What to Expect the First Year by Heidi Murkoff Page B

more babies an FP sees, the more pediatric know-how he or she is likely to have built up, minimizing this potential downside.
What Kind of Practice Is Perfect?
    Decisions, decisions—and here’s another one on your list: What type of practice will best fit your needs, and your baby’s?
    The solo practitioner. Like the idea of one doctor, all the time? Then a solo practitioner might be right up your alley. The most obvious perk of a solo practitioner: You and your little one will have the chance to develop a close relationship with one doctor (which can mean fewer tears and fears at checkup time). The flip side of this perk: Solo practitioners aren’t likely to be on call around the clock and around the calendar. They’ll be around for scheduled appointments (unless called to an emergency), and on call most of the time, but even the most dedicated among them will take vacations and occasional nights and weekends off, leaving a covering physician in charge (a doctor you and your little one may not know, or at least probably won’t know very well). The way to cash in on the upside of a solo practitioner while minimizing the downside? Find out who covers for the doctor you’re considering and whetheryour little one’s records will be accessible even when the doctor is not.
    The partnership. Often, two doctors are better than one. If one isn’t on call, the other almost always is. If you see them in rotation, you and your baby will be able to build a relationship and a comfort level with both. The potential downside, which can also be a potential upside? Though partners will probably agree on most major issues and will likely share similar philosophies of practice, they may sometimes offer different opinions—and advice. Having two points of view (say, on a sleep problem or a feeding issue) can be confusing, but it can also be enlightening. One doc’s tips didn’t cut the colic? Maybe the other’s will.
    Before you settle on a partnership practice, ask whether or not scheduling checkups with your doctor of choice will be an option. If not, and if you discover you (or your baby) prefer one to the other, you may spend half of the visits with Baby Doctor Not-So-Right. Of course, even if you get your choice for checkups, sick kids are usually seen based on doctor availability.
    The group practice. If two are good, will three or more be better? In some ways probably yes—in others, possibly no. A group is more likely to be able to provide 24-hour coverage by doctors in the practice, but less likely to ensure close doctor-patient relationships—again, unless you can schedule the same doctor or two for regular checkups (most practices offer this option). The more physicians a child will be exposed to on well-child and sick-call visits, the longer it may take to feel comfortable with each one, though this will be much less of a problem if all the doctors score high on warmth, caring, and baby charm. Also a factor here: The more doctors, the more opinions and advice—sometimes a perk, sometimes a potential problem.
    A combined practice. Any of the above types of practices may include one or more highly trained and skilled pediatric practitioners who aren’t pediatricians. Pediatric nurse practitioners (PNP) are the equivalent of the nurse-midwife in the obstetrician’s office—they hold a BSN or RN with additional training (generally at the master’s degree level) in pediatrics. Pediatric physician’s assistants (PA), who work under the supervision of a physician, spend 2 years training at an accredited program after completing college. A PNP or PA usually handles well-baby checkups and often the treatment of minor illnesses as well, consulting with physician colleagues as needed. Problems beyond the scope of a PNP or a PA are referred to one of the doctors in the office. Like a midwife, a PNP or PA will frequently spend more time on each visit—which