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Pediatricians Warn Parents Not to Seek Medical Care on Evenings, Weekends
New York Magazine ^ | 2/25 | Jonathan Chait

Posted on 02/25/2014 10:20:17 AM PST by nickcarraway

My family has a terrific pediatrician, but we send our kids to see her less and less often because her office is available only during working hours. When is it preferable to take your kid to the doctor during working hours? Not very often. If it’s nighttime and they’re suddenly really sick, we’ll take them to the urgent-care clinic. If they just need some antibiotics or a flu shot or the like, we’ll go to the local nurse-practicioner, who has weekend office hours. The number of times when it makes sense for one of the parents to miss work, and for the children to miss school, in order to see a pediatrician turns out to be rare.

I think of this as a huge new convenience. Lots of other parents do too, as evidenced by the explosive growth of retail-based health clinics, which offer not only better hours, but charge 30 to 40 percent less for the same services. The American Academy of Pediatrics, on the other hand, thinks of it as a massive threat to American health. The Academy has released a new statement advising parents not to use retail health clinics. Why not? Because:

Pediatricians are specifically trained in child health issues. They know each child’s health history, and are best equipped to take care of both simple and complicated problems comprehensively within the medical home. As young patients and their health issues become more complex, the possibility arises that even a simple complaint may be related to a more serious, underlying condition that could be overlooked by someone who is less familiar with the patient, according to the AAP.

Trust them – they’re doctors! Not small-business owners trying to exclude the competition with hand-waving claims about complexity.

It is surely true that some routine ear infections will turn out to be a “more serious, underlying condition,” and that, theoretically, a single doctor with a long-term relationship may have a slightly better chance of correctly diagnosing the condition. But accepting the higher cost and massive inconvenience of traditional office-based medical care in order to ward off that tiny and probably nonexistent risk is the sort of trade-off that incumbent interests are always defending, but which has made American medicine the worst deal in the advanced world.

The explosive growth of retail medical clinics – CVS and Walgreens, among others, are making huge bets in this sector – is part of the wave of innovation that’s overturning the old medical model and driving medical inflation to historic lows. But every new model of delivering care threatens somebody’s old model, and that somebody is going to try to scare or regulate the competition away.


TOPICS: Conspiracy; Health/Medicine; Weird Stuff
KEYWORDS:

1 posted on 02/25/2014 10:20:17 AM PST by nickcarraway
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To: nickcarraway

With workers freed from the tyranny of the workplace via the wonders of Obamacare, I don’t see where this is much of an issue anymore.


2 posted on 02/25/2014 10:22:05 AM PST by nascarnation (I'm hiring Jack Palladino to investigate Baraq's golf scores.)
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To: nickcarraway

Young children have the uncanny knack of ONLY getting ill evenings and weekends.

If they’re Pediatricians, they ought to know this.


3 posted on 02/25/2014 10:23:42 AM PST by Buckeye McFrog
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To: nickcarraway

i’ve always said that the doctor or dentist who has a “2nd Shift” office with PM an Weekend hours would become a millionaire.


4 posted on 02/25/2014 10:27:23 AM PST by ItsOurTimeNow ("Scheming demons dressed in kingly guise, beating down the multitudes and scoffing at the wise.")
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To: nickcarraway

Most pediatricians are women, and they prefer to work certain hours. It would make sense to have a group practice, and have somebody rotate through covering weekends and evenings.


5 posted on 02/25/2014 10:29:08 AM PST by PapaBear3625 (You don't notice it's a police state until the police come for you.)
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To: nickcarraway

We have a Pediatric Urgent Care that our Pediatrician highly recommends. It has a Pediatrician on duty. Our regulate Pediatrician does frown on using the Urgent Care’s that have P.A’s on duty but understands that a parent has to do what a parent has to do. I for one am thankful for Urgent Care.


6 posted on 02/25/2014 10:33:15 AM PST by yellowdoghunter (Welcome to Obamastan! (Mrs. Yellowdoghunter))
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To: nickcarraway

We have a Pediatric Urgent Care that our Pediatrician highly recommends. It has a Pediatrician on duty. Our regulate Pediatrician does frown on using the Urgent Care’s that have P.A’s on duty but understands that a parent has to do what a parent has to do. I for one am thankful for Urgent Care.


7 posted on 02/25/2014 10:36:43 AM PST by yellowdoghunter (Welcome to Obamastan! (Mrs. Yellowdoghunter))
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To: Buckeye McFrog

“Young children have the uncanny knack of ONLY getting ill evenings and weekends.”

