Ped. or Family Practioner?

[hjdong]

Hi - I went to my family practitioner for my yearly pap yesterday and since hopefully I will have a baby close to the next time I have to see her, I asked if I would bring the baby to her or to a ped. She said I could choose. Does anyone have an opinion on this? I don't have a strong feeling for or against my Dr. (she's fine - I really like her P.A.). My concern is my baby will need lots of unusual tests (well, unusual for american born babies - HIV, Hep., various paprasites etc.) and have her immunizations all re-done (medical records from China can be innacurate). My Dr. said she was wouldn't have a problem with that. If I'm going to choose a ped. I want to make sure to find one who feels the same. Any thoughts on what's better? Thanks.

[mharling]

I can't answer your question specifically, but wanted to let you know that my brother and SIL adopted from Korea and use a family practitioner. They have been quite happy.

Mary & Lane 4/6/03
http://www.shutterfly.com/osi.jsp?i=67b0de21b3237413c427 - New 6/18

[Kimberly H]

Holly, in our area ChinaBabies are very scarce (only 4 other China-adopted babies in the whole metro area, as well as very few other people of Asian origin). I know it's optimum to find someone with familiarity with Chinese adopted kids but it's not going to happen in our case.

I've seen both MD's and DO's with my bio boys - both family practice and pediatricians. As much as I'd rather have gone with the family practitioners, in times of need, my *personal* have always been better with the pediatricians.

I currently see a D.O. in family practice whom I like fine but her partner is one of those double-booking docs and she fills the waiting room, the staff is stressed out, etc. I schedule all of my regular visits for the day of the week the partner isn't there.

So we're going to find a pediatrician (have some recommendations now, will start calling for consults next month) and will make sure it's someone who has NO, as in ZERO, problem referring to either Duke University (3.5 hours away) or MUSC in Charleston (about 2 hours away).

Hope that helps, at least a little.

[KathyO]

I have been very comfortable with bringing my daughter to our family doctor, and skipping the pediatrician. But this isn't some big philosophical position - it just worked out that way.

I think that more important than anything is the doctor's fit with you, and subsequently with your child. Do you feel that she listens, and that she stays relatively current with medical trends (remembering, of course, that to stay on top of ALL the research coming out is like trying to drink the ocean...) Does she take your opinions seriously, and communicate such that you can make informed decisions?

On the administrative side, can you get in to see her on short notice for emergencies? Is she relatively quick to refer patients when a problem needs specialized attention? Does she have a nurse on staff who can do phone triage when the doctor's not available, to help you decide whether you need to come in for something?

If she meets most of these, you may have a winner where you are right now. But by all means ask around and see if there are any great peds worth checking out in your area if you want a point of comparison.

It's certainly true that a pediatrician does specialize in children's issues, but a family doctor (as long as she's not too close to retirement) has their own advantage, of already knowing your child (and vice versa) as they hit the teen years and later.

Hope that helps!

Cheers, and congratulations!

KathyO

[Calmegja]

As someone who's moved all over, and been through an army of peds and family practice, I have to say that I can't agree more with Kathy's post. It's the fit you have with the doctor that's critical.

The best doctor we've had was our family practice doctor two moves ago.

But it all comes to comfort level, your trust in the doctor, and how it all meshes together. Whether that's a ped or a family practice, you'll have to judge when you meet the candidates....;-)

[Karenn]

Hi Holly,
A friend of mine who adopted from Cambodia actually worked with a pediatrician who has a specialty in "adoption medicine." This particular doctor worked with them before they brought their daughter home. Then, after they'd been home for a few months, they switched to a more local pediatrician who has experience with children adopted from overseas, but is not a specialist in that field. There might be doctors with similar specialties where you live. I've also got the names of both doctors my friend used if your interested- maybe one of them could refer to someone in your area. Just let me know. :)

[cara1]

Personally, I would never go to someone other than a Ped. I want DS's physician to specialize in children, not adults, pregnant women, minor surgery, AND children. A family practitioner can't possibly be as up to date on pediatrics when they have so much other literature to keep on top of. If your pediatrician has seen X number of cases of Disease Y, than the family practitioner has seen 1/3 that number. For me it's kind of a no-brainer.

