Some of my friends have moved into the “Expectant Parent” category of life now, and as if they weren’t already getting a boatload of unsolicited advice from parents, friends, and random strangers in the grocery store who want to touch their pregnant bellies, they have very kindly been asking me advice on how to choose a doctor for their child.  First of all, mazel tov! Second of all, please get some advice from someone else as well, preferably someone who has meaningful advice.  Because I am only a second year pediatrics resident, someone who has not yet completed training, someone who does not have “FAAP” at the end of their title, someone who does not have years of kiddie-wisdom stored behind graying temples.  With that caveat, here are some pointers:

Get a pediatrician, not a family practice doctor! To all my family medicine colleagues out there, sorry.  Unless your mom, your dad, your brothers and sisters and your brothers’ and sisters’ children have all gone to the same beloved family doctor for 35 years, and she’s wonderful and kind and intelligent and resourceful and has never-let-you-down, you will want someone who has had specialized training in the illnesses of children.  A family medicine-trained physician has about 3-6 months of formal training focused on children, whereas a pediatrician has at least 3 years of formal training focused on children - and unless your family doc has been taking care of children for generations, they will not have seen the volume and range of illness a pediatrician has seen.  Unless you have a trusted family doc already, I would say you have a much better chance of finding your child a good doctor if you narrow your selection to the kiddie-pool, not to the “general swim” pool.

How much experience should they have? I have heard complaints on both ends of the spectrum.  You don’t want someone who is naive enough to think every rash needs a biopsy and a derm referral but you also don’t want someone who is so old-school that they aren’t keeping up to date with the most recent evidence-based medicine (e.g. docs who still think it’s okay to lower temperatures by giving alcohol baths).  They should be board-certified by the American Board of Pediatrics, too.  I think what’s telling is not so much the individual experience of a practitioner but more the collective years-of-experience the whole practice has: how many pediatricians are in their group practice, what the range of experience is amongst all of them, how many total children does their practice serve? More likely than not, your child is not going to see the same pediatrician for all their sick visits unless it’s a solo practice, and more likely than not, if there’s something unusual about your child’s case, they will likely bring their colleagues in to examine your child, too, or at the very least, use their partners as a sounding board for management advice.

Find out about how they handle 24-hour emergencies.  If you call at midnight with a question, will the phone service direct your call to a nurse triage line, will they page the physician on-call for you, or will you just get an automated voice message that tells you the office is closed, please call during business hours, and dial 911 if it is an emergency? At the very least, you want a practice that uses a reliable phone triage system, that has one physician on-call every night (your particular pediatrician might not be on call every night, but might have a group practice where they rotate through call nights), and that has good recommendations for which emergency rooms to use because each emergency room will have varying levels of experience with pediatric patients and different admission policies.

Find out about office hours and how easy it is to get in contact with a pediatrician in your practice.  You will need a practice that can accommodate your schedule: do they hold office hours at night or on weekends, when most parents get off work? Are the pediatricians available by phone or email?  (A lot of pediatricians aren’t, because they’re seeing patients all day; they do not have time to sit at the computer and respond to email questions all day long).  The other thing I’d be suspect about is how long you have to wait in the waiting room — do you get there for a 3:30 pm appointment that isn’t really until 5:30 pm?  This isn’t fair to the patient, and it is telling of how well an office functions or how overbooked it is.

How do they refer patients when they need a specialist? Do they work with university or children’s hospital specialists? How do they handle children with special needs?  Not that your child may ever need this, but it’s important to know if they have a reliable and often-used network of specialists they can rely on, because it means they are that much more aware and up-to-date with the resources around them.  Also, you don’t want a pediatrician who will just hand-off your child’s special needs to a specialist and not follow-up on management issues.  You want someone who actually reads the letters that specialists send to them after they see your child, and at your well-child check-ups will ask follow-up questions and make sure you understand the care plan or tests that the specialist has requested.

If you can afford the time, interview pediatricians in your community before picking one.  This is the most important thing I can think of.  Most will not charge you for it, and most welcome it, because it’s about finding the right fit for your family’s needs and for your personalities.  Bring a list of questions.  See if they will offer you the chance to talk to other parents who use them, because it will be mostly by word of mouth that you find someone who is right for you.  You might have specific questions about vaccination schedules and holistic medicine practices and beliefs around co-sleeping or breastfeeding or whatever, and you will want to hear your pediatrician’s take on all of it.  Most importantly, you will want someone or a practice who will be an ally in helping you raise your child.
It is excruciatingly hard to find a “good” doctor - it’s not like finding a reliable store to buy pants (although that is hard, too), or a dependable dry cleaners because there are so many factors that make finding a “good” doctor hard, including just having information available.  What’s “good” to one person may not be considered important at all to another person.  And I know parents worry.  One careless comment or suggestion can make make parents stay awake with worry for nights on end - at a delivery I went to, as a father came over to snap pictures of his new baby, he asked me why the baby’s head was cone-shaped and I said, “And all babies who spend a lot of time in the birth canal have heads shaped like this, it’ll just take some time to straighten out.”  It was only later when the pediatrician told me that the dad spent a significant portion of time worrying over exactly how long it would take for the baby’s head to no-longer be cone-shaped and whether it would be cause for developmental delay that I realized that the lifelong worrying of parenthood begins immediamente.

Recommended resources for how to choose a pediatrician:

Your Baby’s First Year has a good checklist for what to look for when selecting a pediatrician.
Visit the American Academy of Pediatrics to search for a list of board-certified pediatricians in your area.