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Old 04-09-2009, 11:21 AM   #1
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Is it time for a new ped? Or maybe I just need to vent...

I used to love our pediatrician and his practice.

-He said all the right things to us in his initial interview 7 years ago.
-We used to go in, wait 5-10 minutes in the waiting room, another 5-10 in the exam room, have a quick but thorough exam and be out of there in under an hour.
-I could call first thing in the morning and get an appointment for that day before 9.
-He didn't argue when I put off the chickenpox vaccine for DD and a new booster for DS1 (on the grounds that he was promised no more shots until he is 10/12!).
-The nurses were always so kind to my son and tried really hard to make him feel comfortable being there.
-I only had one really bad experience there with one doctor in the entire practice so I just didn't see him after that.
-There is another pediatrician there that I absolutely love. He is quick with his exams, but takes time to answer questions and always always always makes me feel like I did the right thing.
-The facility has been updated and looks better than ever.
-The floors there are so stinking clean and shiny I have no issues letting the baby down to play.

BUT

There has been a slow slide that seems to have snowballed this past year to the point where I am considering changing practices. It began a little less than 2 years ago:
-When they did the heel prick for DD (I left her with her father) I came back in the room to find blood and poop all over the exam table. The nurse had laid DD flat on her stomach instead of letting Daddy hold her.
-Even if I call first thing in the morning, the earliest we can get in is 11.
-It takes an hour for the nurse to return my call and sometimes I have to call twice to get a call back.
-The wait time has gotten MUCH longer. I thought my ex husband was just being a toot when he complained that they had to wait for an hour on a Friday afternoon just to get a flu shot for DS1, but I spent almost 2 hours just waiting to see the dr Monday. It was REALLY busy, but they were insisting we come in to verify an allergic reaction to an antibiotic *I* am also allergic to.

Honestly, the way they handled Monday has really gotten me thinking. Last Friday DS1 was diagnosed with strep throat and given amoxicillan. He had an allergic reaction (rash) at his dad's house Saturday so his father quit giving it to him. Monday morning I called before 8. I called again at 10:30 since I hadn't received a call back. (Their records said no answer even though I was home the entire time!) At 11 I finally hear from the nurse, she tells me that the doctor will call in an alternate medication, gets the pharmacy number, and tells me that my newly sick toddler (the one the doctor told me wouldn't get strep) can come in for a strep test (cause I want to do that!) or we can just wait it out.
At 2:30 I call the pharmacy to confirm that the prescription is ready and it hasn't been called in! So I am back on the phone with the nurse by 2:40, because I made a big deal out of things with the receptionist, who tells me she STILL hasn't spoken to the doctor.
At 3:08 the nurse calls me back on my cell to tell me that the doctor wants to SEE DS1's rash. I explain that he has been off of amoxicillan since SATURDAY, has had a dose of benedryl, and the rash is pretty much gone, but she INSISTS and asks if we can be there by 3:30.
I high tail it to the pedi's and walk in to the fullest waiting room I have ever seen. There were people literally standing there with their kids because there wasn't enough seating room. We wait for over an hour in the waiting room before we are called back to the exam room. At one point during our 40+ minute wait there, DS2 starts fussing loudly and I open the door to walk him and a nurse tersely says, "Please, keep the door closed." I explain that the baby has been here over an hour and a half and he has hit his limit.
Finally the doctor comes in, looks over DS1, and says that he's not ready to change his antibiotic because he can't see the rash and for us to give it to him again along with a dose of benadryl to see what happens. I remind him that his father has already done that, blah blah, and he still wants to repeat it. Now, I get this is a CYA kind of situation, but I remind him that DS1's father has nursing training (hence the amoxicillan and benedryl combination) and politely request that he discuss it with him first-especially since he was in HIS care when it happened. The response to this is, "You have him this week, don't you?" as though I would completely disregard my son's father's concerns or lie to him. And continues, "Well, I bumped you up ahead of some other patients and don't really feel right taking their time to call him." After all is said and done, he does right him a new prescription for zithromax (sp) but I walk away feeling unhappy with how the entire situation played out.

I am all for giving second (or third or fourth) chances, especially considering how BUSY they were when I walked in the door. But still, I am wondering....

Is it time for a new pediatrician?

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Old 04-09-2009, 11:33 AM   #2
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Re: Is it time for a new ped? Or maybe I just need to vent...

