Problems with the Pediatrician

• Need to be able to contact my pediatrician more quickly
• Feeling pissed off at pediatrician/group practice
• Unhappy with pediatrician's advice evening/weekend advice service

Need to be able to contact my pediatrician more quickly

August 2016

My boy is 4 month old and this week has been crazy. I started to introduce him to some solids - puree carrots but wasn't sure how long to wait before I can try another type of solid. Recently he's been fussy and arching his back, so despite my husband's request not to, I googled symptoms and found he may have reflux. He's also as of last night, grown a pimple just under his eye. I'm hoping it doesn't grow in size that it impacts his eye. Anyway, all of this while I've gone back to work and my husband's away on a work trip. I like our pediatrician, but don't always get appointments with him in time. Does anyone know of pediatricians that are easier to access via text. My sister found one in DC, whom she texts her questions a lot and gets responses within a couple of hours. Jackie

I'm curious to hear of any other responses to this question. I'm a pediatrician and have been studying how I can legally text my (mostly adolescent) patients and found that with HIPPA laws, it's nearly impossible to do legally. There are programs that allow you to text to confirm or remind for appointments, but nothing that adheres to the strict privacy laws to allow you to actually send and receive medical information. So if you don't get any answers to your questions about finding a pediatrician who will text you, that is why--it is almost impossible to do legally. However, if you do find one I'm curious to know how they do it (it could be that they just are risking fines but doing it in a non-compliant way).

On that note, there are plenty of pediatricians who will email securely, so finding one shouldn't be an issue. Kaiser is pretty good about that, and Sutter is getting better but obviously each individual is different.

Feeling pissed off at pediatrician/group practice

July 2014

Today's appointment for my 2-year old has left me so rattled. I'm wondering, ''is it just me?'' I know I'm going to leave this practice, because the issues are chronic and kind of unsolvable. But I wonder how I can improve the experience for myself and for my anxious little guy, at the next place? I'm looking for compassion or insight or like experiences, please.

What's your experience and how do you handle these types of pediatric-office problems: chronic tardiness by the doc or NP? Canned or script-type answers coupled with blank expressions and lots of empty ''uh huh, uh huhs'' after you speak? The doc going off on tangents unrelated to the nature of the day's appointment? Circular answers to your simple questions? Condescension? And how to have a dialogue with the doc while your child is squirming &/or screaming.

I've been to a total of two group practices since my son was born, and both have had similar issues. I start to wonder if there's something wrong with me, with group practices, or both, and I beat myself up for it. (i.e. ''Can't I get along with anyone?!?'') But of course I can, and do. And besides, I know a gal who switched UNIVERSITIES three times, and she's a wonderful, smart, kind person. It was for the best, in other words. Sometimes we have to switch something up a few or more times 'til it fits, I try to tell myself.

Keep in mind, this was for a simple recheck of his ears, to ensure he had no leftover fluid in them from a couple recent ear infections (and no, there was no more fluid). End of story. Also keep in mind my son was being grouchy and loud, all the while the NP asked me question after question. I started to feel grilled and accused of something. Questions are good, yes! But what about context? I pushed back and questioned her questions a bit. I felt like she was looking for a problem where there wasn't any. And when I pressed her, ''do you have some concern behind all of these questions? We're just here to check his ears?'' She assessed ME, and noted how I ''twitch'' every time my son would squawk or fuss in this appointment. I was pissed of course and said, ''are you judging me?!?'' That's about as heated as it got.

So is this just me? I'm a friendly person and I give everyone a chance; I'm also sensitive and get pissed off rather easily. Nobody can speak for this clinician, I know, but I'm still looking for ''answers'' from my peers. Thanks... Parent

It sounds like you aren't going to be happy in any practice.

Of course the nurse was asking specific questions about speech. It's directly tied to ear infections, chronic or not. I would be pleased that the practice sounds thorough actually. Not one of the questions you mentioned was inappropriate or unexpected.

As far as tardiness of NPs and physicians, every patient deserves time and attention. Kids can be a challenge to treat and examine, and parents can ask a million questions. If one patient is late, it can throw the entire day off and you never get caught up. Likewise, if there is an emergency, something else that is unexpected, or something that just needs to addressed, it is going to push everything back.

Instead of looking for another practice, I'd look to your own expectations and figure out how you are going to manage them. momto4

Your question sounds like an advice request since you state you are seeking ways to improve your experience at your next pediatrician, insight, compassion, and how to handle particular pediatric-office problems (tardiness, style and content of communications, perceived condescension and how to have these conversations with a squirmy or crying 2-year old). But I'll take a shot at it here.

First, with your next pediatrician's office, see if they are willing to meet with you briefly (10 minutes?) over the phone or in person before you move to the practice, so you can ask more about the philosophy, communication style and logistics. if you hate tardiness, ask (politely) when you are making an appointment what time will give you the best chance of your appointment starting on time. It might be first thing in the morning or first one after lunch. If several patients at the beginning of the day are late for their appointments, it can delay all the subsequent appointments as well, so early may be better for you.

Another thought is ... If your child had an ear infection, and the doctor or nurse asked about reasons for speech therapy, they could be trying to learn more about your child's history and current status due to the fact that repeat ear infections can affect hearing, and hearing affects speech development. In which case they may refer you to an audiologist for a hearing test. If that is the case, they are to be commended for being thorough.