After they ate something colorful like, say, pizza :)


8 posted on 02/25/2014 10:37:25 AM PST by ModelBreaker
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To: nickcarraway
They know each child’s health history, and are best equipped to take care of both simple and complicated problems comprehensively within the medical home. As young patients and their health issues become more complex, the possibility arises that even a simple complaint may be related to a more serious, underlying condition that could be overlooked by someone who is less familiar with the patient

And how often do you get Marcus Welby or Dr. House on the first visit for an earache? Usually you're tossed some antibiotics for the first couple visits and then you'll start getting some more in depth examination for repeat problems. It's that way for adults and that way for kids.

9 posted on 02/25/2014 10:42:11 AM PST by KarlInOhio (Republican amnesty supporters don't care whether their own homes are called mansions or haciendas.)
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To: nickcarraway

The author is a nut job. It’s not about competition. Trusting your child’s health to evening and weekend medical clinics staffed by nurse practioners is foolishness. They don’t know your child’s medical history, don’t know what’s abnormal for your child, and are only treating the symptoms present at the moment.

If you establish a long-term relationship with your child’s pediatrician, they will take your phone call after hours and prescribe medicine/treatment or tell you that it’s serious enough for a trip to the ER - if you can’t figure that out on your own.


10 posted on 02/25/2014 10:43:08 AM PST by BuckeyeTexan (There are those that break and bend. I'm the other kind. ~Steve Earle)
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To: nickcarraway

Was never an issue for me. If in my opinion the kid was sick enough to take him to the doctor then he was too sick to go to school and someone wasn’t going to work that day.

At least we had the luxury of being able to schedule an actual appointment time for my son. My poor mother had to sit for hours with me or my brother when we went to see the doc. The old horse doctor we saw had a first come first serve policy, it was up to you to keep up with who came in the door after you. Nothing like 20 people hacking, sneezing, babies crying, etc. sitting in the waiting room watching the Price’s is Right on a B&W T.V.


11 posted on 02/25/2014 10:45:59 AM PST by WinMod70
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To: nickcarraway

Minor Emergency type clinics are opening up all over Houston. Seems like everywhere you look a new one is being built.

Eight years ago I met a doctor who moved to Houston from El Paso and opened up a “cash only” clinic. He said he’ll make a lot more money with a lot less paperwork. I wish I had asked him for some stock tips.


12 posted on 02/25/2014 10:48:19 AM PST by VerySadAmerican (".....Barrack, and the horse Mohammed rode in on.")
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To: nickcarraway
My daughter first told me about the Minute Clinic at CVS several years ago. Her son needed a sports physical and her insurance was such that it was going to cost her about 200 dollars. SHe got an email from CVS offering her a coupon for a 30 dollar physical. She was in and out with her papers in about half an hour.

I'm an old man and so my health history is more complex. My wife and I do have a regular doctor that we see. But for regular kid things such as ear infections, sports physicals, strep, etc.? Those Minute Clinics are wonderful.

13 posted on 02/25/2014 10:54:29 AM PST by old and tired
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To: WinMod70

I don’t ever remember my brother or I going in after hours. No one had to miss work during the day, since my Mother was at home, and my Father wouldn’t have missed work to take us to the doctor, if we remained children for the entire life of the universe.


14 posted on 02/25/2014 10:57:49 AM PST by nickcarraway
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To: FReepers

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15 posted on 02/25/2014 11:09:43 AM PST by DJ MacWoW (The Fed Gov is not one ring to rule them all)
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To: nickcarraway

Be very wary of anything the AAP says, because they are very leftist in orientation. They are far more interested in the socialist agenda than they are childrens’ health.

The conservative alternative is the American College of Pediatricians (ACPeds).

The AAP has said that its members are “ethically” required to find out if parents have guns in their home, and that they may refuse service if parents refuse to say. And, of course, they annotate the answer into the childrens’ medical records, where they can be easily accessed by the government.

It has reached the point that parents need to determine the membership of their pediatrician ahead of time, and to reject those that are not ACPeds members. Otherwise you might be entrusting your child’s health to someone of questionable character.


16 posted on 02/25/2014 11:10:19 AM PST by yefragetuwrabrumuy (WoT News: Rantburg.com)
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To: yefragetuwrabrumuy

My father was in for a Biopsy at Mount Auburn. It was a Monday. the Staff said Mondy-Wednesday are the days when the A-Team Staff is on duty. The newbies get the weekend shifts.


17 posted on 02/25/2014 11:16:37 AM PST by massgopguy (I owe everything to George Bailey)
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To: massgopguy

It is pretty amazing to be told not to get sick except during the day on weekdays


18 posted on 02/25/2014 11:19:35 AM PST by GeronL (Vote for Conservatives not for Republicans!)
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To: nickcarraway
I went through two years when I had to depend on clinic-style medicine. It was great. The doctors and nurses didn't act like gods, and actually listened to the patient and other doctors and nurses.

