case there is a middle of the night emergency.
You want to make sure you can usually see your main pediatrician, but you also want to make sure the other pediatricians in the group are also amazing doctors. With your ob/gyn or midwife group you are encouraged to meet everyone as we don’t know who will be on call when you go into labor. But with your pediatrician you want to get to know each other over the years – ideally until they are done with college! So your goal is to have your pediatrician available every day or most days during the week, and usually all check-ups are booked with that same pediatrician.
You want the nurses and support staff to be courteous and friendly and most of all efficient. You’ll have forms for school, quick questions in terms of dosages of medicines, or just a request for a same day appointment, and you want to make sure your office provides excellent customer service – something that wasn’t always a point of emphasis in the old days of healthcare!
Hot Pediatric Topics, such as Antibiotics and Vaccinations
There are so many hot pediatric topics, from avoiding germs and allergies, when to start solids, to circumcisions, rashes and asthma. Again, I think it’s important that your pediatrician has “been there and back” – and has many years under their belt. I think it’s important to feel your pediatrician respects your values and your judgment, and views this as a relationship – being a member of the team – rather than the boss or dictator.
With regards to antibiotics, all medicines, and even vaccines, I prefer the body to heal itself naturally. So when there is a viral illness, even with a high fever, I believe in providing symptomatic relief to your child and avoiding antibiotics. But there are some very strong and powerful germs out there, and babies can suffer and even die from bacterial meningitis, pneumonia, and urinary tract infections that spread. So if the situation requires it, I will strongly recommend the correct medication or antibiotics.
Along those lines, we need to realize that vaccines are a major method of disease prevention and have been enormously successful in reducing and even eliminating diseases. I understand completely the concerns that parents have regarding possible side effects or links to other conditions such as autism. But when you look at the double-blinded studies involving kids who did and didn’t receive the vaccines, there just isn’t any link to autism, and vaccines are definitely the lesser of two evils. (Check drgilgoff.com for more information on this topic).
Dr. Gilgoff has been working with children since 1986, and has been a pediatrician since 1996. He is available for free, detailed (often one hour long!) prenatal consultations, as well as second opinions and same day sick visits. Read more about Dr. Gilgoff at www.drgilgoff.com, or call 929.210.6000.