Pediatric Consultation Guidelines

Here are some important guidelines that will make you first or next visit to our office more efficient and comfortable.

• Scheduling an Appointment >
• Rescheduling or Canceling an Appointment >
• "Well" vs. "Sick" >
• Appointment Day >
• Walking In >
• Visitors & Tag-A-Longs >
• Young Adult Evaluations >
• Forms & Past Records >
• Behavior >
• Antibiotics >
• Emergencies >
• Telephone Calls >
• Schedules of Visits >
• Prevention >
• Immunizations >
• Summary >

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Scheduling An Appointment

We make every attempt to accommodate your requests when possible. When scheduling an appointment, please:

1. Call early in the day. Our receptionists are available to assist you.
2. Be brief and concise in explaining the problem(s).
3. Understand the momentary dilemma of the receptionist who is attempting to accommodate multiple calls at the same time. If you have a true emergency, state so immediately. Otherwise, please be patient if you are placed on temporary hold. You may be asked to speak with our triage nurse prior to making your appointment, especially when requesting a same day appointment. He/she can assist in evaluating the illness, and provide advice about treatment.
4. Leave your name, phone number and how long you will be available at the phone number provided if your call requires a callback response. Keep in mind that our immediate priorities are those patients in the office at the time. You can anticipate a return call within a reasonable time period. An emergency will receive an immediate return call.

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Rescheduling or Canceling an Appointment

If you are unable to keep an appointment, for whatever reason, please call a minimum of 24 hours ahead of time to reschedule or cancel your appointment to allow another person the opportunity of being seen at that time. "No show" visits for physical exams and consultations are not likely to be rescheduled in the near future because of the lost time involved. We thank you in advance for your thoughtful consideration.

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"Well" vs. "Sick"

Contagious illnesses and problems, such as chicken pox, scarlet fever, lice, scabies, impetigo, etc. will be directed to an alternate entrance designated for infection evaluation.

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Appointment Day

Please arrive at the office 15 minutes early for registration. Late arrivals may need to be rescheduled. We will sincerely attempt to honor your appointment time as we value your time and understand the frustration of lengthy waiting periods. Unforeseen problems or emergencies will arise on occasion, and delay or alter our schedule. We request your patience and understanding when such incidents occur.

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First Visit

For your first visit, please arrive 30 minutes before your appointment. You will be requested to complete a medical history questionnaire prior to your office visit to allow your physician to spend more time with your present problem rather than those of the past.

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Walking In

While we try to accommodate every patient, we may not have availability if you come in without a scheduled appointment. Please call us as soon as you are aware you need an appointment.

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Visitors & Tag-A-Longs

We wish to discourage visitors to the office including siblings and friends. Invariably, they risk being exposed to someone else's illness. Also, please do not schedule an appointment for one child and then surprise us with three children. We need the appropriate allocated time for every patient being evaluated.

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Young Adult Evaluations

We welcome young adults. We will honor requests to have parents/relatives wait outside of the exam room.

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Forms & Past Records

Please remember to bring all appropriate forms. It is very helpful to call your child's prior medical office before your first appointment with us and have copies of your immunization record and complete health record.

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Behavior

For younger children it is difficult to wait in a waiting room. Please plan for a slight delay by bringing your child's favorite to, a book, coloring, etc. Please supervise your child's activity during your visit.

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Antibiotics

Using antibiotics appropriately is important for your child's health. Remember to always complete the requested treatment regimen as prescribed. Do not start "left-over" antibiotics or "share" the antibiotic with other children or friends without discussing this with your pediatrician. We strongly feel that an illness requiring an antibiotic warrants an examination. Telephone requests for an antibiotic will not be honored.

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Emergencies

True Emergencies

Usually a major burn, major bleeding, choking, a convulsion or a coma will not be overlooked or underestimated. However, there are some emergency symptoms that may be difficult to recognize or even be considered serious. Following is a list of "true emergencies."

• Accidental or deliberate ingestion of medication or toxic material
• Asthmatic wheezing with peak-flow meter in the "red"
• Bleeding uncontrollably
• Bluish lips or cyanosis
• Bulging soft spot
• Choking or labored breathing
• Convulsions or seizure-like movements
• Dehydration due to persistent vomiting or diarrhea
• Fever over 105° Fahrenheit or 40.6° Celsius
• Inability to arouse or awaken
• Loss of ability to stand or walk
• Purple or blood-red spots on the skin
• Severe lethargy or pain
• Sick newborn less than one month old
• Stiff neck
• Sudden onset of drooling or spitting
• Tender abdomen or groin
• Traumatic accidents such as head or neck injuries or burns

With any of the above, go to the nearest hospital emergency room or call 911.

