More Parents Go Doctor-Shopping : Couples Getting Down to Basics With Pediatricians Before Their Babies Arrive

The woman visiting the pediatrician’s office had brought along a seemingly endless list of concerns.

“She had seven pages of single-spaced, typewritten questions,” recalled Dr. Loraine Stern, a Newhall pediatrician. “It took an hour and a half, but I answered all of them.”

No small feat, considering the questions were about an unborn child.

Like growing numbers of other first-time parents-to-be, the woman had requested a formal appointment with Stern--and, Stern suspects, two or three other pediatricians--to grill them on child-rearing philosophies and office procedures before entrusting one with the medical care of her child.

Interviewing pediatricians--who provide about 70% of the medical care for infants and young children--is not a new phenomenon.

“Even 20 years ago, (prospective) parents came around to interview,” said Dr. William Singer, an Encino pediatrician in practice 30 years.

But interviewing is becoming more popular, particularly in the last two or three years, concurred

For questions most asked of pediatricians, see story on page 2.

pediatricians polled by The Times. Today’s parents-to-be are much less likely to choose a pediatrician based solely on the recommendation of their obstetricians, as they often did a decade ago.

Of 16 Los Angeles-area pediatricians contacted by telephone, 10 noted an increase--ranging from slight to dramatic--during the past few years in “pediatrician-shopping,” a term that rankles some doctors but makes others chuckle. Four others said the number of requests have remained constant over the last few years. Two pediatricians said they rarely receive such requests.

Dr. Edward Rissman, president of the Los Angeles Pediatric Society and a pediatrician at Kaiser Permanente Medical Center in Woodland Hills, said many subscribers to the health-maintenance organization may not realize they have that choice. In fact, he said, subscribers are encouraged in prenatal classes to select a pediatrician within the health plan.

And Dr. Tom Maeda of Gardena receives few requests, he believes, because he was the only Japanese-speaking pediatrician in the area for several years and “more than 50% of my patients are Japanese-speaking.”

For many other pediatricians, though, requests for prenatal interviews are frequent.

“Maybe what we’re experiencing now is more shopping (around),” Singer suggested. “It may be that parents are comparison shopping now, rather than coming in (just) to meet the doctor.”

“I wanted information,” said Jane Schram of Saugus, explaining why she interviewed pediatricians before her daughter, now 2, was born. “I wanted to know, ‘What do I do as a new parent?’

“And I wanted to see what type of office it was . . . whether it was easy to get to . . . .”

“Interviewing pediatricians isn’t a ‘yuppie’ thing,” said Susan Peak, a 35-year-old teacher who lives in Santa Monica and gave birth to her first child in May. Rather, she said, it’s a natural part of planned parenthood. “I just didn’t want to do anything haphazardly. Interviewing is part of it.”

Expectant parents who interview pediatricians say they check the doctor’s credentials and seek ones whose personalities and child-rearing philosophies mesh with their own.

“It was important for me to find someone who would support me in my decision to breastfeed,” said Laurie Wright, 33, of Phillips Ranch, who interviewed three doctors before her son, now 4, was born.

Said another mother: “I needed to know that the doctor and I would have a good rapport and that he or she would not consider any question I’d ask stupid.”

The interviews, usually requested during the last trimester of pregnancy, take anywhere from five minutes to an hour, pediatricians said. Frequently, they are scheduled after regular office hours, increasing the likelihood of both parents-to-be attending.

Fueling the trend are a number of factors.

-- The ratio of children to pediatricians has shrunk in the last decade, making it a “patients’ market,” according to Candace Croft, senior research associate with the American Academy of Pediatrics.

-- Instructors in childbirth-education classes encourage the practice. “I usually recommend that they interview two or three (pediatricians), unless they absolutely fall in love with the first one,” said Carol Ozanich of Van Nuys, a Lamaze instructor for the last six years.

-- Consumers are becoming more sophisticated about medical information, Dr. David Belzer, a San Pedro pediatrician, said, “and they’re becoming a little more particular.”

As the number of requests for prenatal interviews has increased, some pediatricians complain that a few parents are overdoing what is basically a good thing, interviewing seven or eight doctors when interviewing three or four is usually considered adequate by pediatricians.

Concerned that the interviews are eating into income-producing time, some pediatricians have taken action.

“I charge a very nominal fee--$30,” said Dr. Susan Igdaloff, a North Hollywood pediatrician who devotes about 45 minutes to each prenatal interview. “If they decide to pick me, I credit half that fee to the newborn exam in the hospital.”

“The maximum we charge is $15,” said Dr. Herbert Levin of Beverly Hills, who levies the fee mainly “to discourage the people who are going to see seven or eight doctors.”

Dr. William Misbach, an Encino pediatrician in group practice, charged for prenatal interviews for about a year before “the three other doctors voted me down.”

Group meetings with three or four couples cut down the time investment for Dr. Robert L. Manniello, a Torrance pediatrician.

Some pediatricians view the prenatal interview as a two-way street, an ideal chance to get to know the parents-to-be and perhaps even to “weed out” the more difficult ones.

During the interviews, pediatricians also can garner health information that may help in subsequent care of the child, said Dr. James E. Strain, executive director of the American Academy of Pediatrics, who practiced pediatrics in Denver for more than 35 years.

“A family history of allergy, for example, might make a difference in the way we should feed a baby,” he said.

Igdaloff believes the sessions offer an ideal opportunity to get to know the parents-to-be as people. “It allows me to establish an adult relationship with them before dealing with them as new parents.”

(Referrals to pediatricians by geographic area are available from the Los Angeles Pediatric Society, (213) 757-1198.)