Recently, Lead PB101 Blogger, Kathryn Whitaker, sat down with Dr. Ari Brown, author, speaker and pediatrician based in Austin, Texas, and asked her to share some insight on finding the right pediatrician for your preemie, questions to ask and credentials the doctor should carry.
PB101: Dr. Brown, are there differences between a family practice doctor and a pediatrician when it comes to a preemie or a child with special needs?
Dr. Brown: Yes, although family practice doctors receive training in the care of young children, some do not feel comfortable caring for infants, especially those who have complicated medical issues. So, it is a good idea to interview potential physicians or at least inquire with their office about their policies regarding care of preemies.
PB101: Regarding that interview of a potential pediatrician, what things should a parent look for when selecting a pediatrician? Should a parent consider office staff, hours, waiting room, after-hours calls/emergencies and things of that nature?
Dr. Brown: You will want to find an office that is convenient, and makes it easy for you to get an appointment when you need one. Some offices offer extended hours and weekend hours, which is nice. But, at the end of the day, it is the relationship with the healthcare provider that is most important in selecting a provider. You want to feel comfortable asking your child’s doctor any question or concern you have, no matter how big or small. And, you want to feel that the provider is approachable and reachable when you need to ask a question.
PB101: What specific questions should the parent of a preemie be asking their prospective pediatrician?
Dr. Brown: Certainly, it’s important to know if there are charges for phone calls, after hours care, missed appointments. That is just general and applicable to all prospective patients. It’s useful to know who does the well checks, the doctor or a nurse practitioner. It’s helpful to know who to call after hours and where to go in an emergency.
PB101: If there are other pediatricians in the practice, should a parent always request to see their own? Why or why not?
Dr. Brown: It’s not always possible to see your own pediatrician for visits that are not scheduled ahead of time; well checks are planned, sick visits are not. Obviously, it is ideal to see one doctor who knows all your child’s medical issues. But, his or her partner can see your child and review your child’s chart to get a good idea of what his medical history is. But, this is one reason why it is really helpful for parents to have a medical passport of sorts, a summary or compilation of his medical issues, medications he is taking, etc. That way, the parent can always provide whatever medical history is useful to a doctor who is unfamiliar with your child, no matter where you are.
PB101: Are there certain credentials a pediatrician should have that would be important? Years of schooling or hospital privileges, for example?
Dr. Brown: Pediatricians need three years of residency training beyond medical school. They must pass a board certification exam every ten years to be “board certified” and a “fellow” of the American Academy of Pediatrics (AAP). And, all residency programs provide a healthy dose of time in the NICU! So, most of us feel very comfortable with issues that arise in the NICU and how to manage them once the babies graduate.
PB101: Because you mentioned the time you spent in a NICU during residency, should a pediatrician have relationships established with various specialists or not?
Dr. Brown: Medically complex babies may have several subspecialists who care for them. It’s important to keep the pediatrician in the loop so he/she can be sure all issues are being addressed. The pediatrician is there to handle general pediatric care as well as coordination of specialty care and we feel comfortable in that role. Most pediatricians in primary care have relationships with the specialists in their medical community.
PB101: Many of our parents have a general pediatrician, but some are referred to a developmental pediatrician. What’s the difference between the two?
Dr. Brown: Pediatricians provide well check care/preventative healthcare visits, as well as sick child visits. General pediatricians are trained in both developmental and behavioral pediatrics, so they are able to do basic assessments of a child’s progress through his milestones and catch up milestones in the case of preemies. Developmental pediatricians have additional fellowship training beyond pediatric residency specifically in regard to child development and developmental issues, differences, and delays. They do not perform well checks or sick visits. They do consultations, often with multiple specialties (speech therapists, occupational therapists, physical therapists, etc.) to determine a child’s developmental level and make recommendations for therapy.
Ari Brown, MD, FAAP, is the co-author of Expecting 411, Baby 411: Clear Answers & Smart Advice for Your Baby’s First Year and Toddler 411. She is an active spokeswoman for the American Academy of Pediatrics, an Advisor for Parents Magazine and a Child Health Expert for WebMD. Her television appearances include, The Today Show, CNN, Dr. Phil, Dr. Oz and the Rachael Ray Show and her writing has appeared in the The Wall Street Journal. Brown graduated magna cum laude from the University of Texas at Austin with a bachelor’s degree in child development. After receiving her medical degree from Baylor College of Medicine, she did her pediatric residency at Harvard Medical School/Boston Children’s Hospital. She performed additional fellowship training in developmental and behavioral pediatrics at Harvard Medical School under the tutelage of acclaimed pediatrician, T. Berry Brazelton, MD. She is board-certified and a Fellow of the American Academy of Pediatrics. In private practice since 1995, Brown is a partner at Capital Pediatric Group in Austin, TX. She teaches monthly prenatal and baby care classes, and volunteers with the Texas Pediatric Society, promoting children’s health issues through political advocacy. She is the mother of two and her family resides in Austin. You can find her online at Baby 411 or on her personal website.