Breaking Up With Your Pediatrician

Dear Amy, my best source of non-judgy parenting advice,

I think it’s time to find a new pediatrician for my son, but need an objective ear to tell me I’m not over-reacting (or, if I am), and some advice as to how to avoid jumping from this doctor to another that will be just as bad (if not worse!).

Today was his 9-month checkup.  At this, and other appointments, my questions are answered not based on recent medical research, what the Academy of Pediatrics recommends, or early childhood developmental theory.  Instead, I get advice based on what her daughter did.

For instance, today I asked her, “From a developmental standpoint, is there a better age to start him in daycare; should we wait until he’s 2, or is 1 OK, or some other guidepost we should use besides age?”  Her response was, “Well, just make sure you don’t start him in winter, because he’ll get sick all the time.  We had to put our daughter in daycare for the socialization and I wish we hadn’t because she was just always sick.”  Like, thanks, not my question, and when I pressed further, all I got was,”well, he’ll cry the first few weeks, so just be prepared for that.”  I am prepared for that and, again, not answering my question.

(Incidentally, IS there a better age, developmentally, to start away-from-mama daycare?  I work from home, and am lucky enough that my employer is cool with it as long as I want to do it, but is there even an ideal age or developmental stage for that big of a transition?  Again, am I making a mountain out of a molehill here?)

When I asked if there was anything medical that could be causing his still frequent night wakings, she said, “well, when you’re ready, you’ll just let him cry it out.”  I do not think I will ever be “ready,” thanks for the condescension, though.

If I wanted that kind of advice, I would ask the parents at playgroup, for Pete’s sake.

That said, is this grounds for finding a new doctor?  The process seems so very overwhelming, especially because we were so cavalier about picking this current one – we picked the practice that came highly recommended by my OB, and she was the one we thought was nice during rounds at the hospital (or, should I say, my husband thought was nice – I wasn’t allowed in the too-full nursery due to baby lojac logistical problems).  I would love to have a doctor who is on the same page with me.  Short of moving us all to Southern California and begging for a spot in Dr. Sears’ practice, how do I make sure I “mesh” with the new doctor?

Thank you so very, very much,
A bigger wussy baby than my 9-month-old

Okay, so you know how you mentioned you dislike getting first-person anecdotes instead of professional-type advice? GUESS WHAT YOU’RE GETTING.

We found our original pediatrician through a recommendation from our neighbor — who was not someone I thought I had a lot in common with, parenting-philosophy-wise, though I was pregnant and hadn’t yet had all my parenting philosophies blown all to hell. All of my friends had recommended practices that didn’t accept our insurance and I was feeling fairly desperate because all my pregnancy newsletters had put “find a pediatrician” on the to-do list WEEKS before and our hospital’s information kit specifically said you couldn’t leave the hospital unless your baby had a pediatrician appointment made and OMG OMG OMG PANIC BZZZZTTTT.

But my neighbor recommended her pediatrician and lo and behold, they participated in our insurance. We attended a “new parents night” when prospective patients could come and meet a couple of the doctors and lactation consultant (it’s a biiiiig practice), ask questions and get all sorts of info, from their vaccination recommendations to after-hours questions/emergencies. The session was for expectant parents (ours was attended exclusively by pregnant couples, though our info packet also included lots of advice for adoptive parents, which I thought was nice), and we were sold on the spot.

And we loved the practice. Loved the doctors. Loved the lactation consultants. I found two doctors, in particular, that I liked the “best” and always arranged the well-baby visits and yearly physicals with, though we usually saw whoever was available for same-day stuff like ear infections. There was exactly one doctor who kind of bugged me at first (bedside-manner-wise, mostly), but still, just about every experience with the practice was overwhelming positive. I left every visit with my questions answered and my confidence level boosted. They always remembered little details about us that surprised me. They had a great website where I could get forms and information and even email with the nurses. We just clicked.

And then they got into a dispute with our insurance company. They gave up on resolving it and announced that they’d no longer be participating. Ezra was not even three months old and I seriously think I cried at our final appointment.

