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Choosing a Pediatrician (Part III of III)

This office requires that I fill out forms in advance. My medical insurance is billed. I will be asked for a $40 co-pay when I arrive.

The first thing I notice on the day of my appointment is that the office has two front doors — not unlike some veterinarians — except that instead of dogs and cats, it's separate waiting rooms for well and sick children.

How thoughtful!

I enter the "well" side. A small, tidy room, with toys for the waiting children to play with. A friendly mom strikes up conversation, compliments me on my good luck with getting an appointment with this particular pediatrician. "She doesn't often accept new patients."

My name is called and I am ushered back through a neat and  orderly office to one of the tidy examination rooms. The doctor comes in. Her handshake is firm. She's strong, efficient, direct. She asks, What do I need to know?

It's Monday morning, and I am aware that she has a patient already waiting in another cubicle; I'd met him in the waiting room.

I feel nervous. My eyes glaze over. I tell her I don't really have a prepared list of questions. I mention that I've interviewed two other pediatricians. "You know, meet three, choose one."

"Wow. You're very organized," she says.

"No, no," I defend. "Not really. It's just how I do this kind of thing." I'm not sure, but I think I've miss-stepped somehow at this point in the conversation.

She asks me what I do for a living; trying to determine if this level of thoroughness and organization is evident in other areas, she says. I'm a writer, so: No.

She punches down through the bullet points of her philosophy. She's the daughter of professors, so she has an analytical mind. She will take me through the decision tree every time she makes a diagnosis so that I will learn during my appointments what to look out for on my own when I see symptoms in my child. She's a teaching physician. There will be medical students accompanying her several days a week during patient visits. She went to Harvard. There are five doctors in the practice, all Stanford and Harvard educated. Actual appointments are available on Saturdays and Sundays if needed in an emergency. They have their own advice nurse on staff who is also a lactation consultant.

I ask her position on circumcision. She goes out into the hall and brings back another doctor from the practice to introduce me to, who is also a Mohel. I ask her about alternative medicine. She tells a story of finding a tumor on a patient's spine last week. "There's no 'alternative' there," she says. "We were aggressive in testing and diagnosing the tumor. Fortunately it was benign."

Well, I didn't mean that I'd rub herbs on a tumor rather than get a biopsy, but I didn't say anything.

I try out my glucose-self-testing story on her to see how she responds. This one has her own story about not wanting to drink the sugar syrup. "I was being so careful to eat right for my pregnancy and they wanted me to drink THAT stuff? I made an arrangement with the lab to eat a meal with the exact same calories and carbs and did my test that way."

Well I certainly wish more doctors would offer patients that option. But still, her response was not the rousing compliment on teamwork I'd gotten from pediatrician number two.

The office manager comes in next to talk to me about insurance (this must be standard practice), and chats in general about how great this practice is, how nice that they have an advice nurse on staff whom I am welcome to call by the way, if I have any questions before the birth.

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Choosing a Pediatrician (Conclusion)

So, which way do I go? Have I been too thorough? I am known to over-think these things. All three practices came highly recommended. All three seemed equally competent in the care they would offer my child.

Do I go with the office that appeared so clean and well orchestrated, if a bit intimidating? Do I choose the one that was tidy and efficient while still maintaining a sense of being personal? Do I go with the doctor whom I felt the most comfortable with, in spite of the chaotic environment I'll have to visit her in?

As much as I liked the toys and separate waiting rooms and fancy pedigrees and clean white walls at pediatric practice number three, I think it's going to be koalas and "water pistols" and brown bag lunches for me and my little one, with the artist-turned-doctor behind door number two.