As an expecting parent, one of your first big research projects is to choose a pediatrician.
You’ll probably start with logistics. Does the pediatrician accept your insurance? How long will it take to travel to the office? What are the office hours? Are there designated times of day for certain age groups? Are there separate waiting rooms for sick and well children? Are there weekend appointments for urgent care? What hospitals does the office admit to? Will your child see the same pediatrician each time, or are there multiple doctors? Is this an academic practice? If so, will your child be cared for by medical students and residents? Can you e-mail or call the pediatrician with questions?
You’ll want to ask about a prospective pediatrician’s credentials: where she trained, what accolades she has received, whether any disciplinary actions have been taken against her.
You may also want to know about the philosophy of the office. What are the pediatrician’s philosophies about breastfeeding and co-sleeping? Does the office have a specific vaccination policy that aligns with your own preferences?
These are all great questions. But you shouldn’t be asking them when interviewing a pediatrician.
All of these questions have clear, straightforward answers that you can find on your own. Want to know where the doctor trained? Check the American Academy of Pediatrics or American Board of Family Medicine databases. Want to know the office hours? Call the office or visit the pediatrician’s website.
Answering all of these questions before you interview a pediatrician will save those precious 10 minutes of time for questions you can’t find the answer to anywhere else.
The best question you can ask has nothing to do with credentials or office policies. It’s “what do you read?”
Why academic reading is important
According to a survey of American Academy of Pediatrics members, the average pediatrician read between 145 and 184 academic journal articles each year. The majority of those articles came from journals the pediatricians personally subscribed to.
All of that reading – a rate of about three articles per week – is important because the field of medicine is constantly changing. Those changes can mean that what was once considered true is untrue. What was once considered unsafe is now considered not just safe but helpful.
A survey conducted by the medical professional network Doximity found that 75 percent of physicians alter their practice because of something they read in medical literature at least every three months. For example, prior to 2015, pediatricians advised parents to wait to introduce peanuts to children until at least age three in order to prevent peanut allergy. The Learning Early about Peanut Allergy (LEAP) trial, the first results of which were published in 2015, found that early introduction of peanuts actually reduces the rate of peanut allergy. This finding has led pediatricians to completely reverse their earlier recommendations.
The big question
Academic reading is absolutely crucial to a strong medical practice. But because doctors are authority figures, it may feel awkward to ask a prospective pediatrician about her reading habits. That’s especially true if you do not have any medical training or do not know much about academic publishing.
It will help to remember that you’re not looking for a “right” answer. There isn’t a “right” academic journal to read, or a “right” number of academic journal articles to read. What you’re looking for is a sense that your prospective pediatrician keeps up with the changes in her field.
There are a lot of bad ways to ask a doctor about her reading. “Do you read academic journals?” is a terrible question, because it pins the interviewee between the clearly right (“yes”) and clearly wrong (“no”) answer. Asking this question is going to get you a “yes.” But even if it’s true, that “yes” won’t really teach you anything, because you won’t learn anything about what or how often your prospective pediatrician reads.
Likewise, you’ll want to avoid “what academic journals do you read?” The question is imprecise because you won’t know whether the pediatrician has a 20-year stack of unread Pediatrics issues collecting dust in a filing room or if she is meeting that three-article-per-week average.
Instead of asking about general reading practices, ask about a specific article. “What’s the last interesting academic article you read?”
Asking this question can tell you almost everything you need to know in order to choose a pediatrician. First, if your prospective doctor lights up and tells you about the latest research, you’ll know she has recently been keeping up with her field. If your candidate answers that she hasn’t read in years, or that she doesn’t trust anything she reads in the whole of academic medicine, you may want to move on to the next candidate. (Of course, you can interpret “read” broadly here. Many pediatricians keep up to date by listening to medical podcasts like PediaCast or Peds RAP.)
The second reason this question is so helpful is that it will tell you whether or not your doctor can describe a complex medical issue to you in plain language. Nearly every parenting website with advice for choosing a pediatrician asks you to think about rapport. BabyCenter notes that “only a face-to-face meeting will show you whether this doctor has the warmth, sensitivity, and professionalism you’re seeking.” The Bump encourages you to ask yourself “Did the communication feel natural? Was the doctor easy to understand?” A great test of rapport is whether or not the pediatrician can explain a recent academic journal article to you in terms you can understand. When that happens, you’ll know that, should your child ever be facing a complicated medical problem, you’ll be able to understand what the doctor is saying about it.
Two follow-up questions
If you’re feeling brave, you can follow up by asking your pediatrician to tell you about a time he changed his practice based on something he read.
The pediatrician’s answer will give you insight into that doctor’s position relative to new and contradictory information. Although we expect pediatricians to be experts in their fields, part of that expertise also requires them to be flexible in their practice. You’ll want to know that, if tomorrow a new study revolutionizes the way we think about childhood nutrition, your pediatrician will be on top of the changes.
Some parenting websites advise interviewers to ask prospective pediatricians about their health care philosophy. That is a great question, but it’s a huge question. Imagine if someone asked you that same question right after introducing herself. It would be nearly impossible to answer.
But you can gain insight into your pediatrician’s philosophy of practice with by asking what you should be reading. What books does she recommend for parents? What books would she steer you clear of, and why? What medical issue has been reported in the news lately that she thinks parents are overly concerned about? The answers to these questions will give you added insight into your pediatrician’s philosophy of care, far better than either huge questions about her overall philosophy or narrow questions about breastfeeding or vaccine policies.