Picking Your Doctor

Many of you have an established relationship with a gynecologist. Although they may be the logical choice to help guide you through pregnancy, this isn't always the best option. A good gynecologist may not translate into a good obstetrician. Your potential obstetrician should withstand some scrutiny before being allowed to handle your pregnancy.

The doctor's personality is important. You have to feel that he/she will listen to you. Pregnancy is not the time to become passive. This is a special time in your life! It is both exciting and scary. No matter how unimportant the question, it should be answered with kindness and accuracy.

Let's not forget the office staff, either. From receptionist to nurse, these people make a huge impact on your pregnancy. A pleasant, helpful staff member can set your mind at ease. Scheduling appointments, helping direct you for testing and giving you advice on insurance issues are just a few of the roles these hard working people perform. I've always told my staff that they are the ones that make our office feel like a second home. I've seen offices where the staff has a bad attitude or the office is in chaos. It can make for a very unpleasant experience.

To illustrate the point, I want to share a story about a personal friend of mine. She picked her obstetrician by networking through doctors at the hospital she'd chosen for the birth of her baby. To her surprise, she was carrying twins. She called her doctor on a frequent basis with many concerns. One time, the person who answered the phone forgot to put my friend on hold and she heard the nurse say, "It's her again!" My friend felt horrible and refused to call the doctor again. When she started contractions at seven and one half months, she called me instead of her obstetrician! I sent her to the hospital for what turned out to be premature labor. Fortunately, the doctor there was able to stop her labor. While in the hospital, she switched her obstetrician and eventually had healthy twin girls who are now thirteen years old and doing great.

I think it's easy to see how important getting along with your obstetrician and his or her staff can be. You aren't supposed to know which symptoms are normal and which foretell problems. This is why communication is the key to a safe, healthy delivery. And there is no reason why pregnancy and delivery can't be an enjoyable experience as well!

Five Questions

Let's move on to some of the key ingredients in selecting a doctor.

1. Is the doctor board certified?
Our specialty has a rigorous set of written and oral tests that must be passed in order to obtain board certification. Doctors who have just finished training can't take their final tests until they have practiced for 2 ½ years. These tests are designed to ensure that your doctor has an extensive knowledge of obstetrics and gynecology. If a doctor is not board certified/eligible, you may want to look elsewhere. You may want to ask this question before going for your first visit.

2. Is the doctor in a group?
The days of the solo obstetrician are gone. Obstetrics is a physically demanding specialty and there are times when I work throughout the night. I am tired the next day. I don't believe it is in either the patient or doctor's best interest to have a fatigued physician caring for a laboring woman. Working in a group practice is a good solution. It allows doctors to share the nights on-call as well as maintain continuity of care. Some physicians have shared call arrangements (called cross-coverage). In this situation, a physician you may not have met before could deliver your baby. Although excellent care may be provided in this situation, the familiarity and comfort of knowing and trusting your doctor is missing. In our group, all the doctors know all the patients and they know us, too! Not only does this result in good medical care, it also gives women the comfort of knowing the person who delivers their baby.

3. How do you manage patients in labor?
This is a very important question. We have all heard about doctors who make a mad dash from the office to catch your baby. They are in and out in a jiffy. Although this may be a reality of managed care, it isn't always the best way to monitor labor. It goes without saying that labor has some potential risks. Having your physician watching over you and physically being around helps insure the best possible outcome. I'm not suggesting that the doctor stay at your bedside. However, I think he or she should intermittently monitor your progress and look at the baby's heart rate. In addition, doctors who sprint back and forth from their office to deliver babies are notoriously behind schedule and frequently must cancel appointments. The ideal setting is to have one physician in the group whose sole responsibility is to take care of laboring patients. In this way, your office appointment is honored while other laboring patients are adequately cared for.

4. What is the doctor's c-section rate?
Though this sounds like a good question, it can be misleading. Most obstetricians have a c-section rate between 15-20%. Higher rates may be due to a number of causes that are out of the doctor's control. For example, an obstetrician may take on more high-risk cases where c-section is required. In reality, there are better questions to ask to determine the obstetrician who is right for you.