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Telephone Calls

After Office Hours

Should an "after hours" concern arise that cannot wait until the office reopens, the on-call doctor can help you determine if you should be seen in Urgent Care, in the hospital emergency room, or if you can wait until the next business day. Be aware new/refill prescriptions cannot be prescribed by the on-call provider.

If you would like to have all emergency room visit records and laboratory results included in your child's medical chart, please make this request upon registration and provide the receptionist staff your child's physician's name and office address.

How to Get the Most from a Telephone Consultation

Prior to calling, have a pencil and paper by the telephone.The quality of advice we give over the telephone depends on the information you give us. Prior to calling, please organize your thoughts as follow:

1. What is the primary reason of your call? (For example: injury, earache, cough, etc.)
2. When did the illness or injury begin? How many hours or days?
3. In your opinion, how sick is your child?
4. What treatment, if any, have you given?
5. Does your child have a chronic illness or special need?

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Schedules of Visits

Periodic health care begins at the time of birth and continues throughout life. The following schedule of visits is recommended (aside from acute illness or crisis visits):

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Prevention

The thrust of our efforts is in the prevention of problems, such as major diseases, accidents, and the so-called "life-style" disorders (stress, smoking, obesity, chemical/drug intake and promiscuity). This approach will include diet and exercise guidance, safety and other counseling when appropriate.

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Immunizations

Immunizations against childhood diseases are one of the most valuable preventive medicine practices in the world. We follow the recommendations of the American Academy of Pediatrics. Immunizations are administered at appropriate intervals commencing after birth to protect your child against major childhood diseases.

The health of each and every one of our patients is important to us. We also respect the beliefs and perspectives of all of our families.

We care for many children, some with few or no medical problems and others with significant medical needs.

Some of our patients and/or their family members have immune systems that do not function as well as others and we need to take extra precautions to provide for their safety. These patients may include newborn babies, children with diabetes, asthma, juvenile rheumatoid arthritis, organ transplants and some who receive chemotherapy or other medications that may suppress their immune systems.

In order to protect our patients and community from vaccine preventable diseases, it is our expectation that each of our patients receive appropriate immunizations based on the schedule published by the Center for Disease Control.

We encourage you to talk to your pediatric provider if you have any questions.

Your patience is greatly appreciated when waiting for the nurse to give your child's immunizations. The preparation time is needed to calculate the correct dosage, check for accuracy and document the immunization. You can help expedite the immunization process by bringing a complete vaccine record.

Strive for 95

We’re all in this together. The mission of the Strive for 95 Coalition is to rebuild our community’s immunity to at least 95%, offering protection from vaccine preventable contagious diseases to all community members – including healthy children and those with weakened immune systems. Visit the main Coalition website at http://strivefor95.org/ to learn all about our mission, get vaccine facts, and information on why vaccines are important.

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Summary

• Attempt to seek care during our regular office hours when possible. We encourage you to call to discuss symptoms and a treatment plan with our triage nursing staff.
• The prevention of problems is still foremost important. Be knowledgeable regarding self-care and wellness by having adequate resource materials available for home consultation. Increasing your knowledge and experience, may prevent many office and emergency room visits.
• Most illnesses in children are short lived and caused by viruses for which there is no specific treatment (i.e., medication remedy). Bed rest and encouraging liquids are the primary treatment recommendations. Be patient and allow 2 to 4 days to recover from most mild "evil spirits."
• Reassurance from a parent or friend is a great mental boost. Children quickly sense your anxiety and apprehension, especially if you are focused on a specific disease entity. Not every cough is pneumonia, not every stomachache is appendicitis, not every headache is a migraine, and not every skin rash is leprosy.
• Always attempt to remain calm. Medical facilities are close by and readily available 24 hours a day.
• Illnesses always appear worse at night and "much improved" in the morning.
• Lastly and most importantly, YOU are your child's best caregiver. We are here to help when you need us. Continue to give the same great loving care to your child.