Post # 1
So, now that we’re at 26 weeks one of the things we’re thinking about is wanting to find a pediatrician. My husband and I are both on separate plans through our employer, and it’s WAY cheaper to put our kid on his plan, which is an HMO, so I wanted to make sure I liked a pediatrician at one of the HMO plan offices near us. I called to try to set up an appointment to meet with them, and the receptionist and member services people sounded like this was the first time they’d ever heard of someone wanting to do such a thing, and they’re trying to tell me that they’re happy to set up a “Meet and Greet” AFTER the child has been added to the plan (which obviously doesn’t help if we’re trying to decide whether to put the kid on the plan at all!)
I always thought it was pretty common to interview a pediatrician before signing up to be a patient- am I mistaken?
Also, one question everyone has told me to ask a pediatrician is “which hospital do you send your patients to” and the three hospitals they seem to use aren’t the greatest in the area. How important of a factor do you all think this is? We’re just outside DC, so we do have good pediatric hospitals in our area, should I hold out for a pediatrician whose office has a contract with one of them instead?
Post # 3
@Lozza: Please understand that meet and greets are not reimbursed for us. We do them as a courtesy to the patient’s parents. In an HMO type situation, you’re looking at a practice that operates on a razor’s edge. Each practitioner needs to see a certain quota of patients each day to keep the practice operating. Once they have the child signed up they get a certain amount of money from the plan (capitation) which would make it more financial viable to meet and greet you. It doesn’t make sense, but it’s just another problem with our medical system in the US, unfortunately.
Post # 4
@Mrs. DG: Good to know because I didn’t even think about that. Thanks!
@Lozza: Obviously great question.
Post # 5
We haven’t gone to one yet but the offices we’ve asked people about all have group meetings once or twice a month to talk with some of the physicians that practice there. So it’s not an individual thing but you still get to see in a group how the practice is run and talk to some of the doctors. So at least in our area (not DC) I haven’t heard of a place not having some kind of feel it out day. I’d definately lean towards going to a place that gave you some opportunity to explore. There’s just some people and places you click with and some you don’t and if there is a practice with a good hospital connection I’d definately lean towards them, I guess it just depends if it’s an option.
Post # 6
Some HMO Dr. Lists show the hospital they are affiliated with, if you want to narrow it down that way.
Post # 7
@Lozza:just curious, what are the good pediatric hospitals near DC? i don’t need one yet, but hopefully in a couple of years!
Post # 8
@kitzy: My preferences in DC would be Georgetown or Children’s National Medical Center.(And though it’s not in the DC area per say, Hopkins in Baltimore is also great)
There are a couple hospitals that I definitely wouldn’t want, but plenty that I’m sure are just fine/good for the kinds of things we’re most likely to face as a parent (i.e. most parents in DC don’t actually need to take advantage of Children’s National’s pediatric oncology department), so I’m trying to figure out how much of a factor the hospital should be in a decision about a pediatrician!
Post # 9
Can even you add an unborn child to a plan? Don’t you need to wait until after they are born and have a socail security # etc? We couldn’t add our daughter to our insurance plan till after she was born and had a birth certificate etc. and then it was retroactive.
I met my daughter’s pediatrician before she was born. Her pediatrician made a visit to the hospital to check her out the day after I had her. Maybe I have awesome health insurance and/or a really great pediatrician, but this was my experience.
You should call membership services on your health insurance plan.
Post # 10
I don’t have kids, but luckily when I went to an HMO from my awesome full choice plan (I forget what it was called) I already knew and liked both my primary care physician and dentist so it wasn’t an issue. But I could see how this would be a problem, especially if you can’t change it if something goes wrong.
In Manhattan from what I hear the ‘good’ doctors don’t even take insurance! I wouldn’t know because I’m just a working drone so it’s not like I have a choice..
Post # 11
@eeniebeans: You can’t add an unborn child to the plan, I just wanted to figure out if we could find a provider on my husband’s HMO plan that was nearby and whom we liked… figuring that if we didn’t like any of the docs we could use through his plan, we’d add the kid to my plan instead, which is more expensive but where we have more options. I did talk to member services, they were also confused 🙂
Post # 12
I echo what Mrs. DG said. In the US system, the physician doesn’t get paid unless the patient is present (and the system doesn’t count unborn babies). As an FP, I have never had a request- the parents already know me because I take care of them too. That is one option if you want to meet the doctor prior- go in for yourself. While I don’t get these requests, we sometimes get family members wanting to come in and talk to us without the patient being there, and we have to explain that we can’t do that, but there are more issues with that.
Post # 13
@Mrs. DG: Thank you for mentioning that.
@Lozza: It really depends what area you live in. It’s not essential
Post # 14
I’m not working with an HMO, so things might be different. I also live in a very small city, so while there are multiple options, we ended up making contact with one of the larger offices that has two locations, early morning and Sat hours, and that has a lot of services in office.
I was told on our hospital tour that we need to have a pediatrician chosen prior to birth, because they release the baby from the hospital without it. At the pediatrician office we are most likely going to go with, there are about 8 drs and a bunch of nurses. They have one of the nurses available for prenatal consults, so we don’t take up the doctor’s time, but still get to see the office and learn about how the office runs.
I can understand if the billing/payment is different for an HMO provider that they might have more difficulty being accomodating. Maybe call back and find out if there is someone you can talk to about any questions that you have, so you can decide if you like the office. If there are more than one doctors in the office, then you can change who you see if you find out you don’t like the doctor after the baby is born, or you can change offices.
Post # 15
The American Healthcare system really confuses me. From what I understand, if you don’t have insurance then care costs you a buttload. So what happens if you have no insurance and you get cancer? or in an accident? Do the doctors still treat you?
In Australia 99% of parents of healthy kids take their kids to their family doctor normally a general practitioner. And all our healthcare is subsidised by the goverments medicare program, and its capped so if you need expensive care you only need to pay the excess to the cap and then the rest is free.
For example, I had a laparoscopy done in a public hospital, stayed overnight, and all I had to pay was $10 for 14 days worth of pain killers.
Post # 16
@Roux: Yep–Our healthcare system confuses me, too. We’re working on it. ;0