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 your child’s good health than your pediatrician. Most families develop a long-lasting relationship with their pediatrician. Choosing a pediatrician who matches your personality and needs will help you ensure your child’s healthcare needs are met and make the process enjoyable 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 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 accompanying 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 explain your child’s medical records, educate you in regards to prospective problems found on the reports, and prepare a follow-up to help your physician investigate suspicious conditions 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 and make this a calculated leap.
Soon after returning home with your child, you will want to visit a physician for your child’s post-adoption medical evaluation. Prior to this appointment, it is important to have a pediatrician available and aware of your child’s situation just is case the 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 on the child. The last thing that a child needs is an immediate doctor’s visit, painful blood draws, and multiple vaccines to rock his or her already stressed world. The child needs to experience a calm transition from the orphanage to family life.
Things that adoptive parent needs to consider when selecting their child’s doctor:
- Do you want to take your child to an international adoption clinic, which is usually attached to a hospital environment, or would you prefer an international adoption-friendly private practice?
- Do you prefer a male or a female physician?
- 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.)
- Is your physician listed within your health insurance network?
- Do you feel more comfortable dealing with a younger or older physician?
- 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. A General Pediatrician practices general pediatric medicine, so 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. Some pediatricians do not offer this service because they lack the time, experience, or training. Some pediatricians may not be attuned to the special problems that are unique to this population of children. You are fortunate if you live in a community where your General Pediatrician also cares for internationally adopted children within the scope of his or her general medical practice.
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 pick up your child. This visit will help you to determine whether you feel comfortable with this doctor and whether his or her answers to your questions make sense. It is also important to make your 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.
Questions that you should ask of the office staff:
- How long do patients usually wait to see the doctor?
- What are the office hours?
- How does the office handle routine questions?
- How does the office handle emergency calls and after-hour calls?
- Does the office have evening and weekend appointments?
- How does the office handle Sunday and holiday emergencies?
- Is your physician listed within the health insurance network?
- How much lead time do you need in order to make an appointment for a physical examination?
- Does the office see children urgently on the same day for sick visits?
- 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. In general, pediatricians 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 should never intimidate you. He or she should be considered your ally in the health of your adoptive child.
Here are some important questions to ask your pediatrician during the “get to know you” visit:
- Do you (the pediatrician) have experience dealing with the complex issues of internationally adopted children?
- Will you perform the post-adoption medical examination or will you refer us to a specialty clinic?
- Where did you go to medical school and, more importantly, where did you do your pediatric residency training?
- Are the physicians in the office board-certified?
- If a hospitalization of my child became necessary, would the office admit to a local community hospital or do they admit to a children’s hospital?
- How long does the post-adoption medical examination take to perform?
- Do you feel that the post-adoption examination is just another check-up?
- How many of the physicians within the group actively see internationally adopted children?
- What are your views on well childcare and early childhood development?
- During the post-adoption medical examination period, will a primary adoption doctor handle the entire case or will the care be shared by 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 because of the possibility of unknown medical conditions, extensive laboratory tests, and the multitude of vaccines that need to be administered.
Your physician is your ally in the health care of your child. He or she 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 you turn to to resolve them. He or she will be there to diagnose a medical condition and treat it accordingly. Pick your pediatrician wisely; he or she is not just a name in an insurance directory.
The information and advice provided is intended to be general information, NOT advice on how to deal with a particular child’s situation 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 treatment plan be made. This website does not constitute a physician-patient relationship.