When one is pretty sure what the problem is, why not go to a practitioner at the local drug store? It's better than needing an appointment and then having a doctor overprescribe medication "just in case".

19 posted on 02/25/2014 11:25:18 AM PST by grania
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To: BuckeyeTexan

Though I did have an experience with my daughter where she had a very sore throat for an extended period. We thought she had strep throat. I took her to the Walgreens clinic. The nurse practitioner swabbed a sample to confirm it was strep. She did not want to prescribe antibiotics without first confirming that.

So we went back home and my daughter continued to complain about her throat. The next day my wife threw a fit and insisted that we take her to the ER. They saw her and dutifully wrote a prescription for antibiotics.

She finished her course of meds. Her throat still hurt. The labwork from Walgreens came back negative for strep.

Seems the nurse practitioner at the drug store was thorough in doing her job. The doctor at the ER just wrote us a scrip to get us the heck out of the building.


20 posted on 02/25/2014 11:33:13 AM PST by Buckeye McFrog
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To: nickcarraway

I’m so old, my pediatrician always made house calls if we were ill. We went to the office for shots and some stitches, but other injuries were stitched at home.


21 posted on 02/25/2014 11:46:41 AM PST by reformedliberal
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To: old and tired
Not only that, the times I took my kids to a Quick-care type facility, they received a very comprehensive exam.

I believe that Nurse Practitioners and P.A.'s should play a larger role in non-emergency care. There should be several on staff right next door to every emergency room so that those who run there for the sniffles can be treated quickly and with less cost.

As a parent, I should also know as much about my child's medical history and should communicate relevant details to anyone who treats my child. Of course things can escalate quickly with small children, but any parent who has made multiple trips to the Pediatrician and then ultimately ends up at the ER knows that seeing a Pediatrician vs. a NP is not a magic bullet by any means.

22 posted on 02/25/2014 12:08:50 PM PST by Mygirlsmom (Washington: "I cannot tell a lie". Obama: "I cannot tell.....I lie")
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To: PapaBear3625

“Most pediatricians are women, and they prefer to work certain hours”

Prefer to work certain hours? LOL So,,, have their figured out the cause of that lower pay thing yet?/


23 posted on 02/25/2014 12:34:08 PM PST by DesertRhino (I was standing with a rifle, waiting for soviet paratroopers, but communists just ran for office.)
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To: Mygirlsmom

When my twins were 6 weeks old, one of them got sick. We took her to see the pediatrician, and he just said to watch her. She only weighed 7 1/2 llbs and had a fever. She got worse, and took her back to the ped office on a Saturday and a PA saw her. By then my daughter was throwing uo, and the PA sent us home with goucose water because they didn’t have pedialyte. We gave her that, and then gave her pedialyte.

Well, my daughter continued to get worse overnight. The next morning was scary, and the oed office just said to bring her back in at 11am. A different doctor was there, and sent my husband to the emergency room.

My daughter was having seizures and the glucose water unnbalanced her electrolytes. She had scary low soium.

She has extensive brain damage. The malpractice lawyer said the reason we didn’t have a case is because my daughter has done okay despite the massive brain damage. Thank God, at 17 she is a straight A student. She has speech problems still, seizures, and she is very socially awkward.

I changed pediatricians, and I always have their home phone number.


24 posted on 02/25/2014 12:36:40 PM PST by luckystarmom
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To: Buckeye McFrog
Kids suck, but you can't live without them. This is from the bottom of my heart.

FMCDH(BITS)

25 posted on 02/25/2014 4:13:21 PM PST by nothingnew (I fear for my Republic due to marxist influence in our government. Open eyes/see)
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To: GeronL

People come in the ER all the time, “I’ve been feeling crappy all week.” 8-10 Friday night. In Teaching Hospitals you will be seen by Med Students, supervised by interns and residents.


26 posted on 02/25/2014 7:17:38 PM PST by az wildkitten (8 years 'til I retire)
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To: nickcarraway

It’s all well and good to say that a pediatrician can take better care of a child than a GP, PA, ERMD etc. and this is probably true. However all that expertise is of absolutely NO VALUE if it is not available WHEN IT IS NEEDED. Keeping bankers hours Mon-Thursday and refusing to be on call
or available nights and weekends while advising parents to avoid the
alternatives that are ACTUALLY AVAILABLE is the very height of conceit.

Till these petty assclowns are willing to step up and actually WORK they
need to STFU.


27 posted on 02/25/2014 7:20:31 PM PST by nvscanman
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