Best Paediatricians in the Cayman Islands

Guide to Identifying the Best Paediatricians in the Cayman Islands

We are going to cover a number of concepts in this guide and not all of them have easy or definitive answers. What’s more, if you are going to look for the best paediatricians in the Cayman Islands, you have to consider both the concept of ‘best’ and the process of how you look. We are going to look at a number of important factors, including the following:

• Understanding the Term Best
• Strict Rules on Claims of Superiority
• Defining Criteria for Best Paediatricians in the Cayman Islands
• Practical Considerations in Choosing a Practice
• How to Approach Finding the Best

Understanding the Term Best

Here lies the first challenge. Best is a relative term and you could look at it a number of ways. My advice is to look at it from the following perspectives:

• Best for what?
• Best match to criteria?

Where the concept of best becomes more problematic is when you are trying to work out who the best paediatricians in the Cayman Islands are as a purely comparative analysis of one paediatrician versus another. For instance, one might be exceptionally friendly and outgoing and another may be more formal. Best is then subjective, depending on the style of individual you are most likely to get on with.

However, I am going to make a guess that when you decided this was a topic to read about, you were thinking about who was the best in the same manner that say you might consider who the best 100m sprinter is. In all professions there are individuals at the top of their professional hierarchies and those not so much. The challenge you face is that there’s no race or world record for you to use as a marker. What’s more if anyone claims to ‘be the best paediatrician’ then they are going to fall foul of the strict rules around communications.

Strict Rules on Claims of Superiority

All medical professionals are governed by a strict Code of Ethics and advertising guidelines that protect the standing of the profession by limiting the sort of advertising tactics you might see in some other industries. Broadly, this means adhering to the following:

• Not disparaging a professional colleague (claiming to be the best reduces the standing of others, but it isn’t that simple)
• Only making claims that you can substantiate, which leads to…
• Avoiding comparative claims at all, unless you can demonstrate or prove them clearly

An Example

Our practice has three paediatricians, all of whom have had a tertiary training in newborn or neonatal care. That’s a fact and we can also say that we are the largest private paediatric team with these credentials. Another fact. What we can’t say is that we are the best at neonatal care, simply because it would be impossible to prove that. The information is useful though because if you have had previous complications in a pregnancy or suffer from anxiety over what could happen (common in first time Mums), then you could use that information in your decision-making on who to appoint as paediatrician for your delivery.

Have You Seen ‘Best’?

If you have seen a practice or individual claiming to be ‘the best’ in either generic ways or specific ways that obviously can’t be substantiated, you might want to ask yourself whether you are comfortable or not with that individual or practice as your provider.

Defining Criteria for Best Paediatricians in the Cayman Islands

So, now we can get into more helpful advice and insight. Whereas identifying ‘best’ is a big problem, identifying ‘best paediatricians in the Cayman Islands FOR YOU‘ is much less problematic!

The first step is to define a set of criteria that add up to the ‘best’ for you.

OK, so let’s see if we can help you consider some aspects of defining the best paediatrician or paediatric practice for you! There are the general considerations:

Best Paediatrician when Having a Baby

If you are having a baby, you are going to want to ensure that whoever you choose matches up to the issues you are most concerned about or which are most important to you.

First time Mums are often anxious and of course they have no prior history to know if they are more of less likely to have a complication. Some paediatricians have admitting rights to NICU and others don’t. Some are trained specifically in complications at birth (a neonatologist, such as myself) and have advanced resuscitation skills (for instance, in the UK I was a Newborn Life Support Instructor accredited by the UK Resuscitation Council).

There are practical considerations too, including:

• How far from the hospital do they live? (our whole team is within 5 minutes!)
• Do they have cover if they are away? (babies have a habit of arriving unexpectedly)

I think that birth is a very special time but also one of many anxieties too and so you want to be both confident and comfortable with your paediatrician. I encourage all Mum’s to go meet with potential paediatricians, armed with a good set of questions.

Assessing a good newborn paediatrician

• Tell me about your training as a neonatal paediatrician (neonatologist)?
• Do you have admitting rights to NICU at George Town Hospital?
• When did you last do Newborn Life Support training?
• How far from George Town Hospital do you life (in rush hour)?
• Tell me about some of the complications you have had to deal with in the last 12 months?
  (helps you assess how current they are)

It’s not an extensive list of questions but it’s a very good start.As a team, we are always happy to talk through not just our own credentials but also the sorts of considerations and issues we face as an island nearly 500 miles from Miami.

