7 Secrets For Choosing The Right Pediatrician · 7/7/2014 · These tips should be read by every parent who tries to navigate the healthcare industry. Choosing a pediatrician shouldn’t

7 Secrets For Choosing The Right Pediatrician

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What Doctors Are Saying About This Book

“As a physician myself, Dr. Brottman’s insights are pertinent and relevant and he outlines a comforting and realistic way to look for a pediatric physician. After reading this book, parents will have the confidence to ask the appropriate questions in order to choose the right pediatrician for their children”

Randy McCool, M.D., OB/GYN Northwest Women’s Consultants, SC

“Dr. Brottman has simplified the essential questions that need to be asked and provides a very insightful and honest review of how to choose a doctor. These tips should be read by every parent who tries to navigate the healthcare industry. Choosing a pediatrician shouldn’t be about settling, it should be about finding the right doctor for your child.”

Sai Nimmagadda, M.D., Allergist / Immunologist Associated Allergists and Asthma Specialists, Ltd.

“Dr. Brottman’s book is a fascinating and insightful read into the crucial task of selecting the proper pediatrician for your child. What could be more important than your child’s health?”

Ted Loiben, D.D.S., Pediatric Dentist


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“7 Secrets For Choosing The Right Pediatrician”

How To Avoid Risking Your

Child’s Health And Well-Being

By David Brottman, M.D.


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Copyright © 2014 David Brottman, M.D. All rights reserved.

Published by Healthcare Marketing Professionals, Inc. Carpentersville, IL

www.HealthcareMarketingPros.com

ISBN: 0989001415

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical photocopying, recording, scanning or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the publisher or authorization.

Printed in the United States of America


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Table of Contents

What’s At Risk? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Who Am I? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Why This Book? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 10 Secret # 1 Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Experience really matters. Secret # 2 Personality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

You can learn a lot from a Doctor’s bedside manner. Secret # 3 Affiliations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Be careful who the Doctor associates with. Secret # 4 Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

How can I get in touch with the Doctor when I need them? Secret # 5 Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Is the Doctor even on my health plan? Secret # 6 Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

It matters less than you think.


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Secret # 7 Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Cheaper is not better. BONUS Secret # 8 The Top 20 Questions . . . . . . . . . . . . . . . . . . . . . . . . . 30

What you must ask when interviewing a Doctor. The Next Step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 About The Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35


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What’s At Risk? Choosing a physician for yourself, let alone your child, is one of the most important decisions you will ever make. This person and their skills will directly affect your child’s well-being and longevity. So how do you start the selection process? Do you ask your own doctor, friends, relatives, peers or search the internet? Do you consult your insurance company? What level of training should a doctor have? What questions should you ask them during a consultation? I will answer these questions and more as I share with you the “7 Secrets for Choosing the Right Pediatrician”.


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Who Am I? The short answer is I am a dedicated pediatrician who wants the best care for my patients. I want to teach young families how to sort through the maze of healthcare information and hurtful misinformation in our world today. The long answer is I am the product of a lower middle class family who has learned that life is wonderful, but requires hard work and dedication to succeed. I grew up helping the family business. I swept floors, worked in the warehouse, pulled customer orders and helped the back office staff. I went to medical school because my dad taught me I could work with my back or with my brain, but either way you needed to work hard. He instilled in me that great customer service and being an honest man were the best way to succeed in business. To that end I have been a pediatrician for over 26 years. I have seen over 123,000 patients; from newborns to young adults I am the CEO of Arlington Pediatrics, Ltd. - “The leader in superior service and satisfaction for patients and parents.”


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I attended college at the University of Illinois in Champaign where I received a B.S. in Honors Biology; medical school at Loyola Stritch School of Medicine; residency at the Children’s Hospital of Michigan in Detroit. Before going into private practice, I was on faculty at the University of Chicago Wyler’s Children’s Hospital. I am board-certified with the American Board of Pediatrics, affiliated with Lurie Children’s Hospital in Chicago and Northwest Community Healthcare in Arlington Heights; along with being a member of the American Academy of Pediatrics. Most importantly, I am a loving husband and father of two great children, Lena and Joe.


