When to Fire the Pediatrician?

There's a lot of information out there about how to choose a pediatrician, but not much about when to leave a practice. 

I remember well the time I fired our kids' doctor. We had chosen the physician carefully when I was pregnant, and one of the things I liked was that he had office hours on Saturday, with several doctors from different offices covering for each other. On the Saturday morning when our son's ear infection had definitely gone over the top, I called , and we were told to go to another doc's office, about 15 miles away. When I opened the office door, it looked like LAX when all the flights had been canceled. Standing room only. Rough attitude by the clerks. We left.


So it got me thinking: when should you consider firing your pediatrician? Here's my short list:
 

• When their only response when you call them with a problem after hours, when they're the one on call, is "go to the ER."  Sometimes with kids, it's hard to tell if it's an emergency. Sending you to the emergency department without spending time talking to you to see what would actually be the best approach is worthless.  

•  When you don't like the physicians covering for your doctor or group practice. The chances are good that you'll need them some time, and if you don't like them, you'll be frustrated at best.  

• When they don't do basic labwork in their office.  A kid-centric office wouldn't make you drag the whole family across town just to get blood drawn.  

• When you don't like the hospital where they're on staff.  There's a chance your children will need to be hospitalized, and the facility where your physician practices ideally should be a place where there is a pediatrics unit just for children. Kids require a different approach than do adults and the doses of medication and equipment they need are very different from full-size people. It also should have a strong reputation both "officially" and through word of mouth.  

• When the pediatrician keeps calling you "Mom." It's pretty easy to introduce yourself when you walk in a room and double check who the parent is, such as, "Hi, I'm Dr. Kildare, and are you Ms. Gray?" A doc can also check the chart. When they keep calling you "Mom," it means they don't know or remember you, and that problem means they don't know or remember your child. At the very least, do you really want to have your children treated by someone who won't call you -- or them -- by their name?