Physician: How to Choose a Pediatrician for Your Child

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Does anyone have advice on what to look for in a pediatrician to care for my internationally adopted child, and what questions should I ask during the "getting to know you" interview?

Good health is very important, and other than you as the parent, no one will be more involved in ensuring good health than your pediatrician. Most families develop a long lasting relationship with their pediatrician. If you choose a pediatrician who matches your personality and needs, both of you could work together to ensure your child's health care needs are met, while making it a enjoyable process at the same time. This generalized statement holds true for all parents, whether they have a biological or adopted child. For the Internationally adopted child, there are some special nuances that need to be considered prior to choosing a physician. Depending on where in the United States you live, you may need to have two different physicians who help with the medical problems of your Internationally adopted child. If your pre-adoption consultant also practices pediatric medicine in your hometown you are very fortunate, otherwise you will need two doctors.

During the pre-adoption medical record evaluation, the physician does not need to practice near you in order to help your family. With the advent of the Internet and technology, you could live clear across the America and still be provided with a pre-adoption medical records evaluation. Services provided by Adoption Medical specialist are geared towards medical record interpretations, video and photo analysis and family support. The pre-adoption consultation is designed to be an educational and family support service and not a medical practice. Your adoption consultant will help to explain your child's medical record, educate the parents in regards to perspective problems found on the reports, and to prepare a follow-up to help your physician investigate suspicious condition found on the record. The most important role that your Adoption doctor has is to educate and guide an adoptive family with their decision. A pre-adoption physician cannot pick out or reject an adoption referral. The adoption decision is the sole responsibility of the adoptive parents. International Adoption is a leap of faith, but with proper education and knowledge, parents can be empowered to make this a calculated leap of faith.


After you return home with your child, soon it will be time to visit a physician for your child's post-adoption medical evaluation. Prior to this appointment, it is of the utmost importance to have a pediatrician available and aware of your child situation just is case that child becomes urgently ill immediately upon arrival. The formal big post-adoption medical evaluation should be performed approximately two weeks after arrival. This time is needed for parents to live with and learn about their child, get over jet lag and reduce unnecessary traumatic stress upon the child. The last thing that a child needs to add to his already stressed out life is a immediate doctor's visits, painful blood draws and multiple vaccines. The child needs to experience calm transition from the orphanage to family life.

Things that adoptive parent needs to consider when beginning the selection process of their child's doctor:

  1. Do you want to take your child to a International Adoption Clinic which is usually attached to a hospital environment or would you prefer a International Adoption friendly private practice?
  2. Would you prefer a male versus a female physician?
  3. It is important to have the doctor's office in close proximity to your home. Traveling one hour for an ear infection is not plausible?
  4. Is your physician listed within your health insurance network?
  5. Do you feel more comfortable dealing with a younger or older physician?
  6. Does your doctor have any experience in treating internationally adopted children?

International adoption clinics are usually staffed by pediatric subspecialists such as Infectious Disease, Developmental and Endocrinological services. Each of these pediatric specialties are capable of handling the Post-Adoption Medical Evaluation, but I personally feel that a General Pediatrician should be the one to control the case. Because of the mere fact that they practice general pediatric medicine, they look at the patient as a whole and are not limited by a specialty care point of view.

If your general pediatrician discovers a problem that he can not handle and requires specialty care (ex. active pulmonary tuberculosis) a prompt referral to a Pediatric Infectious disease specialist is warranted.

While there are many general pediatricians around the country who care for Internationally adopted children within their general pediatric practice, there are many more that do not. The reason why some Pediatricians do not offer this service range from lack of time, to lack of experience and training. Some pediatricians may not be attune to the special problems that is unique to this population of children. If you are lucky enough to live in a community where your general pediatrician also cares for Internationally adopted children within the scope of hi general medical practice, then you are very fortunate.

Before you decide on a physician who will care for your child either in an adoption clinic or private practice, you should schedule an introductory "get to know you" appointment with this doctor. This visit should be completed before you travel overseas to pickup your child. This visit will help you to determine whether you feel conformable with this doctor and whether his answers to your questions make sense. It is also of important to make you physician aware of any concerns discovered on the pre-adoption evaluation that may need to be taken care of immediately upon arrival. While you are there visiting the doctor's office, please take advantage of the office staff as well. Speak to them and ask questions. You may be dealing with them almost as much as the physician himself.

Questions that you should ask of the office staff:

  1. How long do patients usually wait to see the doctor?
  2. What are the office hours?
  3. How does the office handle routine questions?
  4. How does the office handle emergency calls and after hour calls?
  5. Does the office have evening and weekend appointments?
  6. How does the office handle Sunday and holiday emergencies?
  7. Is your physician listed within the health insurance network?
  8. How much lead-time do you need in order to make an appointment for a physical examination?.
  9. Does the office see children urgently on the same day for sick visits?
  10. How much lead time do you need in order to schedule a Post-Adoption Medical Examination?

Adoptive as well as biological parents both have many questions pertaining to the health and development of their child. Pediatricians in general are accustomed to such questions and most of them enjoy sharing their knowledge and experience you. Your physician should be kind, caring and by all means he should never intimidate you. He should be considered your allay in the health of your adoptive child.

Here are some important questions to ask your pediatrician himself during the "get to know you" visit:

  1. Does your doctor have experience in dealing with the complex issues of the internationally adopted child?
  2. Will s/he perform the Post-Adoption Medical examination or will he refer you to a specialty clinic.
  3. Where did s/he go to medical school and more importantly where did s/he do her/his Pediatric residency training?
  4. Are the physicians in the office board certified?
  5. If a hospitalization of your child become necessary, does the office admit to a local community hospital or do they admit to a hospital that is geared towards the care of children?
  6. How long does the Post-Adoption medical examination take to perform?
  7. Does your doctor feel that the Post-Adoption examination is just another check-up?
  8. How many of the physicians within the group actively see Internationally adopted children?
  9. What are you doctor's views on well childcare and early childhood development.
  10. During the Post-Adoption Medical examination period will a primary Adoption doctor handle the entire case or is the care shared amongst the entire medical staff?

Having a child can be one of the most exhilarating moments in life, but having an Internationally adopted child can make this a frightening experience at the same time. The reason for this is the stress created because of the possibility of unknown medical conditions, extensive laboratory tests performed, and the multitude of vaccines that need to be administered.

Your physician is your ally in the health care of your child. He is also your support service during these very stressful times. It has been my personal experience that many of the problems discovered during the pre-adoption evaluation are not true. While there are many families with children that have problems, your doctor will be the one to turn to, to resolve them. He will be there to diagnose a medical condition and treat it accordingly. Pick your pediatrician wisely; he is not just a name in an insurance directory.

by George Rogu, M.D.

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Disclaimer

The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

This material has been provided by AdoptionDoctors.com, an innovative adoption medicine private practice and educational service, dedicated to helping parents and adoption agencies with the complex pre-adoption medical issues of internationally adopted children. All medical interactions are performed via, e-mail, express mail, telephone, and fax. There is no need to make a live appointment or travel outside of your hometown. For more information, visit AdoptionDoctors.com or call 631-499-4114.

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