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Would you change pediatricians over this?


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Synopsis: Took dd5 to doctor on Friday when her low fever (that she'd had for a few days) became a high fever. Dr. did a 5-minute strep test (negative) but then did the full culture, and said he would call us with results on Saturday. He did not call.

 

By Sunday, her fever was over 105 degrees and she had a rash on her torso. Took her to the emergency room; they said it was a virus.

 

Monday a.m., I call the doctor; strep results were positive.

 

So, because the doctor did not call me with the results on Saturday (like he said he would), dd felt terrible all weekend and we are starting the antibiotics 48 hours later than we could have.

 

I've been with this pediatrician for over 11 years, and I really like him -- but this is the second time we've had issues with getting test results over the weekend.

 

What would you do?

 

Bonnie

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Would I switch? Probably. I will tell you though, I NEVER wait for doctors to call me back. They are too busy, things fall through the cracks, sqeaky wheel gets the grease, you get it. I ask when the results will be back and then I make sure to call shortly after that time. Sorry your daughter was sick:grouphug:!

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First, I'd have a foaming at the mouth fit and let this doctor know why I'm upset! This is inexcusable!

 

Seriously, a face to face meeting to find out why the call wasn't made is in order. Even if you change doctors, this one needs to know the needless suffering he and his office caused. 105 degree fevers can have serious life-threatening consequences.

 

And, yes, I'd find another doctor.

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I forgot to put that in my original post. I tried to call back around noon on Saturday, but there was no way I could get in touch with my actual doctor (who's a solo practitioner). I could only get to a nurse practitioner-on-call who was not actually affiliated with my doctor's office.

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I would seriously think about switching. The fact that you ended up in the ER as a result of the doc not callling would be a red flag. Would you have been able to call the office on Saturday to get the results? Before leaving the practice, I would want to talk to the doctor and ask how this situation could be avoided in the future. The high fever and rash would freak me out, especially if it was strep related. I am not a big prescription kind of person but I don't mess with things like strep.

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Yes, I would probably switch. Sure, drs. get busy, but this is their job. If, because of the long relationship I had w/ the dr, I chose not to switch, you can bet I'd have a serious talk w/ him. This happened to my oldest son when he was 17, and I ended up switching. We had a child die in out area because strep wasn't diagnosed early enough (the mother didn't bring her in to the dr.) and she became septic.

 

Strep can lead to many complications if not treated - scarlet fever, rheumatic fever, etc.

 

This link says quite a bit.

 

http://www.dhpe.org/infect/strepa.html

 

JMO

 

Peggy

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If you really like this pediatrician, I would try to have a calm, direct discussion with him. It is a serious matter, especially as it has happened twice. He should be made aware of it. Also, it may be difficult to find another doctor, unless you already have one in mind. If you are not happy with his response to your concerns, then I would consider switching.

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I would like to add, I'm not trying to scare you, it's just that this can be serious. Plenty of kids get strep, as I'm sure you know, and the only problems they have are fever and sore throat.

 

My 2 younger dss had strep for over a week when they were in PK and K before it was diagnosed and nothing happened. The older one had it, complained of a soar throat - I checked and didn't see anything and he had no other symptons (fever, upset stomach, etc.) so I sent him to school. It wasn't until younger brother started running a fever that I took him to the dr.; at which point they ran a strep test and it came back positive. I suggested they check the older one - he tested positive too. I had been sending this strep ridden kid to school for at least a week with no clue. Needless to say, I felt like a really bad mom. Not only for my own kids but for the others that they had infected.

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If you really like this pediatrician, I would try to have a calm, direct discussion with him. It is a serious matter, especially as it has happened twice. He should be made aware of it. Also, it may be difficult to find another doctor, unless you already have one in mind. If you are not happy with his response to your concerns, then I would consider switching.

:iagree: Docs are humans like we are, and we are all capable of making mistakes.

 

HOWEVER, I tend to prefer a small physician practice to a large one. If your doc was supposed to call you, and there was no one else available to get you results, then a change needs to be made - policy-wise. If the doc disagrees with this, then I would have to look at another doc.

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Thanks for the good feedback. I have put in a call asking the pediatrician to call me to discuss what happened. I've got my thoughts written down so I don't forget anything. (Basically, what can he do to ensure that this does not happen again? Is there some way for his answering service to contact him in this type of situation?) I'll post again later after he and I have talked.

 

Bonnie

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Are you able to phone and reach him through an answering service after hours? If his medical skills are acceptable I would give him another chance and just be candid about the need to call him for the results since he is forgetful about this important detail.