IMO it sounds like you are more upset by the incovience of having to wait and not having your calls returned as quickly as you want. Take into consideration that you are not the only patient they treat and unless its a real emergency I think its a little unreasonable to expect them to fit you in immediately, not have you wait or call you back within an hour. If overall you are please with the practice then I would stay. If you don't think you can stick with them I would make a list and call local pediatrician's offices. Tell them what you expect...you might find someone able to accomodate your needs.
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Old 04-09-2009, 11:42 AM   #3
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Re: Is it time for a new ped? Or maybe I just need to vent...

OK. I will say that some of your concerns aren't necessarily going to be changed by switching pedi's--like being seen before 11 when you call that morning. The standard is usually being seen the same day when you call, at least in my experience. And unless it's a true emergency (and then you'd need to go to the ER), I'd say that's acceptable. But those are MY standards.

As for the communication issues, I'd say that when you expect a call back from the nurse, you should have it within an hour in most cases.

I'm not sure on the issues with the rash/allergic reaction. See, I'm allergic to penicillin, but I have a true allergy to penicillin--anaphylaxis. My kids get a rash, but that's a sensitivity, not the same as anaphylaxis. Sure, I don't put my kids on the medication, either. But maybe that's where your doctor was coming from. To me, it sounds like your doctor has some issues with bedside manner. I've gotten to the pharmacy before and a promised Rx wasn't ready. Very frustrating!

Now, on waiting in the waiting room, etc., I wouldn't wait that long, either. It's unacceptable with kids, and annoying for adults.

Overall, I'd say that if you're frustrated, but you like the normal standard of care, you could lay all these things out with your doctor--explain that you may need to find another practitioner that has shorter wait times.

And ultimately, if you have any inklings that you're not happy with the care you're getting, switch. I'm a firm believer that you really need to trust your medical practitioner, or the relationship doesn't work well. If you can't trust them, then it's time to move on.
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Old 04-09-2009, 01:29 PM   #4
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Re: Is it time for a new ped? Or maybe I just need to vent...

Those are really long waits. Neitherof the peds we've seen has there ever been a wait more than 10 minutes (ever, with 4 kids!). And they've never taken over an hour to call back. And I am always seen within 4 hours even on a sunday!!!
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Old 04-09-2009, 02:06 PM   #5
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Re: Is it time for a new ped? Or maybe I just need to vent...

Sounds to me like it wouldn't hurt to find a new pediatrician. I realize that sometimes doctors are just very busy, but if I child is needing medication, they need medication and not one that causes a reaction. And not wanting to take the time to speak to both parents, especially the one that dealt with the reaction, is not acceptable, in my book.
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Old 04-10-2009, 10:00 AM   #6
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Re: Is it time for a new ped? Or maybe I just need to vent...

Thank you for your feedback. My mother thinks it is a good sign that so many people like the practice, but it sounds like they're almost too busy. Honestly, I probably wouldn't question it if a) the wait time had always been long or b)they had actually seen us close to the time THEY asked us to come in. When we walked out of the exam room the waiting room was EMPTY. After being full to capacity, seeing walk-ins who openly said they didn't have an appointment (we had an appointment according to the nurse) get in before us, and then coming out to the empty waiting room, I question it. If the nurse had told us to come at 4:30 instead it would have made much more sense!
I am thinking I will look around for a ped closer to me and give that practice a try. It's not fair to the kids to have to do a 20 minute drive and then wait that much and do another 20 minute drive back home.
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Old 04-10-2009, 12:42 PM   #7
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Re: Is it time for a new ped? Or maybe I just need to vent...

Maybe they've had to make some staff cuts due to the economy and that's why wait times (for office and phone) have increased.
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Old 04-10-2009, 02:05 PM   #8
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Re: Is it time for a new ped? Or maybe I just need to vent...

I don't know about getting a new ped. It's really up to you. The office time wait would bother me, but not some of the other things.

I did want to address the antibiotic rash though. I think what they told you is ridiculous. Lots of kids can get rashes and not be allergic but I think it is irresponsible to tell you to give them more at home and see what happens. Often the first exposure to an allergen is a rash and the next time it is worse and can lead to anaphalactic reaction. The same thing happened to my dd. She has food allergies and so I'm always on the lookout for allergic reactions. My sister is allergic to penicillin so when dd's legs became completely covered with a rash after the first dose of an antibiotic, I called the ped. They changed her med over the phone and told me not to give her more. I ended up calling her allergist who felt that we should find out for sure if she was allergic. I took her to the allergist's office and we gave her a dose there and she was fine. But none of her dr thought giving another dose at home was a safe idea! I can't believe they told you that with a family history of allergy to antibiotics.
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