Pedi question.

kelly422

03 mo lurker.

I'm a Pedi. I just finished residency and am starting my first job next month! I have done a lot of clinic, but I just wanted some feedback from parents so I can do my best now that I'm on my own! What things do you like or dislike about your doc and your Pedi office in general?

TIA!

ChristyML

The nurses have to be really nice and kind and actually care about my child, or I will find a different pedi.

Also, my son was circumcised, and my husband and I were not taught correctly how to pull the skin back down. The pediatrician didn't really show us, and I thought we were doing an okay job. When we switched, our new one did it to show us, and he ended up having to break the skin again, and I feel just awful about how we weren't doing it right, but its our former pediatrician's fault. So basically, if you're going to tell the parents to do something to their child (like pull the skin of the penis back down) show them how to do it first.

The reason we switched pediatricians was because our former one didn't seem to give a hoot about our son's yeast infection, and we had to visit the pedi every week just to check on it. It took him 4 weeks before he prescribed something, and then it went away like "that". Our former pedi also didn't seem to have time for us, and his bedside manner was a little too laid back for me (he would crack jokes all the time), and he never gives shots, he always makes the nurses do it because he doesn't want to make kids cry.... 

Katie829

I think that as a pedi you should encourage RFing until 2. I have seen on here plenty of pedi's who are telling them to switch at 1 years old. I think you need to tell them the facts, no legs will be broken, etc.

kelly422

ChristyML:

The nurses have to be really nice and kind and actually care about my child, or I will find a different pedi.Also, my son was circumcised, and my husband and I were not taught correctly how to pull the skin back down. The pediatrician didn't really show us, and I thought we were doing an okay job. When we switched, our new one did it to show us, and he ended up having to break the skin again, and I feel just awful about how we weren't doing it right, but its our former pediatrician's fault. So basically, if you're going to tell the parents to do something to their child like pull the skin of the penis back down show them how to do it first.The reason we switched pediatricians was because our former one didn't seem to give a hoot about our son's yeast infection, and we had to visit the pedi every week just to check on it. It took him 4 weeks before he prescribed something, and then it went away like "that". Our former pedi also didn't seem to have time for us, and his bedside manner was a little too laid back for me he would crack jokes all the time, and he never gives shots, he always makes the nurses do it because he doesn't want to make kids cry....nbsp;

Thanks! That's good to know. Maybe even having the parents demonstrate in front of me so they will feel comfortable doing it at home.

Giving shots is actually something that we never do in residency. It has always defaulted to nurses in every clinic I have ever been in, and it will be in my clinic, too. The doc probably said that to joke around.

I think a lot of times it comes down to personality fits but it's good to hear Feedback from people!

kelly422

Katie829:

I think that as a pedi you should encourage RFing until 2. I have seen on here plenty of pedi's who are telling them to switch at 1 years old. I think you need to tell them the facts, no legs will be broken, etc.

Every Pedi should be recommending this! It's awful that they aren't!

kelly422

LalaMama81:

It doesn't matter how awesome the doc is, if the office isn't run well, I'm out of there. This includes any issues w/ the receptionists, office managers, nurses, etc. It also includes wait times. I'm not waiting more than 20 minutes total in the waiting room and exam room for you. My time is just as important. If the wait time is routinely that long, the office is being mismanaged.nbsp;nbsp;

I agree. I did two clinics in residency on a regular basis. One was run well and I enjoyed that one. The other was incredibly inefficient and it drove me crazy!

I also plan on having a rule about patients being late, too. Many times, late patients are what contribute to a late doctor. Would you all be offended if there was a late policy posted? What if you were late and told you had to reschedule?

dufferoo

I love love love a knowledgable doctor, but I still like him to respect my right to make my own decisions as a mom. For example, I totally get that most doctors think everyone should get  flu shots, and I want to hear your recommendation and reasons why, but at the end of the day, I don't want a guilt trip if I decide to opt out. Same thing with co-sleeping or baby led weaning, etc.