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Why This Book? So why am I sharing this “insider” information that other healthcare providers don’t want you to know? It’s simple; because I believe our children need great doctors. As Americans we are used to the best healthcare in the world. All children need this level of care. Regretfully, our newest healthcare system does not emphasize quality and attention to detail. It seems to promote the business philosophy, “good is good enough”. It frustrates me that the federal government, hospitals, big box retailers and other doctors think the best way for them to make money is to allow our children to receive inferior healthcare from “sub-par” providers. This is just wrong. I don’t accept “fast-food” style medicine, nor should you. We’re talking about our loved ones. Your child’s life! So how do you pick the right doctor? How can you increase the chance you are getting the


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absolute best care for your child? Keep reading. I share my answers and insight on how to avoid risking your child’s health and well-being in the “7 Secrets For Choosing The Right Pediatrician”.


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Secret # 1: Training

First off…who do you want treating your child or loved one? A physician with four years of undergraduate education, four years of medical school education and who trains at a rigorous residency program for sixty to ninety hours per week for three years or more…or…a physician assistant or nurse practitioner who only trains for two years after college? It’s like asking your neighbor to fix your car because he reads automobile magazines and trying to compare them to an auto mechanic who has experience working on Indy race cars. So this is the gimmick…the public is supposed to accept the substitution or “switch”, which is seen in ads on a daily basis. Big box retailers and hospitals constantly tout their “good is good enough” approach to healthcare. You’ve seen the signs, “We treat minor ailments in a fast way…no appointments necessary.”


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I don’t know about you but I want access to the busiest and best medical care I can get for my children. I don’t want the person who is always available. To me, that implies they don’t have a lot of patients and lack experience. So let’s begin the discussion of training… Where does a pediatrician get their instruction? I am always fascinated by how few parents ask me where I trained. They will occasionally inquire about where I went to college, and even more rarely will they ask where I went to medical school. However, I can’t recall ever being asked where I did my residency training, which is the most important question of all! For a physician, undergraduate training can be in any field or endeavor. As long as a student takes the courses needed for the MCAT (Medical College Admissions Test), their major and school are not important. One of the best physicians I ever met was on the USC soccer team as an undergrad. He was accepted to USC to play soccer, not because he was an academic standout…even though he was wicked smart. He had a


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great four years playing soccer, traveling and meeting people from all over the world. I am confident these experiences made him a better doctor because he was a well-rounded person and not due to his mailing address of four years. Medical school is more important than an undergraduate degree to an extent. Quick quiz… What do you call a person who graduates medical school at the top of their class? Answer: Doctor What do you call a person who graduates medical school last in their class? Same answer: Doctor. Understand where I’m going with this? Medical school is like any other experience; you get out of it what you put into it. You can study anywhere and it probably does not matter except it may determine where a student can get a residency. Suffice it to say that if a physician graduated from a medical school in four years…you can move on with


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your questions. If it took a physician more than four years to graduate it may imply they had trouble with the coursework. There could be extraordinary circumstances but these need to be addressed when you interview the individual to be your child’s doctor. If the coursework was the issue, I would pass on this physician. Residency is what really matters. Identify and check out the residency programs of the physicians you’re reviewing. If it was rigorous and demanding, you are on the right track. To establish if a physician trained in a good program, ask other doctors you know and trust. If they don’t know, ask them to do a little research for you. They should be happy to oblige because great physicians always want to associate themselves with other great physicians. Why do doctors require such intense training? The answer is the volume of medical knowledge is huge and grows every year. If a physician has never seen or read about a particular condition, they can’t think of it if they’ve never heard of it. You see…it is not important to know what a doctor knows…it is important to determine if a doctor knows what he or she doesn’t know.


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I am a firm believer…if you think you know everything, then it’s time to retire. A “Dr. Know It All” is really dangerous! A doctor who is omnipotent is actually quite impotent. If any doctor “thinks” they know it all, don’t just walk away, RUN! When searching for a doctor to take care of your child, be sure to consider work experience too. Do you really want your child to be a doctor’s first patient?


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Secret # 2: Personality

So, let’s say you found a physician with a great training resume. The doctor seems intelligent with a solid knowledge base. But can they talk intelligently and in terms you understand? Do they listen? Do they have good eye contact when talking with you? Are they nice on the telephone? Are they interested in taking the time to meet with you and get to know more about your child? Will they answer your questions or just speak about what they have on their agenda? Do they make you feel comfortable? Do you picture yourself asking this person intimate and personal questions? All of these answers must be a resounding YES!


