Surprised by Pediatric Practice

[Anonymous]

OP again - I also didn't "wake up" my pediatrician. I called at 6pm. Our last practice in Boston had a nurse triage service - they were paid very well to take after hours calls - that weeded out the real emergencies from the anxious parent calls. A Dr. was not paged unless absolutely necessary. We loved this service. The nurses were patient, knowledgeable, and very helpful. Why don't practices here do the same?

[Anonymous]

When we interviewed our pediatrician 2 years ago for our first child, he told me that while there is currently no after-hours charge that there would likely be one in the future because that was the trend. So I think peds are moving in that direction. Sadly, gone are the days of home visits, etc. It's more of a "business" now and they want the overtime. I think it's too bad, but it is what it is.

[Anonymous]

I'm in NoVa and our practice recently started charging for after hours calls. Like another PP, I think the fee is waived if it is a true emergency. I believe it is more to weed out the silly questions that they get in the off hours -- e.g., our doc told us about someone calling and waking him up to ask about what vitamin brand to use. Anyway, with the shrinking payments from the insurance companies, and the larger staffs required to do all the claims, it doesn't surprise me that there are more of these convenience charges. I'm sure this is just the beginning.

There was a thread not too long ago on which ER's are the best to visit with children. I don't remember GT being on the list -- so next time you might want to look for one of the hospitals with a dedicated pediatric ER unit. You should do a search on this website.

[Anonymous]

Our practice also has a $15 after hours charge for calls. As I see it, the doctors should get paid for giving medical advice and insurance won't cover those calls. (I'm an attorney and you'd better believe my clients pay for phone calls!) Our pediatricians have a nurse line available during the day and on saturdays until 1 pm-ish, so its really just nighttime that we'd be charged if we needed to call. I think I've done it twice -- and it was well worth it. If you or your husband has an FSA, you can probably get the $15 reimbursed out of that money.

One other place to keep in mind for nighttime emergencies that might not rise to the level of a full ER is Nighttime Pediatrics on Rockville Pike. We went there earlier this summer after a slip and fall resulted in a small chin lac that wouldn't stay closed. I knew we'd wait forever at a city ER, so we tried NP. My 2 year old ended up with two stitches in his chin and the staff could not have been more professional or nicer to him. We were very pleased and will consider it again in the future if we need to!

[Anonymous]

Capitol Medical Group does charge for after hours calls. The do not use a nurse triage so when you do call you're getting one of the pediatricians. ER waits are so variable depending on the season and the time of day. Wait times at Children's for "non-emergent" cases can be hours- 3-4 on a busy night.

[Anonymous]

Our pediatric practice in Arlington doesn't charge for after-hours calls.

As for stitches, our son, 5 yo, had to get them in his head this past Friday night at Virginia Hospital Center in Arlington. We were in and out within 2 hours max - we had very little waiting time.

[Anonymous]

Holy Cross in Silver Spring has a really nice pediatric ER as well (staffed by Pediatric ER physicians).

[Anonymous]

Pediatricians make very little money (for all their education and training) and deal with VERY demanding parents, especially in this area. I don't begrudge them the fee.

[Anonymous]

Anonymous wrote:When we interviewed our pediatrician 2 years ago for our first child, he told me that while there is currently no after-hours charge that there would likely be one in the future because that was the trend. So I think peds are moving in that direction. Sadly, gone are the days of home visits, etc. It's more of a "business" now and they want the overtime. I think it's too bad, but it is what it is.

Well, hate to break it to you, but it IS a business -- with overhead and staff to pay. You can't exactly work for free. And if you relied solely on insurance reimbursement for pediatric care, that's what you'd be doing!

[Anonymous]

Wow. I got to Foxhall Pediatrics in NW DC and not only do they NOT charge for an after-hours call, but the doctors frequently call ME afterhours to see how my children are doing when they are sick.

I've waited up to three hours in the GU ER though. It was on a Friday afternoon, which I'm told is the worst time to go to an ER. But my pediatrician called ahead to make sure there was a pediatrician on-call at the ER.

[Anonymous]

Anonymous wrote:OP again - I also didn't "wake up" my pediatrician. I called at 6pm. Our last practice in Boston had a nurse triage service - they were paid very well to take after hours calls - that weeded out the real emergencies from the anxious parent calls. A Dr. was not paged unless absolutely necessary. We loved this service. The nurses were patient, knowledgeable, and very helpful. Why don't practices here do the same?

I'm with you - pediatricians are in the helping/medical practice and should set-up their practice accordingly to accomodate after hours emergencies. We used to go to CMG and as much as I liked the doctors, I felt VERY nickel and dimed. (For example, getting my kids medical records was outrageously expenisve and a total joke. They use a service and you pay per page, no matter how many pages/kids etc. No exceptions.)

We moved and found a new practice (Takai/Hoover) and they have been a dream to work with - they have a triage nurse service just like your practice did in Boston. (and they have a flat fee for getting medical records - I think $25 per kid if you come and get them yourself but they will fax at a doctors request for free).

[Anonymous]

We have Kaiser insurance, and I really appreciate the 24-hour free medical advice line. That and the ability to get kids in to see a doctor on short notice if necessary, even in the evening.

[Anonymous]

Blue Cross Blue Shield also has a 24 hour line. (I haven't used it, so can't vouch for service).

[Anonymous]

The peds we go to recently (in the past 2 years) started to charge for after hours calls. I think it cuts down on some of the unnecessary calls, like for scraped knees, cut finger, etc. if you know that all the doc is going to say is wash the wound with soap & water and put a bandaid on it.

[Anonymous]

I can't believe you had to wait that long in the ER with a child that young. Unofrutnaltey, I've had many ER visits with an infant and have always been taken immediatley. Mostly I have gone to Alexandria Hospital but have also had a good experience (as good as can be) at Sibley, which could work for you.