[kransden]

Ped. without a doubt for me. The office is kid friendly with toys and art. They often have free samples to try. There is nothing in the exam rooms the kids can get into. They specialize in children's med., are up on the latest litature. Most importantly, I can see them the same day or the next if my child is ill. I love my Dr. but they can't provide that kind of service to dd, yours might be able to.
Karin
Katie 10/24/02

[dogmom]

I would like to put in a plug for FP. My FP is very knowlegable, laid back, and a dad himself so I feel his advice is very practicle. I also vetted him with a nurse practioner I would with that does a day in his office. My neighbor has a son four days older than mine, and I got to say, her pediatrician sounds not nearly as up to date as my FP. (He started her son on cereals before 4 months, he says that flouride drops will help the teeth come out soon, and he son is still in an infant car seat because he said that it is weight, not height you go buy for car seat size. 0 for 3 as far as I am concerned.)

Having said that, I have a healthy baby with no problems. My doctor also is very willing to refer to specialists if asked. I am a nurse, and if I needed a pediatric person I would go to my hospital and get one that specializes in what I needed. I guess I feel I know enough to really keep tabs on what he is doing. His waiting room has toys and kids are there frequently. There is a special exam room for kids only with books and toys. I talked to other moms that use him and they are very happy. I find myself with less of a wait (5-10 minutes) and better coverage (him or his partner) than the people I know that use a pediatrician.

You could always try to FP and if you don't feel she is meeting your needs go to a pediatrician. You could also ask her ahead of time what would be her plan of care for your child.

[kransden]

Wow! With that type of service I would take my dd there too. I don't know of anyone in my area that has that type of service with their FP.

Karin
Katie 10/24/02

[KathyO]

That's an accurate description of the service mine provides too. He will also fit you in at the end of the day if you call in with a concern that won't wait. And keeps a straight face when dealing with all the standard new-parent neuroses ("She hasn't pooped in five days!!!")

Cheers,

KathyO

[Calmegja]

Sigh. That's how my family doctor's practice was, too.

I really, really miss her. She was ridiculously up to date, great with us, great with the kids, and would never ever hesitate to refer us if she thought we needed another opinion. And she knew everyone in the world in our area, so she was the queent of getting us in if we needed to be seen elsewhere (like the opthamologist...)

You know, after my last ped's office wait of 90 minutes as the first appointment of the day, it makes me think I should maybe look a little harder for another family practice, because I was incredibly happy....

[lvp49]

We use a FP, and I have to say, I LOVE him. I have been his patient for about fourteen years, and he knows me. When I became pregnant with my first, I was very happy that I was able to stay with him throughout my pregnancy and he delivered my baby. He sees her now, and even sees DH.

I think that there is a lot to be said for someone who is familiar with you and your whole family. This is truly my "primary doctor", and he has all the history. I loved the idea of not having to get to know a new doctor when I was pregnant, especially since all the OBs in my area are "monster groups" with between ten and twenty five doctors. You never know who might show up for your delivery. This guy gave me his Pager #, cell, and his HOME #!!!


He called me at home after I was discharged with DD, I always get in, and rarely wait. In fact, I like the fact that there is not a waiting room full of sick children and germy toys when I go there.

I acknowledge that this is not the ideal for some. (in fact, some will probably be freaked out that some people never see OB) I really felt that I was not ill when I was pregnant, and did not need a lot of intervention. I am a nurse too, and I KNOW, that the more problems you go looking for, the more you will find, and this is not necessarily a good thing. I did have all of the regularly recommended tests and sonograms, and my DD has had all of her test and vaccinations on schedule with no problem. I never have an instant of doubt that he will refer me out (and he has) if it is required. In fact, sometimes he is too cautious. He did offer me an array of refferals to OBs when I was pregnant, and made it clear that there were to be no hard feelings if I were to choose a "specialist".

