This is going to be a little long, but I just want to know if I'm being unreasonable in my expectations.

For the last six months, my husband (also a doc) and I have been unhappy with our pediatrician whom we've been with since the birth of our boys 4 years ago and are now thinking about switching since I am prenant with third. I am little conflicted and it's not that easy to switch since in our urban community, most of the "good" pediatrics groups don't take transfers-- probably for fear of crazy and difficult parents.
Though we are two physicians, I think we are pretty reasonable people and never call unless it's really a problem since I figure we can handle most things between the two of us.

Our relationship with our pediatrician started off great-- young guy our age and his female partner opened their own practice after leaving a larger more established but highly respected group in town. Neither had kids of their own at that point. I had my boys at 35 weeks and they were tiny but apparently healthy and we all went home 2 days post partum. My husband had a bad cold at the time, which I eventually got and then my kids one after another got too. Turns out, it was RSV and the first kid who only weighed 5.2 lbs at birth got very sick at 2 weeks of age and stopped eating, had labored breathing and had temp of 34.5C. I called the female partner in the group and she told me that I was probably not taking the temp correctly and to take him in the shower and "steam" him and put him on our chest to warm him up. My husband and I decided to take him to ER where he was having long apneic spells, hypothermic, and almost got intubated. Needless to say I freaked out. The female partner came in but between PICU and inpatient peds service, he eventually got better and then the other one also got hospitalized for a week too. Both pediatricians were very attentive during this time periods but they didn't have a lot of pts and weren't too busy. A close family friend who is director of big peds ER in another city told us at that point we should switch pediatricians but we stuck it out since we liked them.

Over the course of my kids first 1 1/2 yrs, they had LOTS of URIs that required albuterol nebs, inhaled steroids, and occasionally oral steroids and antibiotics for pneumonia. They've mostly outgrown all that stuff but we still have issues now and then at 4 and I usually just take care of it without even calling the pediatrician since it's pretty mild. One of them always saw us whenever I did need to take them in and once in the first year, we saw our pediatrician on a saturday that he was on call. We liked him personally as well and talked about hanging out outside of work, etc. we referred tons of patients to him as well.

Now their practice is "the practice" most young ob/gyns refer their patients to and has gotten very busy such that they book follow up appointments 3-4 months ahead and sick visits are always handled by a locum tenems person. During the whole H1N1 scare, we had a huge fiasco with the office where they cancelled our regular flu vaccine the day before saying that they had run out. They left a message on our home phone number which we didn't get until well after business hours. We both were furious and called the office the next day multiple times and asked for our doctor to call us back-- which he NEVER did. I was mostly upset because the kids have respiratory issues and could have gotten the regular flu shot free through our work (but I kept my appt with our pediatrician because I was trying to be a good patient) and no regular pediatric vaccines were available at pharmacies in our community. My husband managed to find 2 vaccines for them eventually. Same thing with H1N1 which we ended up getting from my best friend who is an ob.

Now my problem with them is that they NEVER called us back or even apologized for cancelling our appt. My kids go to a private school that is pretty competitive to get into and our pediatrician is applying for his older daughter this year. He actually called my husband late one evening specifically to question him about the school. Well, I also happen to be friends with two other moms in my kids' class who also go to same pediatrician and they told me he hijacked their last well-child visit to talk about the school and how to get in. They were upset because he won't return their phone calls and they only see the locum tenems person when their kids are sick-- and they pay cash $200/visit since he doesn't take their PPO insurance. (believe it or not, that is common in this community). Well one of the kids (2 year old) is now in the ICU for pneumonia that was allowed to get out of control by the locum tenems person who saw her.

As a side note, both partners work 4 days/week and every other weekend and office is open 9-12 and 1-4:00 for visits M-F. Our pediatrician has written a book that is coming out soon and has appeared on several tv shows so we're concerned he's trying to be a celebrity doctor-- which my husband and I can't stand.

So my question is, should we be interviewing other pediatricians? I'm sure another group will take us since we do have some connections with several of them and I'm expecting a third. My husband is taking the kids to their well child visit next month since he thinks I'm too much of a wimp and won't confront our pediatrician with our concerns.

I would change pediatricians if I were you. They are too concerned with their own stuff and not concerned enough about patient care.

It sounds like you do not have a lot of faith in these providers- if something seems to be wrong with your children, would you trust their assessment?

If not, interview new peds, and they do not need to know why you made the change. In all honesty, it sounds as if they would not notice.

If you are comfortable with their diagnostic skills, then the question becomes what to do regarding the service. I would speak to the office manager- if that doesn't get you anywhere, I would leave. I am sure you are not the only ones having an issue.

We started in our new city with a clinic that has several Spanish speaking doctors- being a bilingual family, we felt this was important. The clinic also serves a large underserved population. After several rude encounters at the front desk, and a phone call in which the first year resident didn't seem concerned about my daughter's loss of consciousness after a serious fall/huge bump on head, I was fed up. The final straw was waiting in line for seasonal flu shots with my three children, and having the staff irritated that the line of patients was so long. The final comment went "Well, you know, when they all get off on the same bus". It was the tone, as if we were animals, and not patients.

I changed peds the next day, without one word.

Trust your instinct-- goood luck!

When is your new baby due? You could take the baby as a new patient to one of the "good" pediatrics groups and then they should transfer the siblings, no? Or at least go interview them now and while you're there (and they see you're not crazy) ask to transfer. Use your physician status, no shame in that!

I see you are in California. You said you live in an urban area but from my experience as a pediatrician in a large urban area in southern California, pediatric offices are numerous and there's never been a problem with people switching to different places over and over again. There are just way too many people here and way too many doctors to care. If you really can't just go to another practice, is there a way you could just go to a practice outside of your area? You could have any hospital pediatrician see the baby and then follow up with the a new one in a new area that you choose. Like I said, I am a pediatrician and people come and go all of the time. I work for a private group. There's no reason to stay at that practice if you are unhappy.