A: Children are healthiest when they have a 'medical home'—a health care provider who cares for them throughout childhood. The provider might be a physician (pediatrician, family or general practitioner), nurse practitioner, or physician's assistant; and might work alone or in a group practice or clinic.

You want a medical provider you can trust in sickness and health, day and night, from infancy through adolescence. The medical home should provide your child's frequent well-checks and immunizations, answer your questions about your child's development and behavior, and care for your child's illnesses and injuries.

When you use the same medical provider over time, you get to know each other and develop a trusting relationship and effective communication. Your child becomes comfortable going to the doctor. You learn how to get your questions answered and get a same-day appointment for an illness. You can work together to resolve your child's difficulties with feeding, sleeping, or school. The doctor maintains the records to ensure your child is up-to-date on immunizations, hearing, vision, and blood tests, and he follows your child's health and development closely over time to ensure early identification and treatment of any problems.

Finding a medical provider for your child
Most families choose a physician who has completed four years of general medical training plus advanced training: a pediatrician, who has at least three years of specialized training in child health; a family practitioner, who has three years of training in child and adult health; or a general practitioner, who has one year of additional training. You may also choose a nurse practitioner, who has master's level nursing training and works in collaboration with physicians; or a physician's assistant, who has two years of medical training at a bachelor's level, and works under the supervision of physicians.

If a family practitioner, general practitioner, or family nurse practitioner provided your prenatal care, they may continue to provide medical care for your child. If you had prenatal care with an obstetrician, ask her for names of competent pediatricians in the community. Ask your family, friends, and colleagues for names of providers they respect and trust. If your health insurance has a list of preferred providers, ask for referrals from the list. Check the phone book yellow pages under 'physician' or contact your local medical society for referrals. A website www.healthgrades.com has profiles of medical providers based on information from the U.S. Department of Health and Human Services, National Committee for Quality Assurance, state medical boards, and patient opinions.

What to look for
Make appointments to interview several medical providers. Find out whether there is a charge for the interview. The ideal time to interview providers is when you're pregnant.

When you call the office for an appointment, notice whether it is easy to get through the voice-mail system to talk to someone, and how friendly and responsive the office staff are. Ask these questions:

• What health insurance do you accept?
• What are the charges for medical visits?
• How do you handle billing?
• What are the office hours? Are there evening or weekend hours?
• What is the average waiting time for appointments?

When you visit the medical office, notice how convenient it is to get there, park, and get into the office. Is the office staff friendly and helpful? Is the reception area clean and organized? Are there developmentally appropriate toys and books for children? Do the children and families in the waiting room look content? Is the appointment on time?

Use the interview with the doctor to determine whether your style of communicating and philosophy of child-rearing are compatible. Tell the doctor a little about your family and ask:

• What is your pediatric background? Do you have a specialty?
• Does the office have other specialists (e.g., lactation specialist, nutritionist, early childhood specialist, or social worker)?
• If we have a question, when is the best time to call?
• How do we reach you after hours or for an emergency?
• If you're not available, who covers for you?
• What hospital do you use?

Making the choice
Listen to your gut feelings. Choose a health care provider who is competent and caring, and whose office is accessible and responsive. Hopefully you'll have a long, successful relationship.
Over time, if you're unhappy about anything with your child's medical care, talk with your provider to try to resolve the problems. If the problems cannot be resolved, consider switching providers. Even when you're satisfied with your medical care, you may need to switch providers if you move or your health insurance changes. Be sure to ask the old medical office to forward your child's records to the new office.

It's worth the effort to make the right choices to ensure the best medical care for your child.