Seeking Care “After Hours”

Sooner or later most parents encounter the difficult situation of a child with sudden development or unexpected worsening of an illness after our office is closed. While we would certainly like to “be there for our patients” anytime the need arises, doctors and their staff are people too, needing time for rest and family. For this reason Emergency Rooms and Walk in Clinics play a role in providing health care in today’s world. While the immediate availability of care is convenient and often important for your child’s health, there are potential problems as well. First and foremost, as these are not the patient’s “medical home”, much is lost due to the lack of previous medical records. Continuity of care is disrupted and making “best” medical decisions sometimes not possible. Often care is provided by physicians who while nevertheless well trained and credentialed, are not pediatricians by specialty training, resulting in medical care that is not at the current standard of care for children. Finally, as we live in a state with a particularly expensive medical malpractice suit history from the healthcare provider’s standpoint, physicians in acute care settings tend to practice a very defensive style of medicine, ordering extra tests, xrays, and scans seeking to protect themselves from the possibility of a lawsuit.

Our first suggestion is to plan ahead whenever possible and seek care through our office early enough during an illness to avoid getting “caught” in an urgent situation after hours. Next, when for whatever reason you do find yourself in the situation of needing care for your child from another source, follow a few common sense guidelines. Be willing to ask questions about the diagnosis, the tests being performed, and any treatments proposed. “What diagnosis are you considering? Do these tests need to be done now, or can they be ordered by my child’s regular physician?, Please explain to me what medications you are prescribing and what they are for.” Keep written notes of what you are told to be able to share with us when you come in for follow up. (It is often difficult for us to get records before you come in for the follow up visit). Finally the American Academy of Pediatrics has a list of 10 tips for parents and physicians on avoiding the most common errors in testing and treatment. (See the link http://www.choosingwisely.org/wp-content/uploads/2014/03/AAP10things-march2014.pdf )

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