Spending a few days with my son, DIL, and GD about to turn 5 and GS who is 2 1/2. I love them, they’re adorable, and thank goodness I go home tomorrow.
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Heading cross country today to spend a month (!) with DD1, SIL, GS -5 1/2, and soon to be born GD.
In addition to gaining a sister, GS is about to lose his first tooth!
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Just got off a video call with GD, who wanted H to call me as soon as her dad brought her home from the doctor’s office. I’m stuck at home with workers while H babysits and waits for SiL to pick up Rx and supplies.
GD looked and sounded so sad and exhausted. It’s her first really bad stomach virus and she had a rough night. Fortunately, I had Pedialyte, Genexa and a few other supplies on hand since D and SiL were unprepared. This feels worse than when our kids were sick as young children.
Hugs.
There is a very bad but what looks like (thank goodness!) short lived stomach bug circulating around. Kid’s family all had it.
Thanks. I hope it’s short lived here, too.
SiL thought the cause might be something we fed her yesterday, so I sent him a detailed list and pointed out that she’d eaten the same things two days before and one day last week with no ill effects. I understand the desire to know the cause so it can be avoided, but I remember how often our kids suffered with some virus, whether gastro or respiratory, of unknown origin.
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So glad you were prepared with Pedialyte etc.
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DD has changed pediatrician group - they moved to this new area July 2023, and DD has been watching and documenting carefully on kids’ vaccines and desired times. The baby recently was signed off and approved to get two shots but the MA drew up one of the approved shots and another shot that was not scheduled that day. When the immunizations were brought in the room, it was in unlabeled syringes, and so DD did not see what was drawn up. On the way home, the medical provider/Physician called her husband’s phone - not hers (and by the time DD got the message, it was after office hours). Well, once DD saw the documentation (on line), DD saw they did not do the vaccinations correctly. She had clearly discussed what vaccinations the baby was supposed to receive, and signed off on these. Usually the office has the PA there to do the well checks and exams etc. and DD was OK with that - PA had been with the group for 4 years. But clearly there is a problem with procedure/MA, and DD doesn’t need to deal with these kind of mistakes.
Thankfully the baby (age 6/7 months at the time) had no ill effects.
Pediatrics is one physician area where running a practice and the insurance reimbursements are not terrific, so they are somewhat creative on how their practice is run.
Can you talk more about this?
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GD had that awful stomach virus. She was ‘down’ for almost a week. Now GS and SIL have it. D and I did most of the care for the kids, but so far we are both okay. 
I think pediatricians are underpaid! We loved our pediatric group so much when our kids were growing up. Dr. Fever (not his real name, but close) finally kicked our son up to family medicine after college. We were sad! D chose a different / smaller group for GS and GD. Their pediatrician answers emails day and evening. One time D emailed her late at night for the next day and was surprised to receive a response after 10pm.
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If you look at physician salaries, Pediatrics is one area where MDs, as specialists, don’t make higher salaries as other MD specialties. Insurance reimbursements for the common medical claims - healthy visits as well as sick visits. The costs to run a practice providing the services while also maintaining profitability.
Some physicians’ offices (what use to be private practice offices) are now under hospital owned practices with the physician being paid a salary. On the west coast, hospital and insurance practices under big names like Kaiser Permanente.
Having a MA (Medical Assistant) instead of a RN or LPN for example in the office doing some of the skilled services (like giving immunizations).
Physician is ‘overseeing’ the MA, while a RN or LPN has the legal status signing off the medications administered under MD orders.
I had utilized a Pediatrician whose own DD also became a Pediatrician (and she was married to a Physician who worked for the hospital in a managerial, M - F job). So father/daughter practice. DDs growing up had really good health care with them. DD1 had an older MD Pediatrician for her children in their city prior to their July 2023 move - and she was so happy with his practice (and he did retire prior to her move, but her older children had a very good foundation of excellent well care and immunizations under that practice). Safety, and physician involvement/oversight in the medical practice.
The paradigm has changed to where there now are walk in clinics and even pediatric walk in clinics for times of illness.
So ‘getting creative’ on how their practice is run - cutting cost corners like employing a MA instead of a LPN or RN to give immunizations - and having an office where a PA is the person giving the care. Yes, a licensed person could make a mistake - but for DD, it was clear to her that she needed to change to another pediatric group.
Just a question - I know your SIL is Active Duty Military, does the military not provide healthcare for the family dependents anymore?
My H was a military officer for the first several years of our marriage and although I had health insurance benefits through my job, I frequently used the healthcare on base. This was 40 years ago, so maybe things have changed?
