Kristie McNealy, MD

Earlier this year, a survey sponsored by MedImmune, the makers of Synagis, showed gaps in routine health care provided to preemies. The surveyed 202 neonatologists and pediatricians about current attitudes and practices when caring for the specialized health needs of preterm infants, and found that 70% of respondents felt that the health care system in the US failed place enough emphasis on or dedicate enough resources to preventive health care for preemies.

The survey showed that only 47% of pediatricians with ten or fewer years of experience spoke with a neonatologist or obtained medical records relating to a preemie’s NICU stay. Less experienced pediatricians were also less likely to have ongoing communication with a patient’s neonatologist during the first few months after discharge.  In addition, results showed that 58% of 34-35 week preemies were considered healthy and at low risk for RSV by their doctors, despite research showing that even late preterm babies are at an increased risk for death during the first year when compared to their term peers.

Leaving the NICU is both an exciting and anxiety provoking time for most parents of preemies.  While one of your best allies while getting through this time should be your pediatrician, the data shows us that this isn’t always the case.  With that in mind, here are a few questions you can ask to help you choose the right pediatrician for your preemie.

• Ask prospective pediatricians about office hours, and how they handle calls from parents during and outside these hours.  Do they take the calls themselves and do they charge for advice given over the phone?
• Find out who your child will see if they get sick.  Are their other pediatricians or staff that are in charge of sick visits, or does your pediatrician generally see all of their patients themselves?
• If the pediatrician practices alone, find out who takes over when they are out of the office?  Does whoever fills in take your insurance, and will they have access to your child’s records?
• Is there any specific follow up they would recommend for your preemie, and are they willing to refer you for any follow up you’d like your baby to receive?
• Do they have experience caring preemies or special needs children?  Do they like to manage any specific problems your baby has on their own, or do they prefer to refer patients for specialty care?
• Discuss their thoughts on Synagis, and whether or not they feel your baby is a candidate this RSV season.

The answers to these questions should help you decide whether or not a particular pediatrician will live up to your personal expectations and make you feel comfortable with the level of care your child is receiving.

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