5 Questions to Ask a Preemie’s Pediatrician

January 3, 2014

Some preemie parents haven’t selected a pediatrician prior to birth because they figured they had forty weeks to do so. I, however, had selected mine based on quite a bit of research. In retrospect, I hadn’t been asking the right questions at all. Preemies and preemie parents deserve to have special attention from their pediatrician and staff. You have been through enough and being thrust into a huge, impersonal, rushed pediatric office is not okay.

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Kate at Dr. Bell’s family picnic

Once we were discharged from the NICU, we were instructed to see our pediatrician within a week to ensure that weight gain was continuing. Because I had not met with the pediatrician prior to making the appointment, I was very distraught to find that her practice was in a huge office building, with an enormous waiting room. My daughter, Kate, was at 34 weeks gestation (meaning she should still be in the womb) and here we were riding the elevator with germy kids and sitting in the waiting room with dozens more germy kids.When we were called back to our exam room by the nurse, she asked many questions that were difficult to answer because of adjusted age versus actual age. And then the pediatrician entered. She was very rushed and extremely curt. No one took Kate’s temperature or weight during the visit. I am not kidding. They did, however, administer a couple of oral vaccines. And when Kate spit them out, they were not alarmed. They said she gets one shot at swallowing them and that was the end of that.

A week later I was in a panic. Kate had gone from pooping four to six times a day to not pooping for an entire week. It was nine o’clock at night and I couldn’t take the worrying any longer. Considering that this was my very first after-hours call, you can assume that I am not the first-time mom who calls the doctor every day at the drop of a hat. My call was answered by an after-hours answering service that took a message and passed it along. When my call was returned, the nurse on the line was calling from a call bank of nurses who were not even in the same state we were in. I shared my concern about Kate and read to her from the journal I kept on diapers and feedings. She sharply told me to throw away the journal as we were not in the NICU anymore. She said that it’s common for babies to go more than a week without a bowel movement. I tried to explain that it’s not normal for my baby, but she would have none of it. The call ended and I actually felt worse than before I called.

The pediatrician did not administer the Synagis/RSV vaccine onsite so I had to drive Kate to the huge Children’s Hospital to face dozens more sick kids every month to receive her vaccine. Luckily, we had the same, most incredible nurse practitioner, Nurse Jennifer, there every visit. SHE was the epitome of the medical professional I wish we could have had in a pediatrician. She always weighed Kate and took her temperature. She always asked how I was doing as a first-time mom. And she was the one who diagnosed Kate with having a skull abnormality. Yes, a concern about my baby’s HEAD.

I called the pediatrician to schedule an appointment to discuss this concern (that she should have noticed during Kate’s exams) and instead I received a return call from a scheduler to have her seen by a specialist at the Children’s Hospital. What? Wait a minute. One medical professional shares a concern and you don’t even want to see her before you send us to a specialist?

We went and saw the specialist and while we were in the Children’s Hospital, we stopped by Nurse Jennifer’s office and asked for a pediatrician referral. Enough was enough.

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Kate with Dr. Bell on Halloween 2008

She recommended a small clinic with a brilliant, compassionate staff. There were two pediatricians and they saw no more than 40 patients a day. The pediatrician she recommended, Dr. Bell, happily met with my husband and I (at no charge) to answer any questions we may have had prior to bringing Kate in. This smaller practice administered RSV vaccines onsite and after-hours calls were handled by the actual pediatricians and nurses who work there. Dr. Bell diagnosed Kate with torticollis on the first or second visit (which is common among preemies and went undiagnosed by our first pediatrician). We have been seeing Dr. Bell for six years and the same nurse calls us back to our exam room every time. Our visits with Dr. Bell never feel rushed and she is incredibly sweet and patient with Kate.

Initially, I was worried about switching doctors for a few reasons. Irrationally, I wondered if the first pediatrician would take it personally. Secondly, I wondered if it would be costly to transfer records. And lastly, I was worried that the records wouldn’t be fully transferred as Kate had a medical file that weighed more than she did.

Well I’m here to tell you that the first pediatrician probably never even noticed we left, the cost for transferring was a mere $25, and all of the records made it safely over to Dr. Bell’s office. If you are not comfortable with your pediatrician for any reason, LEAVE. Today. Seriously.

From one preemie parent to another, five questions to ask:

  1. May I meet the pediatrician prior to becoming a patient?
  2. How many patients do you see in a day?
  3. Are after-hours calls handled by your nurses and doctors?
  4. Do you administer Synagis/RSV vaccines onsite?
  5. Can you guarantee that we will be swept into a room within minutes of arrival due to the threat of RSV?

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