Sounds like a matter of different communication styles, in which case you might seek a practice that is more in line with your style of communicating. Since no one is perfect, you may be trading one set of strengths and weaknesses for a different set.

You should find a practice where you are confident in the doctor's expertise. Once you do that, you have to trust that they are asking certain questions for a reason. While it may not be apparent to you, there could very well be a reason.

I would suggest asking about their line of thought in a less aggressive way, as a two way dialogue is important. Also, your example of the speech therapy didn't seem unreasonable - she wanted an update on the progress from your perspective. As the parent, you would have a lot of insight into whether things seem to be working or not.

As far as how to have a conversation with a squirming kid...um, you just do. Welcome to parenthood. I am not exactly sure what the alternative would be.
 

Unhappy with pediatrician's advice evening/weekend advice service

March 2005

Saturday night I had an occasion to call the night/evening advice line provided by my pediatrician's office (sick child). Frankly I was unimpressed-it seemed to me that the RN on the line was going through a long list of questions, then eventually got to ''If I (mom) had to guess, what did I think it was?'', to which I responded ''Maybe an ear infection?''. This was followed by no advice/information about ear infections or anything else, just advice to take her to an emergency room. Maybe what really put me off was that the call started with ''your call is being recorded'' and ended with ''do you understand this advice and are you comfortable with it?'', all of which left me feeling that the whole thing was nothing but a legal hoop to jump. I know the practice of farming out night/weekend advice lines is common (my previous pediatrician in SF had a similar thing going) but I''m wondering what other people's experiences are-has anyone gotten good advice from these things? Are there pediatricians around that actually answer their own calls on weekends/evenings? Unhappy Mom

I too would be very frustrated by what you described. When my son is sick and I don't know what to do I need someone that can ask the right questions and give me some answers. When I looked for a pediatrician I made sure I would have after hour support.

I picked East Bay Pediatrics. After hours you page the actual doctor who is on call. I have used them on a number of occasions and have nothing but praise for each of the doctors that I've talked to. They respond quickly (unless they are attending an emergency) and will ask specific questions based on your description. If it is something that can be diagnosed over the phone they will even call in a prescription to a 24 hour pharmacy. They have an informative web site at http://www.eastbaypediatrics.medem.com Good luck

I have called the advice line three times in the last year and yes--they are mostly useless. The first time, my daughter was only a few weeks old and had been crying for three hours. We were uncertain if it was colic or if she was ill. So the nurse asked, ''Is she sick?'' That was not helpful--i was a first time mom and wanted help looking for signs of illness. She finally suggested we take her temperature and give her sugar water, at which point I promptly hung up. One nurse was helpful with strategies for a vomiting infant, but that was one call out of three. It's no longer my first line of information--I can go to the internet in the middle of the night and get more insights. I wish it was more helpful to all of us. anon

What you have described sounds like the service our pediatrician's office used many years ago--sometimes the advice is pretty good and other times it is just as you described, although the disclaimers that you describe are disturbing, for sure. Our pediatrician's office--East Bay Pediatrics--has 10 or so physicians and when their office is closed (evenings and weekends) one physician is on call for each day, so that when you call the office number, you can tell them your problem into a voice-activated messager, and the on-call physician will call you back to give advice, usually within 5 or 10 minutes. It's a much better method than the nurse-run advice line you describe, because when we call, many of the on-call physicians have seen our kids and are familiar with their problems and can even access their files, if need be, for more thorough advice. I recommend them highly, and know they are still taking new patients. Our pediatrician is Wm. Rhea, but all of the doctors in that office are truly excellent. They are in Berkeley and take most forms of insurance. Karen

I,too, had some frustrating experiences with the CHO after hours pediatric advice line (I'm assuming that this is what your pediatrician uses because I think that most around here do) but I recently figured out a trick that may work for you. We were at the ER late at night and had to make some decisions about a procedure that they wanted to do, and I really wanted to talk to our pediatrician for advice. I called the after hours # (which, with Bayside Pediatrics, is an answering service that connects you to the advice line) and I said that I didn't want the advice line, but was there any way to talk to our dr. They wouldn't give me her #, but did have the dr on call for the group call me back. He was very helpful to speak to, and he even agreed to try to get ahold of my dr. and have her call me (even though she wasn't on call) which she did! He called me within minutes of when I called, and when I had called the advice line earlier that night before going to the ER, they said that there was an average of 1 hour waiting time for a call back which was unacceptable to me especially for a potential emergency. I didn't wait for the call back, just took him to the ER. From now on, I will always ask to speak to the dr. on call rather than the advice line. I hope that works for you too! milli

I feel for you and your less than satisfying after-hours Peds call. I wanted to write to let you know that there ARE pediatricians out there that answer their own evening and weekend call lines. I don't know where you live but we go to Lamorinda Pediatrics in Lafayette. It is a short 15 - 20 min. drive from Oakland and we get great care from them. I even called once on a Sunday about possible wheezing in my daughter and the on call doc told us to come in to the office even though they are not officially open on Sundays. Saved us an emergency room visit and a whole lot of anxiety. I would encourage you to consider a new peds practice if this issue bugs you enough. Jennifer