We met Emma's potential new pedi today. He has a huge practice in a beautiful office in Stone Oak, (N. San Antonio). He has 20 years experience in pediatrics and was highly recommended as one of the best in the area.
It took his assistant a full 35 minutes to input Emma's basic medical history and list of specialists into the computer before he walked through the exam room door with that look on his face... He was apparently viewing the patient info from his own computer and decided he might as well jump in. (I'm sure the fact that we were 15 minutes into his lunch hour had something to do with that.)
"Wow, how many specialties do we have here?..."He was very nice and very matter of fact about his lack of experience with diabetes in young children, (he asked if her cgms controlled her insulin/bg... don't I wish), his lack of knowledge about current JIA treatments and the meds she's been taking, and the fact that he's never had a patient with Lupus nephritis or any similar AI problem. ("I remember reading about this in medical school" was what he actually said) He was about 60% stunned and 40% intrigued by her history, but mostly he was amazed that "she looks so good" in spite of it, the same thing we've heard from every doctor since her D dx's. I personally think she's just a beautiful kid and it confuses people since "sick" and pretty don't normally go together... but whatever. ;-) Her growth is good and she is doing well overall, so my efforts in her care over the years have paid off and he was impressed.
I think he's a good pedi and he'd be OK for routine things, but he really has no idea what to do with her and I'm certain that he'll defer to her specialists for anything beyond antibiotics. Maybe a pedi with a closer practice (this was 40 minutes away) will be fine since none of them seem to have any actual experience anyhow.
He said we were better off keeping all of her specialists together in Dallas because San Antonio doesn't have anything comparable. Children's Medical Center has every specialty we need and they all share the same computer system, which means superior continuity of care. So, we will continue to travel to Dallas every 4-8 weeks for the time being. Bummer!
I keep hoping that someday I'm going to stumble upon a doctor that won't say "I've never seen/done/heard of/ managed this before". A doctor that has enough experience with complex auto-immune issues to know what to do at least half the time would be amazing, but I guess in Emma's case that's just too much too ask. As we left the office today he said "well this is going to be interesting!" ~Yep! That's my favorite thing to hear from my kid's doctor... At least she has me to manage everything, no wonder I feel so freakin' old! lol
Monday, January 5, 2009
Another MD in the headlights...
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1 comments:
Strange as this may sound, I think you may have lucked out in your choice of pedi! What you are going to need in this day of HMOs and required referrals is a pedi who will immediately turn her over and defer to the specialists. Very last thing you need is a doc deciding she may not need to see the specialist and/or a hesitance to refer. He is honest and, if intrigued, may be willing to learn. If you can find one with the same attitude closer, that would do as well. You need the best, top specialists, not too much need for the pedi except as a front man.
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