JoNi2010

When I took my 11week old to the pedi urgently because he had a fever, the staff and doc were so nice and comforting.  The next morning, the pedi actually called me to make sure he was ok.  Now, I don't know if this was because he was less than 3 months or because I also worked in the healthcare field (and in the same hospital).  But that was just extraordinarily nice and I still love my pedi and his staff.  He is also just so relaxed about everything - he does not judge about me EBF'ing, nursing LO in middle of the night, etc. The only thing he told me he really pushes for are vaccinations, which I totally agree.

JoNi2010

kelly422:

LalaMama81:

It doesn't matter how awesome the doc is, if the office isn't run well, I'm out of there. This includes any issues w/ the receptionists, office managers, nurses, etc. It also includes wait times. I'm not waiting more than 20 minutes total in the waiting room and exam room for you. My time is just as important. If the wait time is routinely that long, the office is being mismanaged.nbsp;nbsp;

I agree. I did two clinics in residency on a regular basis. One was run well and I enjoyed that one. The other was incredibly inefficient and it drove me crazy! I also plan on having a rule about patients being late, too. Many times, late patients are what contribute to a late doctor. Would you all be offended if there was a late policy posted? What if you were late and told you had to reschedule?

If they ran on time most of the time and I came in 15min late, sure, I get it, I have to reschedule.  I do also understand that docs can run into emergencies even in their offices and that once in a while, I may have to wait a long time.  But if a doc was consistently late in seeing me, then they better not reschedule me for being 15minutes late.

kelly422

jociejones:

I love love love a knowledgable doctor, but I still like him to respect my right to make my own decisions as a mom. For example, I totally get that most doctors think everyone should get  flu shots, and I want to hear your recommendation and reasons why, but at the end of the day, I don't want a guilt trip if I decide to opt out. Same thing with co-sleeping or baby led weaning, etc.

All I can do is educate and it's up to the parents to decide what is right for them  

kelly422

JoNi2010:

When I took my 11week old to the pedi urgently because he had a fever, the staff and doc were so nice and comforting.  The next morning, the pedi actually called me to make sure he was ok.  Now, I don't know if this was because he was less than 3 months or because I also worked in the healthcare field (and in the same hospital).  But that was just extraordinarily nice and I still love my pedi and his staff.  He is also just so relaxed about everything - he does not judge about me EBF'ing, nursing LO in middle of the night, etc. The only thing he told me he really pushes for are vaccinations, which I totally agree.

I'll be in a small town, so I think it'll be pretty easy to give more "personalized" care! 

ChristyML

kelly422:

jociejones:

I love love love a knowledgable doctor, but I still like him to respect my right to make my own decisions as a mom. For example, I totally get that most doctors think everyone should get  flu shots, and I want to hear your recommendation and reasons why, but at the end of the day, I don't want a guilt trip if I decide to opt out. Same thing with co-sleeping or baby led weaning, etc.

All I can do is educate and it's up to the parents to decide what is right for them  

I think the point she was making though, was that, don't give her crap for her choices, which is a great thing in a pedi.

Another thing: We do not do any shots (for very good reason), and I told my former pedi that we would not be doing any ever. He just said "oh, okay" in a sort of offended way, but didn't say anything about how I should be making better choices for my son. The next appointment, he said "now the shots he will be getting today are..." and I interrupted him saying that we weren't doing shots...I had expected him to write a note in our chart or to remember something like that...I was pretty offended.

I have yet to see if our new pedi remembered or wrote a note for next time (we only have seen him once for a check-up).

So, remembering and/or at least writing a note in the child's chart about something important and out of the ordinary (like no shots), is pretty important. 

smileybabyboy

I wouldn't be offended. I think it's fair that the parents should be on time. 

beckcour

I really like our pedi. I like that at every appointment she asks at the end of the visit, "Now what would you like to discuss/ask/talk about?" I love their extended hours which I know would not be great if you were an only doc in the practice. DD had pinkeye and an ear infection last week and we called at 8 am on Monday and they got her in at 9:15. All the docs in the practice seem really caring. Love them.

beckcour

I should have added that I would love a doctor that makes people reschedule if they're late but in reality it may be a hard practice to follow. I work for a doctor's office and people are late all the time. Granted, we are mostly a walk in clinic but we still have some scheduled appointments. It seems like the people who are the latest are the ones who complain the most when they have to wait. In short, make a policy that works for your practice but no matter what you do someone is going to complain.

aylafsu88

LalaMama81:

It doesn't matter how awesome the doc is, if the office isn't run well, I'm out of there. This includes any issues w/ the receptionists, office managers, nurses, etc.

