Pediatrician acts as parenting partner

NEW YORK -- Parents approach the search for their children's doctors like it's a professional endeavor -- they research, they interview, they check credentials. Once pediatricians are chosen, however, parents treat them like part of the family -- calling at any hour and asking questions that really don't have anything to do with medicine.

"Parents rely on their pediatricians for so much more than care for pink eye or a cold. We're much more of a partner. We talk about sleeping problems, nutrition, discipline, safety, development," says Dr. Jennifer Trachtenberg, of Carnegie Hill Pediatrics in Manhattan.

Trachtenberg says she's a partner in the parent-child-doctor triad.

"When I started, I probably didn't know that I'd be so close to the families, I'm now 'friends' with so many of them. But I knew from the beginning that pediatricians take on two patients at once: moms and kids," Trachtenberg says.

She adds: "I also see a lot more dads than I thought. Sometimes moms and dads come together, sometimes dads come alone with their kids."

Better informed

Trachtenberg says proactive parents who do their homework, studying up on symptoms on the Internet or at the library, are good for children and good for doctors. Doctors armed with information make better diagnoses and recommendations, she explains, and parents will feel empowered to make better decisions because they won't feel that they're being talked to in a language they don't understand.

But parents also need to have enough confidence in their pediatricians to trust their advice, Trachtenberg says. That's why a compatible partnership is so important, she says.

According to a new survey taken by iVillage, a Web site that features content aimed at women, personality was a top consideration for mothers in selecting a pediatrician. Health insurance was the No. 1 factor.

Almost four in 10 expectant mothers selected their pediatrician before becoming pregnant.

Trachtenberg, who also is a clinical medical instructor at Mount Sinai Medical Center, says finding the pediatrician that best fits your family makes sense since the doctor is one of the first people a baby will come into contact. A pediatrician also helps see children through many social, emotional and physical developments as they grow into young adults.

Visits for vaccinations

Children generally make more frequent doctor's office visits than adults, and that's especially true of infants and toddlers. And nearly every one of those visits include vaccinations, making immunizations the most talked about topic between pediatricians and parents, according to the iVillage poll of 1,031 women with children 2 years old or younger and 87 expectant mothers.

Most mothers realize those shots are a necessary evil but that doesn't make them feel better when they see their kids in pain, says Trachtenberg. What's surprising to Trachtenberg, though, is that more mothers don't ask if there is anything that can be done to cut down on the number of frequency of shots.

Some doctors will offer combination shots, putting several immunizations into a "single serving."

Pediatricians might not think to suggest combination vaccines if parents don't speak up about their concerns, Trachtenberg says.

She suggests parents come to all appointments armed with a list of questions, comments and issues. "Once you're there, and the baby is crying, you'll forget all the things you meant to ask. If you have written questions, you're much more likely to get the answers you want and need."

And parents shouldn't limit themselves to cut-and-dry queries about illness, Trachtenberg says. They ask open-ended questions about new options, procedures and technologies.

Being a mother herself, Trachtenberg says she tries to pick up on subtle clues about what parents are thinking about.

"I even try to address some of these 'silly questions' before parents have to ask," Trachtenburg said. "If parents say they have a picky eater, I'll show them the charts that show their child is growing beautifully. If a mother has a baby who sleeps through the night wonders if the baby is getting enough to eat because all the other babies she knows wake up and cry, I'll say, 'Never wake a sleeping baby. You are one of the lucky ones!"'

Tips to finding a good pediatrician

The Associated Press

Dr. Jennifer Trachtenberg, a New York pediatrician, teamed with the Web site iVillage.com to suggest tips for parents looking for doctors who will be a "partner" for their families:

Don't wait, start looking early. It's wise to begin looking for a pediatrician during the second trimester of pregnancy, allowing enough time to interview several candidates.

Get recommendations. The best way to find a pediatrician is to ask your friends, relatives and neighbors. If you are new to your neighborhood, it's a good idea to ask the local hospital, your obstetrician-gynecologist or your insurance company.

Don't settle. In many ways, your pediatrician will become one of your most important health care advocates. Choose the one that best matches your child care philosophies, complements your personality and offers practical advice.

Determine what your preferences are. Would you rather work with a solo or group practice? A new practice or an established one? What's the physician's hospital affiliation? Is the pediatrician a member of your insurance plan? How far is the office from your home or workplace?

Interview. Ask questions about a doctor's philosophy on child rearing, views on breast-feeding, circumcision, sleep habits, antibiotics and prescription drugs, and immunizations. Then ask yourself, can you live with the doctor's answers?

Learn about the doctor's office and staff. Ask about hours, scheduling, who returns phone calls.