Your first few paragraphs are true - about health system buy outs of private practice offices and even that there are walk in clinics - much of what you said is true of many disciplines - not just peds. Same with MA’s, PA’s and NP’s. They can be found in many disciplines and do not give lesser care - they do not have the responsibilities of those with more degrees and letters behind their names. They have important jobs and are key to making an office run smoothly.
And walk in clinics that specialize in peds? How wonderful! Making last minute or weekend health care specialized for children accessible to families of all socioeconomic situations!
I have worked in a pediatric academic setting for 30+ years. Medical Residents know from the get go that peds pays less than other disciplines. This is part of what makes pediatricians great humans - they keep the health of our most precious little people in their hands with less $$ in their pockets - a choice.
I’m sorry if your family had a less than perfect experience with ONE office. But as a former health care professional I’d would hope you wouldn’t pile all/many pediatricians in a “how can we get get rich quick” basket!
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SIL is active duty Army (enlisted) but his work building is on an Air Force base. They live quite a way from either base, so all their medical (except for SIL) is done off base. When people live on base or near base, they often utilize the services there. Since DD works full time, and she has the medical expertise, she is typically the one handling the children’s medical visits and uses sick leave time from her VA Hospital job. Since she is in management, her time is a bit more flexible than those in direct patient care jobs. They found a rent house that was perfect for their needs, and only 2 years old - so they do drive a bit further, but 100% they got a great rent house and their city has traffic no matter if you drive 10 - 15 minutes, or a bit longer. They have a Costco near them, they don’t regularly use the PX (although do for special purchases), and use a regular very big grocery store where they do on line order and schedule pick up.
Not that general assumption at all. But many MDs have large student loans to pay off, and they often have their own family started - so they have to think about their own household income and expenses.
We have utilized an orthopedic walk in clinic within a couple of months, both with different PAs - and the more critical situation (major broken bone) had a weak PA encounter; I was unprepared (in quick thinking and also initiating dialog) for not getting quickly passed off out of the encounter and key decisions that were not really addressed. That won’t happen again. 4 days later had to spend a lot of time on telephone tag with this same orthopedic group to have spouse seen by a MD (which didn’t happen 4 days earlier) and also given pain medication - and did ‘push through’ to have him seen by the right orthopedic specialist. W/O knowing the specifics on ‘navigating the system’, and also getting a picture sent of the limb changes so the MD did say “yes we need to see him today”. Took 7 hours of telephone tag.
DD had been to that one pediatric office enough times to know she needed to change to another pediatric group.
I consider many physicians that pursue practices, especially with children, premies, and Children sub-specialties (where they have to be in a city with a Pediatric Hospital) the most ‘pure’ in their desire to be a physician healer.
Thanks. This sentence answers my question.
We don’t heavily moderate the Cafe and appreciate that conversations wander a bit, but let’s make sure this doesn’t completely turn into a pediatrics thread at 3k posts. Thanks.
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Interesting!
https://www.cnn.com/2024/02/16/health/grandparents-mother-depression-study-wellness/index.html
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My D often tells me that their family works successfully because of my help. An exaggeration, but I do know that my, and H’s, help makes a difference. Besides part-time babysitting and school pickup-ing, we can often help with spot evening babysitting (they don’t go out much, but often have work, school, etc related things in the evening), dogsitting (doing that right now), sick kid advice, and other small things. They don’t have the money to be able to just hire people for all that. We are both under seventy and in fairly good health, which helps. I don’t “work” (except for writing which pays pretty much nothing) but H still does. So we basically fit the description from the article of most likely to make a difference, plus living close by.
I always say, to them and to my S and his GF who also live nearby (no kids), that we operate as a family unit, trying all to help out each other as much as possible.
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I chose not to work because I knew that I wasn’t able to handle the demands of a family and maintain my sanity given the situation I was in. I want to help my D because I know how hard it would be if I wasn’t able to help. She and her H are very capable, and they could handle things … but my help makes their load more bearable. The fact that I truly enjoy it is a bonus.
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I stopped working (which I loved) because both sets of grandparents were 800 miles away and it was not manageable without some level of support/backup. (my husband also traveled).
We are 10 minutes from D, SIL and GD. We no longer have the regular Mimi Monday gig, but we fill in (example this coming Monday, kids both have to work, daycare closed) as well as do some weekend babysitting. We also dog sit, are available for pick up, etc. They just had wood floors refinished in their house and spent a week with us. We are happy we are able to help them. We both love spending time with GD.
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