I agree.  We love our office because the staff is amazing.  They are very helpful and always friendly. As a FTM some of my questions may be silly or unlikely to happen but the staff are always informative and nice.  The other thing I like is that they have a nurses line during the day.  I can call with a question or concern and the nurse will evaluate the situation.  If it is an emergency then she gets me in to see the doctor, if it is not she tells me what I can do to help LO.  As a FTM that the nurses line has been a huge help!  Our pedi is wonderful and very friendly.  She personally calls to follow up if LO is very sick or dealing with a concerning issue.  My LO had RSV when she was 4 months old.  It was very stressful and she stopped eating much.  We saw the pedi for an appointment or she called every day for 5 days to check on LO.  It was nice to know that she really cared about her!

kelly422

Thanks, everyone!  Good tips

Kissty

Hi, good luck in your new practice.  I'm responding a little late but...Please have a good bedside manner and do not blow parents concerns off as "babies do that".  Educate the parents.  I want someone who will tell me "The AAP reccomends... As a parent I recommend..." being a FTM seems to be trial and error many times and good advice is invaluable.  As previous posters have said do not try to guilt trip the parents if they chose a different parenting style (attachment, bed sharing, BLW).  Please learn about those so that you can help and educate them. I am not comfortable with CIO yet my pedi continues to suggest it even after I told him that I am not comfortable and have not asked for sleep advice.  Make sure you have a great staff.  If your staff aren't friendly and supportive you will lose clients no matter how good you are.  Again good luck and thanks for asking what parents are looking for.  You sound like you will do just fine

jnnfrrose6

One thing I like about our pedi is that they do the shots in a separate room from the exam rooms.  They say it's so the kids don't begin to associate the exam rooms with shots and get worked up.  We're not at that point yet where he would know the difference, but I've seen the older kids there, and I can tell it's nice that they have that separate space.

twinkletoes3126

My favorite thing about my pedi is that they never rush me. They always answer all of my questions. This goes hand in hand with my least favorite thing, I am always waiting forever. Sometimes 45 minutes for a regularly scheduled appointment. I know this is because they don't rush people though.

cmrand4

Like pp'ers,  because the office staff/reception is attentive, efficient, and friendly.  Also like the dr himself because I was impressed with our first visit.  He took a good chunk of time to get to know me and my husband as parents and really takes time to explain things.  It's not a 'diagnosis and dash' kind of feeling.  Always ask what my concerns or questions are at every visit. He has a calming presence without having a condescending tone. 

bigbootyjudi

LalaMama81:

It doesn't matter how awesome the doc is, if the office isn't run well, I'm out of there. This includes any issues w/ the receptionists, office managers, nurses, etc. It also includes wait times. I'm not waiting more than 20 minutes total (in the waiting room and exam room) for you. My time is just as important. If the wait time is routinely that long, the office is being mismanaged. 

 

EXACTLY. This goes for any doctor. My old OB was notorious with this and I switched. Just remember, you're replaceable. As harsh as that sounds, there are thousands of other doctors that do exactly what you do. 

Other than that, just simple, expected things; keep your research up-to-date, provide paper resources for parents who may doubt what you/the AAP recommends, and don't overbook yourself. Call back in a timely manner, don't recommend rice cereal at 4 weeks old, and don't put aside a parents concerns just because you don't "think they're right."

GEM529

I would love it if my Pedi office had a sick and well space.  Right now we all just sit in the same waiting room.  I get so nervous when I have the baby there for a well check up and other kids are sitting around coughing.  I would also like certain check up rooms for well check ups and sick appts.  I am sure DD got thrush at 9 months from the appt room we were in.  We went in for her 9 month check up and she was fine... two days later she had thrush.  She probably touched something that another baby had put in their mouth. 

Mrs.RockyM

I think parents should call if they're running late, Especially with babies it does happen.  There's always something that prevents you from getting out the door on time (they need to eat, they spit up over themselves, there's a poopsplosion) and I don't think parents should have to reschedule - maybe a fee or something would be better. 

ec0983

my ped's office has several doctors.  when DS was first born, i didn't care who i saw, as long as he was seen.  now, i always request the same doc, and for several reasons:

1. she has never made me feel like an idiot (unlike one of the other doctors at the practice).  she listens to what i have to say (even if it's a crazy ftm worry), she validates it, and then she gives me a solution with medically founded reasoning behind it.