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If not, keep on searching. One point I want to make absolutely clear…pediatricians are not surgeons. Technical competence and bedside manner are both important because of the long term relationship and the nature of care for your child. In a pediatrician you need knowledge, personality and empathy.


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Secret # 3: Affiliations

The world of medicine is changing quickly. The new healthcare reform, the Affordable Care Act (“Obamacare”), is invading and we’re already seeing doctors scurrying off like rats and onto “sinking ships”. These same physicians are forming and dissolving alliances rapidly in fear they will be left behind. Some of the “sinking ships”, large medical groups, retail clinics, and even some hospitals, strongly encourage physicians to refer solely within their group. (Note: It is illegal for a doctor to do this, however, that doesn’t mean it is not done.) Make sure the doctor you’re interviewing practices at a hospital you favor. Ask them if they routinely refer patients to physicians outside of their group or hospital. If they don’t, ask why not. Better yet ask the doctor does he always send his patients to the physicians he would send his own spouse, parents or kids to. In my experience, not all physicians are equal, some are better than others. This is true for any profession; plumbers, teachers, salespeople, etc.


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You and your child deserve the best! Period! No exceptions! This is your family and your child’s life! Personally, I would only use a small fraction of physicians I have met over the years. I carefully evaluate them. I DO NOT SETTLE FOR JUST OK for my family. I don’t need to go to the best restaurants, have the biggest TV, wear fancy clothes or drive expensive cars. What I do need is the best doctor…and so does your child! This brings us to a new twist in healthcare; is it better to go to a doctor who works for a large hospital or a huge corporate entity or see a pediatrician in private practice? There are great physicians working in both of these settings. But think about it…when doctors run their own business, they have “owner” mentalities. They want their practice to be the best it can be. They change, update their office and improve customer service. Doctors who’ve decided to leave private practice and


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work for big, hospital-owned medical groups will say, “What can I do about enhancing customer service? It’s out of my hands. The hospital makes all the decisions. I’m only the doctor.” In this new healthcare environment, you’ll see “independent” physicians fight for survival but the true “Doc Stars” will build their private practice while creating a better patient experience.


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Secret # 4: Access

When is the doctor available for appointments?

When are they available by phone? If your child is sick, can you be seen the same day? Under what circumstances will the doctor send your child to the Emergency Room? Will they see you in the hospital if your child is admitted? Who covers for the doctor when they are off or on vacation? Is the doctor close to retirement? If they have partners…what are they like? If it is a group practice…can you see the doctor of your choice? Do they have evening and weekend hours? Does the doctor work full or part time? These are some of the questions you need answers to before making the decision of who will be the right


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pediatrician for your child. You may be able to find many of these answers on the doctor’s website. If you don’t, be sure to ask them directly when you interview the doctor yourself. As part of the new landscape of medicine, electronic health records along with e-mail and texting have been integrated to seemingly help with access and efficiency. Being a great pediatrician is about communication… real person to person interaction. This includes all of the “non-verbal” communication that is lost in electronic conversations. As of the date of this book’s publication, there is no medical study that shows electronic health records provide better patient outcomes. However, there is data to support the opposite opinion; poor patient outcomes have occurred as a result of utilizing electronic health records. Many patients also feel physicians, who use electronic health records, spend far more time interacting with their computers rather than engaging in direct person to person interactions.


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Secret # 5: Insurance

Is the doctor on your insurance plan? Many people would say this is the most important question you should ask and the first thing you should consider when selecting a doctor for your child. I would say it is number 5 on the list. I say this because…you need to pick your insurance based on the doctors in the plan, not the other way around. People almost always have some choice offered through their work. Insurance exchanges under the Affordable Care Act will also offer a variety of plans. However, I’m here to warn you… DO NOT TAKE THE CHEAPEST INSURANCE. If you’re asking why not, refer back to Secret # 1: Training. If a doctor is not under the insurance plan you select for your family, contact them and ask…how can I get you to see my child anyway? I have practiced in the same community for over twenty years. I constantly run into parents who tell me


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they used to come to my practice, which they and their kids loved. They’ll even say, “Dr. B you are so much better than the doctor who’s treating our child currently. However, our insurance changed and we had to switch practices.” The truth is…these parents are actually settling for inferior care for their child because of cost. Today there are many choices when it comes to types of insurance and healthcare providers. Unfortunately, many parents pick the cheaper plans offered to them and are sorely disappointed with the results. So I want to challenge you. What is more important…your child’s health and well-being or “stuff”? Take a few minutes, sit down and really think about this. What do you value more…great medical care for your child or another “bright shiny” object (be it a new TV, tablet or the latest cell phone). Now don’t get me wrong, health insurance costs are high but that has little to do with your primary care provider, which I’ll address later in Secret # 7.