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I will be sure to ask when he got the results. On Friday, though, he specifically said he would call with the results on Saturday. So, if there was a problem with the lab, I still think he should have called me to let me know.

 

In response to another reply, the ER offered to repeat the strep test, but I declined because I knew I would get the original test results earlier than I'd be able to get the ER results. They specifically said that it didn't look like scarlet fever, though, which surprises me since that's apparently what she has.

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Yes, I would switch doctors. But I am wondering how the ER missed the scarlet fever/strep diagnosis as well????

 

No doubt! I thought the scarlet fever rash was pretty telltale.

 

I can't imagine how a rapid strep test would come back neg by the time a full-blown strep rash is present. Did they not do a rapid strep test in the ER? If not, the peds office is not the only place I'd be taking issue with...

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When we've had doctors that used a nurse/answering service, they had ways to page the doctor. I would definitely find out if there is some way to avoid this in the future.

 

If there is nothing to ensure it doesn't happen again, I would switch.

 

If you can come up with a procedure for the future, and he's very sorry and apologizes, and this is the only problem you've ever had with him in that length of time.....I would stay. It is very hard to find a doctor.

 

We have a $15 copay for doctor visits and a $100 deductible. We have a $250 deductible that is calculated separately, if we go to the ER. So, this situation would have severely ticked me off.

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Snickelfritz, you pin-pointed what I want to talk about when (if?) my pediatrician calls me back. I need to make sure that the answering service isn't at fault here (although I explained the situation, that I was inquiring about test results). If he can explain to me how he will improve the communication mechanism so this will NEVER happen again, then I would very much like to stay with him.

 

The money part ticks me off, too. I had a $15 co-pay for the office visit on Friday. I had a $100 co-pay for the ER visit last night.

 

If I don't get a call from the pediatrician today, that will definitely mean that I will no longer see this doctor.

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I would probably switch. When it comes to health, I couldn't put up with a slacking dr. What if this were something more serious? I mean I know doctors can be very busy at times but they should have had somebody call with the results if even just a nurse.

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Synopsis: Took dd5 to doctor on Friday when her low fever (that she'd had for a few days) became a high fever. Dr. did a 5-minute strep test (negative) but then did the full culture, and said he would call us with results on Saturday. He did not call.

 

By Sunday, her fever was over 105 degrees and she had a rash on her torso. Took her to the emergency room; they said it was a virus.

 

Monday a.m., I call the doctor; strep results were positive.

 

So, because the doctor did not call me with the results on Saturday (like he said he would), dd felt terrible all weekend and we are starting the antibiotics 48 hours later than we could have.

 

I've been with this pediatrician for over 11 years, and I really like him -- but this is the second time we've had issues with getting test results over the weekend.

 

What would you do?

 

Bonnie

 

I assume the rash was Scarlet Fever.

 

http://www.mayoclinic.com/health/scarlet-fever/DS00917

 

There are possible complications with this that should not have been ignored. Yes, she will no doubt be fine, but waiting could have been a bad thing.

 

http://www.mayoclinic.com/health/scarlet-fever/DS00917/DSECTION=complications

 

You ought to speak with your doctor to tell him that this is the 2nd time this has happened. He either needs to change the way weekends work or you need a new doctor. If his system is not working well on weekends, he needs to know this (he may not). Others will benefit by your speaking up.

 

Moving to another doctor or not might be a matter of seeing how he responds.

 

Jean (whose dd has had Scarlet Fever, too)

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He was very apologetic -- he was on a scout camping trip with his sons all weekend. When he told me on Friday that he'd call me on Saturday, he wasn't thinking about the fact that he wouldn't even be in town.

 

When I explained that his actions had caused me to end up in the ER with dd, he offered to waive my co-pay for visits to his office in order to make up for the ER expenses.

 

Hmm . . . I'll have to think about this.

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He was very apologetic -- he was on a scout camping trip with his sons all weekend. When he told me on Friday that he'd call me on Saturday, he wasn't thinking about the fact that he wouldn't even be in town.

 

When I explained that his actions had caused me to end up in the ER with dd, he offered to waive my co-pay for visits to his office in order to make up for the ER expenses.

 

Hmm . . . I'll have to think about this.

 

I guess the big question is.....do you know of anyone better?

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. . . I don't know of anyone better. I have a family doctor that I like (and might take my daughters to if they are uncomfortable with a male doctor as they get older). I'm leaning towards staying with him. Over 11+ years, the good has most definitely outweighed this bad experience.

