Surprised by Pediatric Practice

[Anonymous]

Our ped doesn't charge for after hours calls.

We've been to the Georgetown ER 4 times and have never had to wait longer than 15 minutes to be seen by a nurse, maybe 30 to see a doctor - although one time we were there 4 hours total by the time they were done will the procedures and did the discharge, etc.

[Anonymous]

Our ped does charge $15 for after-hours calls, which we don't really have a problem with. Presumably they were bothered far too many times by non-urgent questions.

OP, you mentioned the nurse-triage service--our insurance (Aetna) has this; you might check your insurance. I have called them a couple of times and they were helpful. I will say, however, that they are RNs and not, for example, nurse practitioners, and so perhaps not as knowledgeable you might hope.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You have a problem paying a measly $15 to wake up your pediatrician? Yes, that's what they're there for, but they're not there to fill non-urgent prescriptions at 3AM or to deal with a chronic problem in the middle of the night. The fee (nominal in my opinion) is there to weed out the nutjobs who would otherwise call at the drop of a hat.
People don't blink at paying their hairdressers $300, but $15 for your sick child is too much.
This is the reason doctors are leaving practice in droves.

Oh for the love of all that is good and holy. There is so much wrong with this annoying comment I just don't even know where to start.

Ok, good, then don't.

[Anonymous]

Hi OP - we are thinking of moving to Boston, any recs on where to go up there (for pediatrics and ERs).

Having been up there frequently we ended up in the ER at Childrens' once -- it was great, but I hated to
use the ER for a minor issue (was the kind of thing where at home we would have just waited until
next day to be seen by our doc). Do they have any of the "urgent care" care centers in Boston that you know of?
We could not find any on line in the whole Boston area! When traveling in other cities and faced with a non-emergency health issue
we have gone to Urgent Care centers and found them much preferable to the ER (probably way more cost-effective too -- I hate using the ER as it makes me feel like a resource hog).

Speaking of which -- to DC moms - is the "Nighttime Pediatrics" the only urgent care center around DC? I would
love to have a walk-in option other than ER for non-life threatening issues that come up with my kids in DC at night or over weekends. Anyone know of any?

[Anonymous]

Anonymous wrote:Hi OP - we are thinking of moving to Boston, any recs on where to go up there (for pediatrics and ERs).

Having been up there frequently we ended up in the ER at Childrens' once -- it was great, but I hated to
use the ER for a minor issue (was the kind of thing where at home we would have just waited until
next day to be seen by our doc). Do they have any of the "urgent care" care centers in Boston that you know of?
We could not find any on line in the whole Boston area! When traveling in other cities and faced with a non-emergency health issue
we have gone to Urgent Care centers and found them much preferable to the ER (probably way more cost-effective too -- I hate using the ER as it makes me feel like a resource hog).

Speaking of which -- to DC moms - is the "Nighttime Pediatrics" the only urgent care center around DC? I would
love to have a walk-in option other than ER for non-life threatening issues that come up with my kids in DC at night or over weekends. Anyone know of any?

OP here. I'm thrilled you're thinking about Boston! We love it there and still consider it our real home. We hope to be able to move back in a few years. Anyway, Dr. Richard Mizner is amazing!!! He's with Massachusetts General Hospital Group Pediatric Practice (located right at Mass General). You can look him up in the "find a doctor" section of Massgeneral.org. He's so on the ball but very relaxed at the same time. He takes a conservative approach, covering all bases, without ever being an alarmist. He's pragmatic, knowledgeable, and so clearly loves what he does. He's probably late 30's, which we liked, because it meant he wasn't going to retire any time soon. We have 3 children and he was marvelous with all of them and really struck a nice rapport with our 5 year old. He also takes parent concerns (even those you may think are silly) seriously, explains everything very clearly, and always respects your role as a parent. Some people find him a bit dry, but we found him very personable and thought the world of him. If you end up west of the city, Jonathan Winickoff is fabulous too. He's with Mass General West Pediatrics out of Waltham, MA. He was our first pediatrician, but when he switched offices he was too far away for us to keep going to him. He was incredibly affirming, helped calm all those new mommy worries, and really appreciated the many questions parents asked. As for urgent care centers, I'm not aware of any, but we had a few ER trips in the last 5.5 years and all were very quick and successful. Mass General has a separate pediatric ER, so the children don't have to wait as long as they would have to in a regular ER setting, and it means pediatricians are always there. We dealt with croup and stitches, and each time we were exceptionally pleased with the care and efficiency we experienced. Well, I hope that helps, and I hope you get to move to Boston! Good luck!

[Anonymous]

My wife asked was reading this thread and asked me to comment:


About 7 years ago I moved to the DC area after working in Boston as a board-certified pediatrician for a number of years. Even as an experienced pediatrician with Harvard credentials, I had an awful time finding a practice that was able to pay a salary that could support someone relocating to the area because the insurance reimbursements are the worst in the country- especially in Maryland. For example, the practice I eventually joined was paid $20/month by Aetna/USHealthcare (of which 30% of our patients were enrolled) for each baby and $7.15/month for each adolescent. At those rates, it is a miracle that we could pay our office staff, nurses, rent, and utilities- not to mention giving ourselves a salary.

The older pediatricians in the group told me that they had seen a 50% decrease in their annual income over the previous 10 years. So, when someone bemoans the fact that they are asked to pay $15 to speak to their (implied "greedy") pediatrician, I have to say- ARE YOU SERIOUS?

I was a really really good pediatricians. My patients all loved and respected me and my colleagues really liked working with me. Ultimately, I had to leave the field and go back to school to get an MBA in healthcare management. I just couldnt see how I was going to raise a family, pay my ($200,000) med school debts, put money away for my daughters' college and maybe one day purchase a home on a pediatrician's salary in the Washington DC area.

Primary care Pediatricians ARE leaving the field in droves. nationally as well as locally. Many local practices are having a bear of a time recruiting new associates- especially ones who are looking for full time employment. Pediatrics is a great field- unfortunately, it is financially underappreciated by the insurance reimbursers and this bottom line is what drives practices to have to charge for phone calls, chart copies etc.

Take a look at your insurance's Explanation of benefits the next time that you take your child to the pediatrician. Do the math. You'll be shocked.

[Anonymous]

bump

[Anonymous]

hi, OP. I'm sorry you had such a bad experience. I've never taken DS to the georgetown ER, but my husband and I have both been there and never had to wait more than an hour, if that.

I did take DS to children's hospital on a saturday morning and waited maybe a half-hour, after triage. but, the line for triage was a half-hour, too. so, an hour total. and the nurses and ER doc were all very nice.

I don't think one can compare docs in DC vs. boston in a general way. it all depends on the practices/hospitals.

oh, and our ped practice doesn't charge for after-hours calls, but I'm not surprised that some do.