April 12, 2012

Finding the Right Doctor 101: Starting from the VERY Beginning

A friend of mine recently told me about her experience and dilemma with finding the right OB/GYN. She and her husband are trying to get pregnant and when she discussed this with her current doctor, she was surprised, saddened and slightly frustrated to hear that her doctor is only a gynecologist, not an obstetrician. She now needs to start from scratch and try to figure out what she is looking for in an obstetrician.

I urged her to take some time and really think about what kind of care she is looking for. I cannot stress enough that finding the right care provider, one that shares a similar philosophy of birth, is instrumental in shaping your pregnancy and birth experience.

Here are some guidelines for those in the same boat.

Do you have a preference for a male or female care provider?

Are you a high risk or low risk pregnant woman?
If you are considered a low risk pregnancy, it’s best to find a provider that works mainly with low risk women. They are more likely to have an open mind regarding the use of unnecessary routine interventions.

Group Practice versus the Solo Practitioner
Group Practice
While it seems logical that all the doctors in a group practice share similar birth practices and philosophies, this is not always the case. When interviewing doctors, ask if all the doctors are on the same page and will honor your requests should you need to see another doctor in the practice.

Since it is unlikely that you will get to meet all the doctors in the practice before signing on as a patient, see if you can make appointments with as many as possible early in your pregnancy. Once you choose a care provider, you will generally be seeing that particular person for your visits and only start to rotate through other doctors towards the end of your pregnancy. However, I have worked with many women who have expressed a dislike for one provider, and desiring to have one doctor over another on call during her birth. As mentioned above, I cannot stress enough that the attitude and support you receive from your care provider greatly impacts your birth experience.

Understanding that you are not guaranteed to have “your doctor” at your birth, are you ok with this set up? If not, then a group practice may not be the place for you and you may want to consider a solo practitioner.

The Solo Practitioner
If you have decided to go with a solo practitioner, you will have all your appointments with this care provider, and you will not be surprised by who will be attending your birth.

However, there are a few things to consider when signing on with this type of practice. You may find that your appointments can be canceled more often than with a group practice. With a group practice, your doctor will only have certain office days and the other days, he/she is on call in the hospital. You will not be booking your appointments on the days that your provider may need to attend the birth of another patient, since you know those dates in advance. A solo practitioner’s schedule is less structured, as there are not designated days that this person will be on call for hospital duties.

Even with a solo practitioner, emergencies and vacations arise, and they generally have another doctor or midwife as a backup. You may want to find out who the back up is, and possibly meet them before your due date.

If you are admitted to the hospital during a week day, your doctor is likely to be seeing patients in the office at that time. So, when does the doctor arrive at the hospital? He/she is not likely to cancel the days appointments if you arrive and are in early labor.

Get To Know The Doctor

You have now decided if you want a male or female doctor, if you are high risk or low risk and if you prefer a group or solo practice. The next step is to determine if your philosophies and desired statistics match up. Awhile back, I wrote a blog call “5 Questions to Ask BEFORE Your Birth” . In this blog, I reviewed some basic points that can help establish what kind of care you can expect from your provider.

The Cliff Notes version of the blog are the following 5 questions:
What is your birth philosophy?
How aggressively do you manage patient care?
What kind of schedule will you be on?
What are the statistics or rates of the practice?
When does your care provider arrive at the hospital or birth center? How involved is he or she in the labor process?

Once you determine how you feel about these questions, you can then interview a care provider to see if your answers match.

Considering you will be relying on this person for guidance through out your pregnancy, do you like his/her bedside manner? Is this person patient with you and willing to spend some time answering your questions and offering you resources to help answer your questions? Or is he/she in and out of the room so quickly you didn’t get a chance to ask anything? Is this person easily reachable? If you do have a question or problem, does the doctor get back to you in a timely manner? Since you will usually have to deal with a “middle man”, aka the office staff, are they helpful and organized?

Which Hospital Is The Doctor Associated With?
Just as your care provider will effect your birthing experience, so will the place you choose to have your baby. (Read, Where You Birth DOES Matter).

Again, the abridged version of this blog-
Are you ok with a teaching hospital?
Do they primarily handle high risk or low risk women?
What kind of NICU (Neonatal Intensive Care Units) is at this hospital?
What are their policies?> For example, do they allow intermittent fetal monitoring or is it mandatory to have full time fetal monitoring?
What are the statistics of this hospital? Meaning- what is the cesarean section rate? What is the induction rate?

Also keep in mind the proximity to your home when choosing a hospital and your doctor. You will be going to prenatal appointments often, especially the last 4 weeks of your pregnancy when you go every week. As for the hospital, you may want to factor in your comfort level with traveling while in labor.

I hope that this list provides a helpful framework for those starting their quest to find a care provider. Best of luck and hope you enjoy the journey! 🙂



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