How to choose a doctor for your child

Finding the right doctor to treat your child is an extremely important decision, and one that is not easy for most parents.  Understandably, parents want only the very best for their child.  In one way doctors are no different than teachers, auto mechanics, carpenters, or anyone else whose services you might need: a few are really not very good, the vast majority are going to be good but fall within the average range, and only a few can be truly exceptional.  It can be frustrating to have to take your car back to the mechanic because the problem was never fixed right the first time, but no one wants their child to have to go back for a second operation that might have been prevented.  If only one or two doctors can be considered the very best craniofacial surgeons, it is most likely that even for parents who live near a top medical center, to get the very best treatment for their child will mean traveling to another city. Of course, every doctor wants to be considered one of the best.  How do you find the very best?  Unfortunately, there is no easy way.  Without a medical background, it is impractical to try to read all the published scientific articles on different treatments in craniofacial surgery and try to decide which doctor has the best results with the lowest complication rates.  If parents want to get some idea of the level of care offered by their local doctor, it is important to get more than one opinion, preferably multiple opinions.  Treatment recommendations can vary significantly from doctor to doctor.  Here are some suggestions meant to assist parents before they meet any doctor:

• Do your homework.  Do some research on your doctor: has he or she published articles relevant to your child’s condition?  Ask your doctor to see if you can talk with other families who have undergone similar procedures (because of HIPAA, these families would have to contact you), or check in Internet chat rooms.  Have other families with the same problems had positive experiences with this doctor? 

• Look at a doctor’s web site: does this doctor seem to be more focused on cosmetic surgery or craniofacial surgery?

• Prepare a list of questions in advance and make sure that you have the time to get all your questions answered.  If you feel rushed during your appointment, and you do not have enough time with your doctor, then this may be a sign that you should seek other opinions.  Doctors who rush through an initial office visit, may rush through the planning phase of your child’s care, hurry through the surgery, and barely follow your child after the operation, all leading to a poorer result.

• What kind of experience does this doctor have with your child’s condition?  Numerous studies suggest that results improve, and complication rates drop, with experience.  Of course, the more rare the condition, the less experience any doctor is going to have. 

• What kind of experience does the hospital have with your child’s condition?  Treating a child with a birth anomaly requires a team of dedicated health care workers.  Pediatric anesthesiology is critically important, as are the pediatric neurosurgeons, intensivists, otolaryngologists, etc.  The level of nursing care and experience is also very important.  Unexpected problems can happen to any surgeon.  If the hospital team has the necessary experience, a disaster can be averted.  Will students, interns, residents and fellows be looking after your child, with the doctor insulated from what is going on?  If this is the case, then consider planning surgery in the spring, as far from July 1 (when all new residents start the year) as possible.

• How well were your questions answered?  Doctors who don’t directly answer your question, or speak in generalities may not have sufficient experience.  On the other hand, if your question is clearly answered, and the response makes good sense to you, then probably you are speaking with someone who has the necessary experience to treat your child.

• Finally, listen to your “gut feelings.”  A “prima donna” attitude in a doctor can be a sign of insecurity (perhaps about their own ability). Any doctor who discourages second opinions, or acts insulted if you consider this option, is most likely the wrong doctor.  Does your doctor seem to truly care about your child? 

Take the time to do your homework and don’t feel rushed.  Decide for yourself, what level of care do you want for your child.  There are capable doctors in most major cities in the U.S.; however, to have your child treated by one of the best will probably involve travel.  Don’t let insurance companies tell you that you must stay home, it may take a lot of work, but persistent parents almost always get what they want for their child.