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Secret # 6: Certification

During medical school and after the first year of residency, physicians in training take three board exams. Foreign trained doctors also take exams. If these exams are passed, then a person can practice medicine in the United States. They can “hang out their shingle” and be a general practitioner. Most physicians go on and obtain further training to become an internist, pediatrician, OB/GYN, surgeon, etc. Other physicians pursue more advanced training and become sub-specialists. At the conclusion of this advanced training, doctors take “board” or “specialty board” exams. These tests must be passed within several years after the successful completion of residency or fellowship. Recertification is also required every ten years. Specialty or sub-specialty board certification is a requirement for doctors to remain on staff at most hospitals. It is very important for a physician to pass these exams.


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The score a doctor receives on these tests does not matter. These exams have little to do with how good of a physician a person is but rather if they are good at taking tests. So make sure the physician you’re choosing to take care of your child has passed their “boards”. When it comes to being a member in good standing of the AMA or the American Academy of Pediatrics, it’s nice but hardly tells you what you need to know to make an informed decision. The number one requirement for inclusion into most medical societies or organizations is the ability to write a check that won’t bounce.


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Secret # 7: Cost

According to the federal government, low cost seems to be the number one criteria for measuring the quality of healthcare today. Besides this being incredibly stupid and short sighted, I find this fascinating. When you pick a lawyer to represent you, do you hire the cheapest attorney? When getting an estimate from a contractor, do you always select the lowest price? When you’re looking to buy a house or a car, is price the sole factor of your decision? Of course not, you need to consider many factors. The same applies to the doctor you plan on choosing to take care of your child. The truth is…the largest cost in healthcare has nothing to do with your primary care physician; it has to do with hospital care. Hospitals and nursing homes are the ones running up healthcare costs. Doctor’s fees are not the problem. The public has


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been sold a complete bill of goods by both the federal government and the media. The true cost in healthcare has to do with “end of life” care, not routine care. Yes all costs are important, but when you are looking for the right doctor for your child, a good one will cost you less money in the long run. They will be thorough and practice preventive medicine. Providers with less training may be cheaper, but tend to diagnose disease later when it’s at a much more advance state. Thus, costing you more money down the road and putting your child in danger. This is why medical clinics inside a drug store make no sense. Experienced pediatricians diagnose patients sooner than lessor trained providers. (Remember Secret # 1: TRAINING). So when you’re searching for a doctor to treat your child, check costs. If they seem high, ask the physician or office manager why they are higher than similarly trained physicians in the area. It may be because you’re going to get a lot more value. Ultimately, you must compare “apples to apples”.


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BONUS Secret # 8: The Top 20 Questions

The most important thing for you to do once you’ve created a list of doctors, suitable to treat your child, is to interview them. Then you’ll get the answers to the questions I’ve presented throughout this book along with the ones I share with you in this chapter. Most offices will accommodate your request to interview a doctor, although some practices will charge you for it. If this is the case, find out if your insurance plan will pay for this consultation before making the appointment. Some health plans will, as long as it’s billed as an office visit. If it’s no covered by your insurance, pay for it with cash. It is a small investment for the most important relationship you may ever establish on behalf of your child. In case you were wondering…I don’t charge for this visit. Although my time is extremely valuable, these visits provide me the opportunity to decide if I’d be the right pediatrician for a family. If I don’t think there is a good fit between the parent(s) and myself, I’ll tell them so


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during the visit and recommend other doctors who may suit them better. This point should not be underestimated in its value. This is not a popularity contest. A doctor and a child’s parent(s) have to be on the “same page”. It’s alright if you find out there’s not a good fit. If a doctor points this out to you, don’t get offended, they are simply looking out for your child’s best interest. To equip you with the necessary information you’ll need in order to determine whether you’ve found the right pediatrician for your child…I present the essential top 20 questions you must ask when interviewing a doctor. 1. Which hospital(s) is/are the doctor affiliated with? 2. Will the doctor (or one of their partners) see your child in the hospital or will the only contact be in the office? 3. Do the doctor’s hours suit your schedule? You might prefer one who works certain days of the week or who offers evening or Saturday hours. 4. How does their office handle telephone inquiries?