I asked my friends for recommendations — I started with the friends whom I thought I had the most in common with, parenting-wise, foolishly assuming I’d have that much of a choice. Turns out our insurance was thoroughly and completely HATED by every reputable pediatrician in our area, and I had very few options. Ezra still needed monthly check-ups and there wasn’t much time to make a decision. Just when it looked like I was going to have to close my eyes and point at a random name in our (slim) provider directory, I became friendly with a new preschool mother who loved loved loved her pediatrician and OH THANK GOD THEY TAKE OUR INSURANCE SOLD!

One problem: I could not stand that doctor. I mean, she was a fine doctor.  It was a fine, well-run practice. She just…rubbed me the wrong way, at every visit. Instead of a list of age-appropriate milestone questions, she always ran through the same list of questions about Things I Might Be Doing Wrong. Do my kids wear sunscreen? Do I check them for ticks? Do we own a car seat? Do we have guns in our home? (Seriously. Guns. EVERY VISIT, she asked me about guns. I’m sitting there breastfeeding my cloth-diapered baby in a sling telling her NO, WE DO NOT OWN A GUN for the fourth or fifth time, wondering why they hell she can’t just file her patients as GUN/NO GUN or something and be done with it.) I found her to be pushy and alarmist and our visits felt more like trials. She didn’t listen to me. I mentioned that Ezra was experimenting with water in a sippy cup and she immediately assumed I was giving him whole bottles of water every day and FUH-REAKED out at me and told me he’d have a seizure if I kept it up and then promptly changed the subject (PROBABLY BACK TO GUNS) before I could explain. I found myself turning to the Internet more and more for my developmental questions.

The final straw was when she enthusiastically recommended a feeding program to help Noah get over his texture issues, a program that she supposedly referred patients to “all the time.” But when I called said program, I found out it was only for critically ill kids, like kids coming off of stomach tubes who were learning to eat for the very first time. Um. Thanks for that great advice, doc.

So when Jason’s company sent around the new insurance network options, the very first thing we did was see if our old pediatrician participated in any of them. They did — with the very most expensive option. It did not matter. We picked that one and I hightailed it back with my kids’ vaccination records in tow as fast as I could. And I am once again so very, very happy.

Wow, that story went on and on, didn’t it? And my entire point is that if you don’t feel comfortable with your pediatrician, for any reason at all, SWITCH. It’s a really important relationship. It matters. If you feel like your questions aren’t being taken seriously or your choices condescended to, SWITCH. I actually don’t believe the “experts” have a perfect recommended age for a child to begin daycare — it’s not something people always have the luxury of controlling that much — so I guess maybe your doctor was just deflecting instead of just saying, “No, there is no ideal age, there are pros and cons at every stage, illness being a con and socialization being a big pro.” The cry-it-out thing — well, you’re never going to find anyone (doctor or otherwise) who agrees with you on everything, but I don’t think it’s too much to ask your doctor to be aware that CIO is not an acceptable option for a lot of parents and have a few more suggestions.

But really, those specifics hardly matter. You’re not happy. Move on. Are there other doctors in the practice you could see, just to possibly save yourself from the paperwork nightmare? If you like other things about the practice (front-desk staff, location, ease of getting appointments), it might be really worth it to try out the other docs and see what their bedside manners are like. It sounds like your doctor takes a “I’m your PAL!” approach, but you’d be happier with someone who exudes a more “confident professional” vibe.

If same practice/different doctor is not an option, start asking around. Start, like I did, with friends you already gel with about stuff like shots, CIO, etc. Ask what they like about their pede and what they don’t like (too traditional, too AP, a flaky front desk?). Then call the office and find out if they have any ways for prospective patients to learn about the practice, be it a website or a chance to interview the doctor/s in person. (I didn’t do this. That was probably pretty dumb.) You might fall in love on the spot; you might not and repeat the process a couple times. I feel like it’s very gut-feeling sort of thing, no matter what those “How To Choose A Pediatrician” online checklists might suggest.