Pediatrician, how to choose the right one

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Philippe Gloaguen
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He was born: a child, perhaps the first, and among the many things to do in its early days, one of the most important is the choice of the pediatrician, the doctor who will accompany the growth.



"It is not just a question of health assessments and the diagnosis and treatment of any diseases" immediately explains Manuela Orrù, pediatrician of free choice in the city and national councilor of the cultural association of pediatricians. "The children's doctor is one of the few specialists who should work more on health than on disease: on education, prevention, support for parenting. Which means helping mum and dad to build a good relationship with the little one" .



In this article

 



  • A doctor from birth to adolescence
  • How to enroll the child
  • Useful criteria for an effective choice: proximity and timetables
  • Doctor, it's a relationship of trust
  • The preliminary interview and health assessments
  • Diverging opinions

A doctor from birth to adolescence

The National Health Service provides that every child between 0 and six years old has his own pediatrician: of free choice, it is said, precisely because parents can choose him from those who have an agreement in the health district of reference.



Between the ages of six and 14 you can also decide to go to the family doctor, while on the fourteenth birthday the transfer is automatic. Unless there are chronic diseases (such as asthma, diabetes or cystic fibrosis) or handicap, because in these cases you can ask to stay with the pediatrician up to 16 years. "In some regions, the diseases for which an exemption is possible are so many that the request is almost always accepted. In others, however, obtaining the extension is very difficult" underlines Adima Lamborghini, family pediatrician in Silvi (Teramo) and member of the Study Center of the Federation of Paesena pediatricians (Fimp).

How to enroll the child

From the point of view bureaucratic, choosing a pediatrician is a very simple operation: just go to the relevant office of your local health authority with

  • an identity document (from mom or dad),
  • the child's tax code
  • and the certificate (or self-certification) of birth,
  • and indicate which pediatrician you want, among those available with agreements.

Registration is immediate. In some large cities this can also be done directly in the hospital where the baby was born.

Of course, the choice is not always really free: especially in metropolitan areas, it may happen that some pediatricians are "full", that is, they have reached the maximum number of patients required by law (800, also in this case with exceptions) and do not accept other children . But if there are multiple options, some guidance on how to decide which doctor to turn to for a parent may be helpful.

Useful criteria for an effective choice: proximity and timetables

There are no scientific guidelines or criteria to refer to, but theAmerican Academy of Pediatrics (AAP) has come up with a little guide and some suggestions are also valid for us. For example, those on the more organizational aspects, starting from the location of the studio: is it close to home or in any case convenient to reach, by car or public transport? Are there architectural barriers?

"In the city, proximity and comfort are very important criteria" comments Orrù. "Especially if both parents work, you shouldn't complicate your life with an unreachable doctor". In this regard, it is also good to take a look at the surgery hours: generally the ASL provides them, together with the curriculum vitae of their doctors.

It's still. "It is useful to know if the pediatrician works alone or in a group or in association" adds the specialist. "In the first case, several colleagues work in the same structure, in the second in locations close to the area, always trying to coordinate schedules. In these situations, if your doctor is absent it is generally possible to contact colleagues". The AAP also advises to ascertain the physician's attitude towards the possibility of receiving phone calls outside of office hours or answering questions by email.

It is a relationship of trust

Obviously, logistical issues are not the only ones to be evaluated. "The really fundamental ingredient for the relationship between parents and doctor to work is mutual trust" underlines Luigi Greco, family pediatrician in the city and vice president of the Del Paesena Society of paediatrics. To understand which doctor is most likely to get along with, among those available, you have to get busy.

Often, the new parents they rely on word of mouth from friends with older children: it can be useful for them to ask if the pediatrician is available to listen, if he welcomes questions, if he seems up-to-date, if he conveys the feeling that he likes his work, if the children are happy with him.

Others go on the internet: some parent forums provide "reviews" on their pediatricians, not to mention that more and more specialists have blogs, websites, or collaborations with online magazines that help to understand their positions and attitudes. And it is certainly worth asking for a preliminary meeting with the "candidates", even before the baby is born.

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The preliminary interview and health assessments

The AAP also suggests paying attention to some elements: do the clinic and the waiting room appear clean, comfortable, child-friendly? Did the doctor and possibly his staff appear courteous, attentive, ready to listen, or hasty and rude?

After the first impression, it is time to begin to understand how the pediatrician's work will be structured in the years to come, starting with periodic checks (health balances). Lamborghini offers some tips: "Just ask how they take place. In the answer, the doctor should not focus only on the aspects related to growth, but show attention to the stages of the child's neurological development and to issues of health education and prevention of diseases and accidents. It should emerge that the checks will be an opportunity to explain to parents what to expect in the following months, what aspects to pay attention to, how to intervene in case of problems. More generally, it should be understood that the pediatrician considers the child not as isolated entity, but as part of a larger unit, which is the family ".

A further indication comes from Orrù: "Building a beautiful relationship with the child, which is full of empathy and positive stimuli, can help the little one to grow up balanced and self-confident. The pediatrician can lend a hand in this process and references. projects such as Born to Read or Born for Music are an indication of attention to these aspects ".

Diverging opinions

In addition to the parents, the first meeting is also important for the doctor, who has the opportunity to know who he is in front of and evaluate their expectations, values, beliefs. Sometimes, on controversial issues such as the duration of breastfeeding, the type of weaning, sleep education or vaccinations, there may be different points of view.

"In these cases - argues Lamborghini - it is good for the doctor to insist on his positions if the health of the child or the community is at stake (I am thinking of vaccinations, if the family is against it). But he should avoid paternalistic or too taxing attitudes and look for a meeting point ".

In any case, if the relationship between the family and the chosen pediatrician does not work, all is not lost. You can always change doctors, or at least try. In theory it is a right. In practice, it is not always possible because, as we said, for simple numerical reasons in some situations the choice and revocation of the pediatrician are a little less free than they should.

A criticality that, at least for the moment and judging by the limited data available, does not seem to affect the degree of satisfaction of Del Paeseni with their pediatricians. According to a Censis survey published in 2022 in the Quaderni of the Ministry of Health, about 40% of the interviewees judged the quality of the service offered to be good (and 50% judged it sufficient): the professional skills and report of doctors.

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My son has a fever. Why doesn't the pediatrician come to visit him at home?

There is no doubt: fever is the condition that most often leads parents to ask the pediatrician for a home visit. However, this request is not always accepted. "Also because in this case the home visit is just not suitable" comment pediatricians Adima Lamborghini and Luigi Greco. "In fact, the doctor does not have access to useful tools for an initial diagnosis, which he has instead in the clinic". Moreover, if the child is normally healthy, he can go to the doctor even with a fever. for example because he is attached to survival equipment, or if the doctor feels he must personally check the environment in which he lives. Or, again, in the context of integrated assistance programs, in the case of particular chronic diseases.

Read also: When to go to the pediatrician?

Questions and answers

At what age of the child is the pediatrician obligatory?

The National Health Service provides that every child between 0 and six years old has his own pediatrician: of free choice, it is said, precisely because parents can choose him from those who have an agreement in the health district of reference.

When is it possible to go from pediatrician to family doctor?

Between the ages of six and 14 you can also decide to go to the family doctor, while on the fourteenth birthday the transfer is automatic.

TAG:
  • pediatrician
  • pediatrician for children
  • 1-2 children years
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