Wednesday, February 13, 2008

Choosing an Infant Healthcare Provider

If possible, you should try to meet with several doctors before you have your baby. This gives you an opportunity to find out what they are like -- their style, their approach, their fees, and so forth. Most doctors encourage this and usually don't charge for the visit.

Note that if you participate in a managed healthcare organization (HMO, PPO, or others), your choices are limited to those doctors participating in your specific managed care program. You should still meet with a few of them, so you can choose from among those available through your insurance carrier.

If you already know you want to see a particular doctor, be sure he or she participates in your program. Otherwise, you may be responsible for charges which could have been covered under your insurance program.

Questions to Ask

When you go for the get-acquainted visit before your baby is born, you should bring a list of questions. The prenatal interview appointments usually last from 10 to 15 minutes, so you will not have the opportunity to discuss all your questions. Decide on a few areas that interest you the most and discuss those. Take notes, and follow up on any answers you don't understand.

Be aware of the doctor's style and how he or she answers the questions. Do you feel secure picturing this person as your child's health care provider? Are his or her style and philosophy compatible with yours?

Here is a list of some questions you might ask:

What hospitals do you use?

You may want to be sure the doctor uses the hospital you prefer. If he or she prefers a hospital far from your home, find out why. Perhaps that hospital offers special services or has a different approach to taking care of children. You may find the approach or services worth the inconvenience.


What hours is your office open?

With medicine becoming more competitive, doctors are doing more to attract and keep patients. This includes offering evening and Saturday office hours. If a doctor's office hours are inconvenient for your family, you may want to find another doctor.


What services do you provide in your office?

Many doctors now provide a number of services in their offices to make obtaining appropriate health care for your child more convenient for you. For example, they may take blood samples there to save you a separate trip to a hospital laboratory; they may even perform some laboratory tests at the office. Many doctors also perform hearing and vision tests in their offices. The more done in the office, the fewer places you may have to take your child. (Although, if an abnormality is found during a test conducted in the doctor's office, you may have to go to a hospital laboratory for further testing.)


Do you conduct all the examinations or do you use the services of physician assistants or nurse practitioners?

The presence of these physician extenders is really an added bonus. Remember that they often have more time to spend answering any questions you may have about your child's health and development. Unlike doctors, these professionals are not usually called away to handle emergencies, so you may have to spend less time in the waiting room. They refer any questions or problems to the doctor, so your child in no way receives lesser professional care.


What should I do if my child gets sick at night or on the weekend and I can't reach you?

Most doctors arrange to have other physicians cover for them when they are taking some time off or are out of town. Be sure the doctor has such a system. Find out who the covering doctors are because you may have to deal with them. Be wary of a doctor who tells you to take your sick child to the emergency room when he or she is not around.


How do I fit into the care of my child?

Some doctors encourage parental education and awareness and want parents to actively participate in the medical care of their children. They may even provide newsletters, pamphlets, or other educational materials or services to parents. Other doctors want to be completely in charge and make all the decisions without input from parents. You need to know the doctor's feelings in this area. If they conflict with yours, the doctor probably isn't right for you.


What type of training did you receive?

Any doctor should be willing to tell you about his or her training -- medical school, residency, and any special training. It is a good idea to ask if the doctor is board-certified -- that is, if he or she has demonstrated, by completion of certain requirements and passage of an examination, competency in a specialty. You may also want to ask what measures the doctor takes to keep up with the latest information and developments in the specialty. Does he or she attend conferences? Take continuing medical education courses?


What are your fees?

Different doctors may charge different fees for the same services. If you have health insurance, contact your insurance carrier to find out the extent of your coverage. Some insurance carriers reimburse at a higher rate if the doctor or hospital belongs to a specific network or organization. Find out about any such policies before you choose your baby's doctor.

After you have visited with a few physicians, talk to friends and coworkers. Find out what doctors they see and why. If they have a doctor that you visited, ask them the questions you asked the doctor (especially about service and availability), and see if you get the same answers. When you have all this information, you are in a position to make an educated decision.

Once you decide, let the doctor's office know. Find out if the office needs any information about you. If another doctor has any records of your children, arrange for them to be sent.

After all this work, there's still a chance you'll decide, after a few visits, that your new doctor isn't what you expected. You should discuss this with him or her. Try to explain why you aren't satisfied. Maybe a misunderstanding has occurred that is easy to correct.

Your doctor's reaction to what you say is important. If the reaction is anger or rudeness, you should look for another doctor. Don't feel obligated to continue to see a doctor with whom you disagree on some important matter, such as approach, treatment, or fees.

When you change doctors, you should get your child's old medical records. Contact the former doctor's office to ask staff to send the records to the new doctor. Physicians do this as a service to all patients. Most states require doctors to do this: The law says the contents of the records belong to the patient even though the actual records belong to the physician.

Most likely, you will be asked to send your request in writing and, to comply with federal regulations, to fill out a form allowing your child's former doctor to release the records to the new doctor.

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