You can always arrange an antenatal appointment with myself and my colleagues: Antenatal Meet Up

Best Paediatrician for General Paediatrics

Doctors are encouraged to be honest and humble about they abilities. It’s part of not claiming to do everything brilliantly and then finding yourself in trouble. In many respects, knowing your strengthens, limitations and indeed weakenesses is what keeps a doctor (and your child!) safe.

Different periods of a child’s development require different skills. In the same way I have a very extensive background in newborn care, my colleague, Dr Jasmina Marinova, has a special interest in paediatric skin conditions and she has spent more time in general paediatrics. It means that if a child presents with an unusual rash, I will often defer to Dr Marinova. If it proves REALLY unusual, she will defer to our Paediatric Dermatologist, Dr Alison Duncan (a real strength of our practice is the ability to escalate and discuss challenging cases within our group). The point is that you want to consider what stage your child is at when making your decision about which paediatrician is best for you, as well as any special health needs your child may have.

Most parents want to have a paediatrician that they grow to know and trust, and more importantly, learns about their child over time. That may well have benefits in spotting changes or indeed putting observations in context, and thus identification of problems. One of the benefits of a group practice is that you can have the benefit of longer term follow up or well-child checks from the same paediatrician but also the specific skills or expertise of other paediatric specialists when needed. As a group of 3 paediatricians, all covering general peadiatrics but all with individual additional areas of expertise, we really value being able to ask our colleagues in these areas.

Assessing a good general paediatrician

• What are your qualifications and experience with respect to general paediatrics?
• Tell me about your experience in developmental follow up and well child checks?
• What admitting rights do you have should there be an emergency e.g. to the paediatric wards?
• What are your qualifications and experience in more complex diseases?
• What happens if my child has problems out of hours?
• Do you offer appointments that fit around school, where possible?

Practical & Holistic Considerations

The age of your child and the type of care required are obviously important but there are many practical considerations too. The following are some suggested areas or questions to ask about.

About the Paediatrician and their Care

• How long have you been in practice?
• How many years experience did you gain as a consultant after fully qualifying before moving to Cayman?
• What is your childcare philosophy?
• Do you have children, of what gender(s) and age(s)?
• Are you part of a group practice? (So you can understand holiday cover, out-of-hours etc)?
• How long is a standard consultation?
• What are the normal office or clinic hours and what happens outside that?
• How are emergencies handled?
• Do you take walk-in visits?
• Do you make house calls e.g. over the weekend?

About the Clinic and Waiting

The following are good questions or reflections when visiting the practice itself.

• Is the waiting area clean, and does it have clean toys and books?
• Is there a separate child-friendly waiting area for children to play?
• Is the staff friendly and helpful?
• Do other patients seem to be waiting for a long time?
• How does the practice feel, generally? Is it a happy place?

About Insurance Cover and Referrals

• Does the practice accept your insurance provider?
• Are payment plans possible if you are faced with a big out-of-pocket bill?
• Does the practice charge Standard Health Insurance Fee rates or more premium rates?
• What hospital affiliations and admitting rights does the team have?
• Does the practice have other specialists on staff?

How to Approach Finding the Best Paediatricians in the Cayman Islands

So, not forgetting all that we’ve said about defining your criteria, just how should you approach the actual task of finding and evaluating the best paediatrician?

We advocate 3 basic steps:

1. Word-of-Mouth
2. Social Media
3. Go Visit

Word-of-Mouth

The beauty of the Cayman Islands is that it is small and people know people. My adivice is to seek out people you know and trust who have similar standards, children at similar stages and with similar needs and ask them.

My only word of caution is that many people have only experienced one paediatrician and so may only have a partial view. It’s worth just asking that question so that you know where their recommendation sits.

Social Media

Facebook is obviously very well-developed here in the Cayman Islands and a great source of information. New parents (or new to the Island) can join various groups such as KY Mommies or Women in Cayman (formerly Real Women of Cayman), which between them have over 10,000 members.

Do remember the same principles apply as for word-of-mouth and not everybody is neutral. Additionally, it is worth looking at someone’s profile to see if they are likely to have similar criteria to you (and to check that they are real – generally lots of connections and a clear history).

Go Visit

Hopefully by now, you’ve got a short list of paediatricians and a page full of questions. It’s time to go visit.

The best paediatricians for you will be the ones that are glad to meet you, without charge, and spend time answering your questions. They won’t be irritated by them or defensive (and if they are, perhaps that’s a criteria that should go on the list).

You should never feel under pressure and you can change too. You are under no obligation to choose one versus another and if you are having a baby in a practice with OBGYNs, you certainly don’t need to have their paediatrician (but go meet them, obviously).

The choice is yours and that’s the point – the best paediatricians in Cayman are the ones you choose, based on some sensible criteria pertinent to you and your child, properly researched, actively evaluated and then based on an informed choice.