2.  she gives me plenty of opportunity to ask questions.  she never interrupts, rushes, or talks over me.

3.  she remembers me, my son, his history, and my past questions and concerns.

4.  one time, she did the majority of his exam on the floor because he was down there playing when she came in and she saw that he was content down there.  she even sat on the floor with us and talked.  we moved him to the table so she could exam his diaper area, but that was it.

5.  she makes it clear that she understands that i am the mother and that her job is to help me make the best decisions possible for my baby- not to tell me how to raise my kid.

best of luck with your new job- i think you're going to be a wonderful ped; the fact that you took the initiative to  come on here and ask a bunch of moms what they're looking for says a lot about how you want to run your practice!

kelly422

I appreciate all the responses!

Everyusernameistaken

Be up to date on BFing!  SO many of my friends have gotten wonky info on BFing even from fairly young docs (my friend was just told that her 1 year old needs to be off breastmilk and get onto cow's milk exclusively because WCM has more fat and is therefore better for brain development than BM!)

Congrats and good luck

linzeek44

I agree with a lot of the suggestions already given. 

Is there a lactation consultant with your practice? If not, compiling a list of LCs in the area would be a great resource. I think sometimes even well-intentioned pedis give not-so-good BFing advice, and having contact info for LCs could really help make sure that every mom who wanted BFing help had more information for BFing.

Nurses also asked at the old practice "How much formula does he get each day?" While a little question, I was always put off by it as a nursing mom. "How do you feed him?" would have been a better first question, and then asking about bottles or nursing sessions would have made me feel a bit more supported. 

Our new pedi is great. He always narrates what he's doing, so when he's "playing" with my LO he's saying "I'm just looking to see if he's tracking the toy with his eyes" and things like that. I enjoy hearing what he's looking for and it makes me feel like he's doing things thoroughly. Our old pedi would take a quick glance at him and that was it. 

morrkim

We are thinking of switching because our doesn't seem to make things a priority or explain things and he doesn't follow through.  When Alexis was around 3 months old I noticed blood in her stool.  I called the doctor and left a message.  He called me back and suggested I cut out milk and possibly do a stool sample the next day, Friday.  I called the next day to see if I was just supposed to bring a diaper in or bring her too.  They did no t call me back till Monday afternoon.   We ended up going back and forth trying to get apt, because he went on vacation and he didnt have available apts for around a week.  about a month later he finally saw her and had us do stool samples and told me to cut out milk without really explaing anything to me. A month later he had us do samples again and they came out positive again, so he said to retest again a month later and we never got a call telling us how she did. He also always assumes that she is formula fed and I keep telling him that she is bf.  It would be one thing if he asked if she was formula fed, but he always starts out by asking how much formula she takes.

kelly422

linzeek44:

I agree with a lot of the suggestions already given. 

Is there a lactation consultant with your practice? If not, compiling a list of LCs in the area would be a great resource. I think sometimes even well-intentioned pedis give not-so-good BFing advice, and having contact info for LCs could really help make sure that every mom who wanted BFing help had more information for BFing.

Nurses also asked at the old practice "How much formula does he get each day?" While a little question, I was always put off by it as a nursing mom. "How do you feed him?" would have been a better first question, and then asking about bottles or nursing sessions would have made me feel a bit more supported. 

Our new pedi is great. He always narrates what he's doing, so when he's "playing" with my LO he's saying "I'm just looking to see if he's tracking the toy with his eyes" and things like that. I enjoy hearing what he's looking for and it makes me feel like he's doing things thoroughly. Our old pedi would take a quick glance at him and that was it. 

LUCKILY, I have a 9 week old LO (preemie) and we didn't have a great experience with BF and now I EP.  I also had supply issues in the beginning, so I did all my research on things to help with that.  I've visited with numerous LC and discussed a lot of things over email with them.  Now, I feel MUCH more confident being  able to help my mom's who are having issues with BF.  I've learned so much by having a baby!