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Does their practice set aside specific times for parents to call in with questions or is there an “open advice line” during office hours? If staff members handle the inquiries, do they dispense their own advice or relay the doctor’s? 5. How long does it take to get a non-emergency appointment with the doctor? 6. How are sick appointments handled? If in a group practice, is there a good chance you’ll get to see your child’s own doctor? 7. Are there separate well and sick waiting areas? 8. Does the doctor’s office run on time? 9. Does the doctor offer value added services, like an “in-house” pharmacy? 10. Is the staff warm and helpful? 11. How do you reach the doctor if your child gets sick after hours? When your doctor is not “on call’, who covers? (For example, some doctors will send patients to urgent care clinics while others will meet them at the office even at night.)


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12. Does the doctor have a subspecialty or an area of interest? 13. How does the practice handle payments, billing, laboratory charges, and insurance claims? 14. Do you and the doctor have similar views on medical topics and treatments? 15. Will the doctor consider alternative medical treatment options? 16. Pay attention to such intangibles as the doctor’s style. Do you want a doctor who offers choices and lets you decide which one works best for you or would you be more comfortable with one who gives you a lot of direction? 17. Is the office easily accessible with ample parking? 18. Take stock of the overall atmosphere of the office. Is it clean, warm and inviting? 19. How many “active” patients are in the practice? 20. Lastly, ask the doctor…do your patients look forward to seeing you? (The answer should be YES!)


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The Next Step Now that I’ve shed some light on the how to choose the right pediatrician for your child, my hope is you’ll put it into action. After reading this book, you already have a good sense of who I am and what I stand for. You may even think I’d be a good fit for you and your family. If so, I invite you to set up an interview with me so we can meet in person. You can schedule a FREE “Get Acquainted” visit with me by calling my office, Arlington Pediatrics, Ltd. at (847) 398-0400. You should plan on spending about one hour for our visit, as I’ll be sharing with you all the benefits of our practice along with everything you’ll need to know before bringing your new baby home. Be sure to bring your list of questions too, I’ll answer them all. One thing I always tell parents...“at Arlington Pediatrics, the first 5000 questions are free and none are too silly.”


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About The Author Dave Brottman is a self-described “throwback” in medicine. He believes in quality, service and truth. This is in an age where those values are seemingly lost. This stems from his humble beginnings on the south side of Chicago. He was taught by his parents and immigrant grandparents…right from wrong, the value of hard work and perseverance. “I was inspired by my parents and grandparents who were innovators in their fields. I watched them run their small family businesses. They taught me the value of hard work and to always appreciate your customers. They instilled in me the joy of being an entrepreneur. They taught me to celebrate and appreciate the success of others. They also taught me to learn from other’s mistakes and mourn with them when things did not go as well.” When Dave went to medical school, he met father John Fahey, who taught him on the first day of medical school that patients needed to be treated like family members. Dave has lived by those words ever since. They are part of his corporate mission statement and he even inscribed them on the front wall of his office.


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“I love being a pediatrician and an entrepreneur, but my true passion is my family. I have worked tirelessly to achieve the necessary balance between work and family. I am the proud father of two great kids and have been married to my best friend for over 20 years.” Besides coaching innumerable sports teams, Dave and his wife have been able to be the consummate volunteers for numerous community organizations. “Jan and I love a good fundraiser. We have a hard time saying no when volunteers are needed.” One of Dave’s patients commented to him once that he should run for mayor or state representative, “you know everyone”, they said. Dave replied, “No, I know what I don’t know. I would want to tell the truth, be honest and help people. I would never fit in Washington or our state capital. I love my career and want to keep practicing pediatrics as long as I am able.”

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7 Secrets For Choosing The Right Pediatrician · 7/7/2014 · These tips should be read by every parent who tries to navigate the healthcare industry. Choosing a pediatrician shouldn’t