Your pediatrician will become an interactive part of your new family. You will want to have them “on call” before you adopt to review available pre-natal, birth, hospital or institutional records, as well as to examine the child shortly after you arrive home. They will not only be following your child’s physical and medical status, but will be a source of information on many aspects of child development and parenting.
You will call them when your child spikes a fever, is lethargic or gets hurts. You will call them if your child is exposed to a contagious illness like measles or chicken pox or you are traveling and wonder what shots or precautions to take. They also offer advice on eating, sleeping and social development and provide referrals if there are questions about meeting developmental milestones.
When you adopt, there is even more to consider when choosing a pediatrician.
1. ADOPTION EXPERTISE
You want a pediatrician who has experience with adoption and adopted children. If adopting domestically, you want a pediatrician familiar with the placement of infants or older children. If it is an infant, the pediatrician should be willing to talk to an OB/GYN prior to birth to review pre-natal care and then again to the pediatrician at the hospital at the time of birth. If adopting internationally, the pediatrician must be familiar with the medical care system, as well as growth charts, local illnesses and institutional care in the country from which the child will be adopted.
2. PRE-ADOPTIVE MEDICAL REVIEW
All adoptions include the provision of some medical information prior to placement. In a domestic placement of an infant, there should be pre-natal care records, hospital birth records and information on the birth parent(s) medical, education and social background.
For toddlers and older children adopted domestically or internationally, there should be additional medical records, social and educational information. An “adoption-aware” pediatrician knows what information is typically available from a country, what additional information to try to obtain, and which countries also provide videos of children. They will know what illnesses or environmental factors are typical to the area and need to be considered in a particular country. If available, the pediatrician should be able and willing to contact the treating physician or medical center, as well as review any psychological or psychiatric evaluations or testing, academic records or other available data.
You also want to know how many adoption reviews the pediatrician has done and over what period of time. Is the pediatrician familiar with international medical terms and growth charts of the country in question? This is critical in being able to assess a child’s development based on the country’s typical height, weight and medical system (not those of the United States). If they have done other reviews, they will be able to determine if your child’s medical referral information falls within normal guidelines for that country.
Since you never know when you will get referral information, it is important to know when the pediatrician is available. Ask how they like to receive written materials, photos and videos. What is their time frame for getting back to you? How do they handle follow-up questions?
Do they have someone who fills in for them, if unavailable? If so, you want to know if that person has domestic or international adoption experience, etc. (See #1 above).
You will want to know the fees for pre-medical reviews and ongoing pediatric care, what services are covered and what insurance they accept. You also want to know if the fee paid for pre-adoption services covers all reviews of medical information or if you need to pay per review. Find out the fee to schedule a consultation prior to the child’s referral or adoption to discuss general medical and country specific issues, as well as any preventive medical care you should receive prior to traveling overseas for an international adoption.
5. ONGOING PEDIATRIC CARE
You will want to know if the doctor you are using for the pre-adoption medical review also provides ongoing routine pediatric care or annual check-ups. If they provide this service for your child, you will want to choose a physician whose office is near to where you live. You will also want to ask about the costs of ongoing care and annual reviews, as well as what insurance is accepted for those services. If they do not provide those services, you will need to locate a local pediatrician for ongoing routine and sick child care. This pediatrician should also be an “adoption-aware.”
Ask friends and family members whom they trust. Ask families with young children in your building or neighborhood. Typically, the same name will be repeated by many. It may not be an adoption-aware pediatrician, so do the leg work and ask. Joining a local adoptive parent support group is a good resource for information on pediatricians, as well as for local parenting services and for providing an emotional support network for you and your family.
Your child’s pediatrician will provide a wealth of information, as well as advice, support and any needed referrals for you and your child as your child grows. Many families continue to stay with their pediatrician until their child is out of college, so the decision is an important one.