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He was very apologetic -- he was on a scout camping trip with his sons all weekend. When he told me on Friday that he'd call me on Saturday, he wasn't thinking about the fact that he wouldn't even be in town.

 

When I explained that his actions had caused me to end up in the ER with dd, he offered to waive my co-pay for visits to his office in order to make up for the ER expenses.

 

Hmm . . . I'll have to think about this.

 

I would likely give him another chance. If I had a long relationship with him, and I liked him generally, I would be inclined to stay. I would make sure though that any time there are test results to come back that he will either be in town, or have the results forwarded to the on-call NP/Dr. There needs to be a better system for getting the test results, and you need to work something out with him in regards to that. It will hopefully not only benefit you, but his other patients as well.

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I would likely give him another chance. If I had a long relationship with him, and I liked him generally, I would be inclined to stay. I would make sure though that any time there are test results to come back that he will either be in town, or have the results forwarded to the on-call NP/Dr. There needs to be a better system for getting the test results, and you need to work something out with him in regards to that. It will hopefully not only benefit you, but his other patients as well.

 

 

:iagree: 11 years is a long time with a pediatrician and it's not so easy to start over. He's a person and a mistake was made. I, too, go to a small office sole practitioner and while that has many, many benefits, sometimes these kinds of things can fall through the cracks. You voicing your concerns may bring this more to the forefront as a problem with his office and he will likely put some systems in place so it doesn't happen again.

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I would be alarmed that there is no back up plan or way to reach your doctor on the weekend. I like having access to medical care on evenings and weekends, that is not the ER.

 

He was likely out of cell phone range and there WAS a nurse practitioner line that would have been able to help general medical situations like "My baby is constipated or extremely stuffy, what do I do?" That would have covered MOST of the needs of his patients, in addition to the ER facilities. But, it's not often that you have a case like this where that one specific doctor is a critical link in the chain and no one else is able to get the information that he has.

 

This case, the doctor definitely flubbed. He should have arranged a backup to receive the results and call you and prescribe medicine. A thorough doctor would have arranged it with you in the room and told you who would be contacting you.

 

He's expressed remorse and offered to fix the financial implications, which I don't think you could have forced him to do......short of suing.

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He was likely out of cell phone range and there WAS a nurse practitioner line that would have been able to help general medical situations like "My baby is constipated or extremely stuffy, what do I do?"

The nurse practitioner did not get in touch with him, or communicate between the doctor and the patient, and the doctor neglected to leave instructions about his patient.

 

My kids have had most of their urgent problems on nights and weekends, so, given that 8-5 M-F (with an hour off for lunch!) is less than 25% of the time in a week, I have made this a priority in selecting my children's doctor; that was my point. When there's no back up, no contingency, and a big delay in finding anyone, these sorts of problems are very likely to occur.

 

When my son was a newborn, the nurse on the line on a Friday evening didn't bother to call the doctor (or any of the other 5 doctors in the practice!) to find out the instructions for a piece of medical equipment when I called, and just made up something; the lack of use of that piece of equipment led to a several days' stay in the hospital. And the doctor was furious when he found out. A few months later I changed to another doctor because of other issues (and lingering anger at the substandard after hours care). And I'm about ready to do it again due to delays and delays with regard to urgent medical needs.....

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In case this wasn't clear, he does share weekend / off hours call duty with several other physicians in the area (although not in his practice). If I had a question about something that came up over the weekend, I could speak to another physician. This time, the issue was that I needed results from a test. Talking to another physician wasn't what I needed.

 

I think if I'm ever in the situation again, I will ask him to be very specific about when I will get results. I'll probably even ask him whether he's definitely going to be in town.

 

I was glad that he offered to waive his co-pay for the next several times. I didn't ask him to do that -- he offered. This tells me that a) he definitely knows that he goofed, and that b) he is willing to do the right thing in response.

 

Bonnie

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Not to mention, you were out an ER bill. If I trusted the doctor and liked him, I would mention this to him and tell him your concerns. Tell him you were out an ER bill and your dd was miserable for the entire weekend when a call, AS PROMISED, on Saturday would have saved both situations. :( I would be thoroughly disappointed and definitely sit down and talk with him.

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I would consider switching because he's a sole practitioner. It's really difficult to be on call 24/7. Practices that have several doctors tend to have longer office hours. Ours has 4 docs and both Saturday and Sunday morning hours. This has saved us several trips to the ER. I usually get an immediate call back/results.

 

I wish I could support a independent doctor, but its just to convenient having such a responsive practice.

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