I also love the fact that my daughters doctor delivered her. He has pictures hanging in the waiting room of all of the babies he has delivered. Its great, and he's very proud of them too. There was a twelve year old there last week, and he was telling a new staff member "I delivered her". She sees the same doctor everytime we go. He does have a partner, and I have made a point to see her so that I know her and she knows me in the event of an an emergency.

I know that this does not answer your adoption question specifically, but I can say, I have NEVER (in fourteen years) felt that he was not up to date, or out of his league. This is a great alternative for families, and one that I think is not used enough.

If the FP is affiliated with a large institution, and has the resources, you are not missing anything. Remember, this is really how medicine was always practiced. There was one doctor in town. I just can not say enough good things about it.

[KathyO]

That's interesting... my FP did a sub-specialty in obstetrics, and up until recently, also delivered babies. Loved doing it. I would have been happy to have him deliver #2 (wasn't hooked up with him in time for #1), but he'd just, reluctantly, given it up. He was getting to the age where he couldn't pull all-nighters and then work all day, and now that his girls are school-age, he really didn't like constantly having to dash out of their school plays, swim meets, and so on, and I can't blame him. Oh, well.

He and my OB are doing "shared care" for this pregnancy, which means that I alternate seeing one, and then the other, and the records pass back and forth between. He says he likes staying in the loop. Do any of them do this down in the States?

Cheers,

KathyO

[parkersmama]

We use a pediatrician but that's just how it worked out. I certainly would feel comfortable IF I could find the right family practitioner.

The only time I've taken one of my kids to a FP was when Parker was one. He had terrible diarrhea for days on end that wouldn't go away and my first-time-mama syndrome kicked in and I thought he needed to see a dr. I hated our pediatrician and was shopping around for a new doctor so I took him to dh's FP. Although he is a good doctor and a nice man, I didn't think he was thorough enough to work with a small child. For goodness sake's they didn't even weigh him!! How are they supposed to tell me Rx doses, etc, when they don't even know how much he weighs?! Good grief. After that we luckily found our pediatrician. He was newly arrived in town (hometown boy just finished residency) and actually studying to take his boards when we started with him. He is simply wonderful! He has young children and I trust his opinion plus I told him upfront that I wasn't going to blindly follow all of his advice and he said he could live with that. He seemed to support the same things that I believe in so we went with him. Now (5 years later), his kids attend preschool with mine and I'm friends with his wife! His oldest son and Parker were even great buddies in 4K. It's nice having a more personal relationship with your doctor.

I do like knowing that our doctor specializes in children's medicine but I think the most important factor is that you get along well with your doctor and share similar philosophies. If you find that in an FP or a ped, go with the one you feel comfortable with!

[MaKetels]

This post is a little later than most, but I feel REALLY strongly about this topic. My hubby is a FP Resident (3rd year), so some may think that I am partial for that reason.
HOWEVER, when we moved here for his Residency, I was 4 mos pg with DD. I had seen an OB/GYn my whole (adult) life, a pediatrician as a kid, and just assumed my fam would do the same. WRONG. I have never received better care than with my current FP. She is very well-read, and down to earth, as well. When I met her for my first (trial) prenatal, she promised me that she would be with me when I delivered (short of her own death, lol). When my water broke at 5am, hubby called her, and she was at the hospital 15 mins after we were. Stayed with me the whole day, and was in the OR when I had to have my C/S. I am now 21 weeks pg with twins, and she will be with us all the whole trip--
She has known my DD literally from the moment she was born, and it shows in the care she provides.
A big CAVEAT: just like with any other practitioner for yourself, family, or children, the most important thing is feeling comfortable in their knowledge, personality, and practice. Good luck,
Shorty's Mom

[Torey]

I say go with the Ped. We currently see a Fam. Practioner but I am getting pretty fed up with her. The FP doesn't seem to keep up with the latest baby info and is fairly dismissive of questions that I have. Also, I feel like I end up diagnoising ailments myself rather than getting answers from her. I haven't been to a Ped. with DD, but my hunch is they have a better feel for babies since they see so many babies and children every day.