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And Baby Makes ... Four

The first challenge of parenthood comes before the stork arrives: To whom will you entrust your child's medical care? We've cornered ten of the city's best pediatricians -- and some of the parents who depend on them -- to talk about everything from their treatment styles to the treats you'll find in their offices.

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If you set out to design the perfect pediatrician, what qualities would you seek? You'd require a doctor who is endlessly patient with the angst of new, jittery parents; one who will cheerfully take a midnight call about diaper rash and who, to paraphrase famously hypochondriacal playwright George S. Kaufman, will be home studying medicine when he isn't examining your child. A combination, come to think of it, of Marcus Welby and my own childhood pediatrician, the wise, laconic Sam Bernstein, known as Dr. BeBe.

Which brings us to another truth: Pediatricians, more so than other doctors, are family. The ones profiled here aren't the only great pediatricians in New York, just ten of the top practitioners in the field, ones whose patients -- and their parents -- find in them the qualities I was looking for when I became pregnant, even if their personal styles differ (sometimes dramatically). We asked school nurses, other doctors, and, of course, patients and parents. When making your own selection, don't be shy about interviewing several candidates and asking lots of questions: Will the doctor make house calls? How hard will it be to see your doctor if it's a large practice? Are the referrals nearby or on the other side of town? Is he or she a member of your HMO (even doctors within practices can differ on this)? Does the doctor treat from infancy through adolescence?

Be sure they're board-certified in pediatrics; ask how long they've been in practice and whether they have a medical-school affiliation (a tie that, while not essential, makes it more likely that the doctor will be versed in the current literature and the newest treatments). And trust your instincts: One doctor's examining-room style may be perfect for your best friend but all wrong for you and your child. You want a doctor you'll feel comfortable with over the long haul.

Oh, and don't forget to check out the waiting room. Given the amount of time you're likely to be spending in it, you'll want to feel comfortable there over the long haul, too.

Laura Popper
116 East 66th Street
212-794-2136

Practice: Birth through adolescence
HMOs: None
Hospital affiliation: Mt. Sinai Medical Center
Associate: Dr. Jacalyn Shafer
House calls: Yes
Bribes: Stickers, Blow Pops,
Tootsie Roll Pops, Ring Pops

There's a buck in it for any kid who can count to five faster than Laura Popper can give a shot. She's so quick with a needle that come flu season, a sizable adult contingent eagerly rolls up its sleeve, and in Popper's almost 25 years on the job only one kid has pocketed that dollar bill. "I let her win," insists the doctor, 55, who has short hair, a relaxed, confident manner, and a sense of humor that finds expression in the mat just outside the front door -- it's got the image of a reclining Bugs Bunny and the words eh, what up doc? -- and in the sign posted in a small, tidy waiting room stocked with toys, books, and videotapes: children left unattended will be towed away at owner's expense.

Often sick as a child herself, Popper decided to become a doctor because of her own pediatrician. She decided to become a pediatrician during medical school, when she was making rounds at Babies Hospital with a crusty old professor. "There was a baby crying in a crib," she recalls, "and the professor, not breaking stride, picked the kid up, took him in his arms, patted him on the back, took him along with us, and completely quieted him."

Popper places an extremely high value on quiet. "My philosophy of medicine," she says, "is if you shut up and listen, your patient is going to tell you what's wrong. If a kid comes in with terrible stomach pains, do you immediately think of all the terrible medical things? Well, you do think that: Do they have ulcers, colitis, appendicitis? But first you have to look at the kid and listen, and sometimes you don't have to do anything else."

"There are two things about Laura that make her special," says the actress Tracy Pollan, the mother of an 11-year-old boy and 6-year-old twin girls, all of whom Popper relates to with ease. "She makes you a partner in the well-being of your children. She's interested in hearing what I believe might be relevant. She's very smart and has the courage of her convictions. If she doesn't think your child needs a lot of tests, she won't send you for them just to cover her ass."

When Popper diagnosed the ultimately fatal cancer of 3 1/2-year-old Andrew Jeffries, his parents, Leslie and Chuck, took him to Memorial Sloan-Kettering for treatment. "Laura continued to keep closely in touch with us," says Leslie, the mother of two other children. "Last year, when my daughter was 8, she was afraid she was getting the same disease that had killed her brother, and Laura took her very seriously, explaining about neuroblastoma, and gave her a complete physical. She said, 'Erin, I don't think you have this and let me tell you why. But if you still want me to take blood, I will.' It was very impressive. My daughter needed the reassurance, and Laura understood that. She believes children have something to say and she's never dismissive of them -- or of me."

Paula Prezioso
317 East 34th Street
212-725-6300
20 Plaza Street East
Park Slope, Brooklyn
718-857-5500

Practice: Birth through adolescence
HMOs: Most Hospital affiliations: NYU Medical Center, Beth Israel Medical Center
Partners: Drs. Sol Zimmerman, Harris Burstin, David Horwitz, Ellen Putter, Debra Greenstein, Gweneth Levy, Aviva Oppenheim
House calls: No
Bribes: Stickers

Emily Listfield knew she'd chosen the right pediatrician at least two months before her daughter Sasha was born. She'd had "a very problematic pregnancy" that included surgery, and she was deeply concerned about the effect of the anesthesia on her unborn child. "I was seven months pregnant when I interviewed Dr. Prezioso, and she was very reassuring," recalls Listfield. "And when she examined Sasha after she was born, she remembered the conversation we had and she remembered my personal story."

Prezioso, 39, has continued to impress Listfield. "When Sasha was 3, she was very tall for her age and very thin and her knees were splayed. It was as if she hadn't grown into herself," she says. "I hadn't really noticed it, but Dr. Prezioso did, and she would have Sasha walk around so she could look at her. She said, 'In another era they might have put her legs in braces. But I think you should put her in ballet class and have her ride her bike,' both of which I did, and the problem was solved in a practical, nondisruptive way. Dr. Prezioso doesn't just see the sore throat; she sees the total child."

Prezioso credits this familiarity to good listening skills and the ability to make connections between her own life and the lives of families in her practice. "My father was in the Police Department, and I had a father come in who was a brand-new cop and we talked a little about that and about the police picnics we'd been on. And when that family calls me, I'll remember, 'Oh, he's a police officer who's in the same precinct my father was in,' and then I'll dig down to the next level and remember that he has three children, and then down to the next level and I remember one of them recently had a bad ear infection. It's sort of a mnemonic device and it means you aren't always having to check patients' charts, which makes them feel special."

Outside the office, Dr. Prezioso, a divorced mother, tends to her own two kids; teaches at NYU, an activity that "forces you to keep up on things and know the current literature"; and worries. "That's the Italian side of me," she says, laughing. "I've had situations where I've been dealing with a family and I can't stop thinking about the kid. I worry whether I should be doing some other treatment. I worry along with the parents, but they don't know I'm worrying.

"To a parent, diaper rash or colic is a crisis, and they come to a doctor not just for help in curing it but for help in calming down. They want to be told everything is going to be okay. And in a sense, isn't that what we all want?"


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