By Karen Finucan Clarkson

Whether you're the parent of a newborn or a teenager, having a pediatrician you and your family trusts and can communicate with can make for a happier, healthier household. Finding that doctor, however, may require some forethought and perseverance.

"In this area we're pretty lucky, as we have the highest concentration of pediatricians in any metro area," said Dr. Robin Madden, immediate past chair of Pediatrics at Holy Cross Hospital and a pediatrician with Discovery Pediatrics in Silver Spring. "Parents have a lot of options."

Expectant parents would be wise to begin their search about two months before the baby's due date, according to the American Academy of Pediatrics. Parents who are new to the area or looking for a new pediatrician shouldn't wait for their child to get sick before starting their search.

Education and experience are important, experts agree, as is certification by the American Board of Pediatrics. "In this area, virtually nobody enters private practice without being fully qualified," said Madden.

When looking for referrals, friends and family are a great place to start. But don't forget to ask your obstetrician, midwife or childbirth instructor. With several names in hand, Madden suggests you find out which pediatricians are on your health plan.

That was a primary consideration for Liz Wagger of Bethesda. After comparing health plans, she and her husband realized they could save $6,000 a year using his plan instead of her HMO. Relying primarily on the insurance company's Web site for names, Wagger then asked neighbors, via a listserv, to let her know if they'd had any experience with the doctors. After several false starts—doctors either no longer in practice or accepting new patients—she finally found a pediatrician she's happy with.

"When choosing a pediatrician, remember that this relationship could last 25 years or so," said Madden. "So you want to choose wisely, which means don't choose the first doctor you interview….You can always go back to the first if that's who you feel most comfortable with."

During those interviews, explore how the office runs, suggests Dr. David Austein, a pediatrician with Albert & Austein, MD PA in Olney. "Find out who handles incoming phone calls during office hours. Are all questions diverted to a nurse or can you talk to a physician? How are after-hours calls handled—by the practice, an out-of-town nursing service or other doctors in the community? Will you be charged if you call after hours? That's important to know before your child runs a fever at 2 a.m.," he said.

Perhaps the most important considerations in selecting a doctor for your child are personality and philosophy. "You really need somebody you can talk to," said Madden. "If you can't express concerns or have a conversation with your doctor, you won't get nearly as much out of your health care."

Communicating and connecting with the child can be important, too. If you're the parent of an adolescent, does the doctor engage the teen—ask them what the problem is—and involve them in discussions? Or does he speak primarily to you?

A pediatrician's child-rearing philosophies shouldn't clash with yours, said Austein. "In our practice we're adamant about keeping up with vaccines. If you're not going to follow the vaccine schedule, we won't be responsible for your child's care. Other pediatricians may have a different philosophy."

Parents may also want to gauge a pediatrician's views on breast versus bottle feeding, pacifier use, co-sleeping, circumcision and the use of antibiotics. Look for a doctor who either agrees with you or, at least, respects your opinion. A pediatrician's gender may be a consideration. "If a child has a particular shyness around one gender or another, which sometimes comes into play with older children and teens, parents should honor that when they can," said Madden.

"Once the kids hit anywhere from 11 to 13, they tend to segregate out," said Austein, whose practice includes two female and two male pediatricians. "Boys may see a woman for an ear ache, but for a physical, they often want to see a man."

Considerations for parents of older children include the look and feel of the office. "Is it really ‘babyfied' or is it welcoming to older kids? Can they do sports physicals on same-day or next-day notice? And what age will they see children through? If you have a 15-year-old and the practice stops at 18, you'll be searching for another doctor in just a few years," said Austein, noting that his practice handles children until they graduate college.

Given the long-term potential for a family's relationship with a pediatrician, it is important you are satisfied with the doctor, her communication style and advice. While every aspect of a practice may not be perfect, you should have a high level of comfort with the pediatrician and of certainty that your child is receiving quality medical care.