Q: How can I work with my child’s health care provider to make sure my child gets the best possible care?
A: Whether you’re awaiting your first referral, or already have a houseful of kids, a good working relationship with your health care provider is crucial. Luckily, there are a number of things you can do to start off on the right foot, and keep the relationship going strong.
Choosing a Pediatrician
Ideally, you’ll be able to find a pediatrician experienced with adoption. Because that’s not always possible, be sure to ask each prospective doctor, “Do you have a specific protocol for dealing with adoption?” But don’t let a doctor’s lack of experience with adoption keep you from choosing him if it feels like the right fit otherwise. Just explain that you need to set up two appointments: one pre-adoption, and another for after the placement. If the staff balks, explain that a pre-adoption visit is the same as a prenatal visit. (Be aware that this visit may not be billable to insurance.)
When making your decision, be sure to ask whether you can call the office with questions while you’re traveling to adopt your child.
When a Specialist Can Help
Decide who will review your referral information well before it arrives. If your pediatrician is knowledgeable about adoption, he may be a fine choice. If he has limited experience with adoption or if you’re adopting internationally, you may wish to seek an adoption medical specialist. She’ll be familiar with illnesses and conditions not generally seen in the U.S. and know what to look for in a confusing or incomplete medical record. (For a list of specialists, go to www.aap.org/sections/adoption.)
Ask your doctor’s receptionist how she’d like to receive information from the specialist. Should it be faxed? Should the specialist call your doctor? Or should you bring the information with you the next time you come in?
If your specialist’s office is nearby, you may want to ask her to conduct your child’s first examination.
The Referral Review
The purpose of the pre-placement appointment is to review information from the caseworker or adoption agency, including medical records, growth charts, photos, and videos. While the reviewing doctor (or adoption specialist) won’t offer advice as to whether or not you should go ahead with the adoption, he will offer an assessment of your child’s health, based on the information available. He’ll look for both current and possible long-term medical issues, and should advise you what further tests, treatments, and immunizations are necessary. Be sure to ask how soon after placement your child should be seen, or whether the doctor advises waiting to let the child settle in.
The Child’s First Checkup
Your child may need tests and immunizations the pediatrician may not know about, so take along handouts of any pertinent information. During the checkup, also ask when your child should see a dentist.
Making the Most of Office Visits
To build and maintain a good relationship: Keep a running log of questions to raise during well-visits. Also record appointments with specialists, as well as the findings and necessary follow-ups. In order to get the service you need, tell the person scheduling the appointment what kind of visit you need. Well-care appointments take more time, because they include immunizations, vision and hearing exams, developmental assessments, laboratory studies, and questionnaires (for you to fill out) about growth and development. You may also need a longer visit for an evaluation for school problems, say, or for a sports physical. A routine sick-visit for a rash, sore throat, or ear infection is quicker.
When you’re dealing with the doctor’s office, pour on the charm: The staff is more likely to go that extra mile if you’re unfailingly polite. Save demands for instant service for true emergencies.