New patient portal coming in June

To bring you better service, more features and more reliability we will be changing our patient online portal to a FollowMyHealth. Like before, this will communicate with our medical record system and offer many of the same features you've already experienced such as sending a message, requesting appointments, requesting medication refills and paying your bill. In addition the new portal will allow you to see upcoming appointments, review health information much more easily and view information from multiple children from each account. FollowMyHealth is the same portal already used by Salem Clinic so if you already have account for yourself you can use the same account to communicate to us and view your children's health information. 

Current portal will be offline beginning 5/28 and will about 2-3 weeks to switch over. Keep an eye out for updates here! Unfortunately it will require creating a new account. Stay tuned!

See video below for an introduction.

Hey, Why All The Questions? I Just Want An Appointment!

When you call our office to schedule a check-up for your healthy child or a routine follow-up or a minor illness, chances are the only questions our staff will be asking are things like “What time/day works for you?” and “Is this still your phone number/address/email/insurance?” But for some appointment types and for some more complicated children, there are some questions that we need to ask before we can make your child’s appointment, and the reasons behind those questions are important.

For everyone, all the time: we need to make sure that we have identified your child correctly, and that we have the correct contact information and insurance information for your family. This is hugely important. When you give us your child’s name, we should be asking for the date of birth if you haven’t already given it to us. We should be asking for your preferred phone number and double-checking the mailing address. We do this to make sure we are talking about the correct child but also to make certain that someone else isn’t pretending to be the parent of your child, fishing for information. And of course, it’s imperative that we have your BEST phone number so that we can call you if more information is needed or if we have to make a change to your appointment time.

We need to make sure that your child is safe to wait for the proposed appointment time, and that we are in a position to provide the needed services. For urgent sick appointments or injuries you may find your call transferred to a nurse, who will ask you a few questions about how sick your child is or how severe the injury appears to be. Depending on the answers, she can get you an appointment as well as give you advice on what to do in the meantime. She can discuss the case with a physician if needed. If your child sounds very ill or severely injured then she may have to direct you to a hospital Emergency Department in order to make sure your child receives emergency or specialized services right away. We also want to make sure that you aren’t disappointed by making an appointment and then finding you have to go elsewhere. For example, there isn’t much we can do for a broken tooth -- call your dentist!  A badly ingrown toenail that we’ve already seen and treated with non-surgical care may need a podiatrist. And adolescent girls who desire long-term contraception such as an IUD or one of the implants will be referred to a gynecologist, so you can skip seeing us first if that’s what is desired.

On certain days, such as Sundays or holidays, or when there are very few appointments left, you will be asked to talk to a nurse first before scheduling an appointment.

We need to give your child or adolescent the right amount of time to the appointment. A depressed teenager or a elementary school student who needs to be evaluated for ADHD or a child who has had abdominal pain for six months all need to have more time set aside than someone who has had a sore throat for two days. We want to make sure that we have enough time to fully address the concerns that you have.

We want to make certain that we schedule you with the right person for the job! Most of the time your child will see his or her PCP, but for some urgent problems we will use another provider on the same team if the PCP doesn’t have timely availability. If no one on the team is available then we may have to make the choice of having your child see someone that they’ve never seen before versus waiting for the PCP or team member to have an opening. We need to have a good idea of the nature of the concern to make that decision. Also, not every provider has the same skill set. Serious mental health issues and children with very complex health needs will normally be cared for by our physicians rather than our mid-levels (although there are exceptions). By the same token, some of our physicians are All Thumbs when it comes to suturing or placing casts on minor fractures... and our PAs are great at these! And our PNPs really shine when patient education is what is really needed.

We want to be as prepared as possible for your child’s appointment. Perhaps we need to order an interpreter, or make sure that one of our lactation nurses is around at the time of the appointment. Maybe your child has seen a specialist recently? In that case, we want to make sure we have notes from that visit. Maybe you’ve consulted with a psychologist or psychiatrist about your child or adolescent and have a huge report that the PCP needs to read?  In that case, we want to get that packet to the PCP well in advance of the visit. Perhaps your little darling was in the ED over the weekend and we are seeing her for follow-up: we want to be able to get the ED notes and any labs that may have resulted after you were there. Sometimes special tools or equipment may need to be located and checked to see if they are working! The list is almost endless, but there are many situations in which a little knowledge on our part means better coordination of care for your child and a more useful visit with us.

Whew, what a list! Hopefully that gives you a better idea of why we do ask all of those questions. Please help us by answering as honestly and completely as possible. Always feel free to volunteer any additional information that you think could be relevant to your child’s appointment. And please let us know if you aren’t being asked to verify that BEST phone number every time you call or visit us!

Staying Healthy on Summer Trips

It’s May, and so the end of school isn’t far away. Many of you are thinking about summer vacations with your families. You might be thinking about a grand expedition across the country, or to Europe, or some exotic location... or simply a weekend or two at the beach enjoying the matchless Oregon coast scenery. Whatever your plans are, it bears to do a bit of advance thinking about how travel might affect your child’s health care needs. Here’s a list of tips that you might find helpful, both in the planning phase and once you get out on your travels.

 Are you traveling to an unusual, far-away, or exotic location? You and your offspring may need either additional immunizations prior to the trip, or, in certain cases, special medications to fight off infections during your travel. Your best resource online is the CDC; their website has a user-friendly travel section. In general, tropical locations have increased risks for mosquito-borne illness, while travel to undeveloped countries carries an increased risk of catching nasty things through contaminated food or water.

Are you traveling to a destination with an outbreak of a vaccine-preventable disease? Measles has cropped up in New York, in California, in Texas, and in both the UK and many parts of continental Europe. Healthy travelers who have had both doses of their MMR should be protected. Since we don’t usually give the second dose of MMR until the four-year checkup, children between the ages of 13 months and 4 years may qualify to get that dose early if you are planning travel where there is an outbreak. There needs to be a minimum of one month between the two doses; the first dose is usually give at 12 months at our practice. In the case of travel to areas with a high incidence of measles, the first dose can be given a few months early (but it doesn’t ‘count’ and must be repeated at one year). Obviously, everyone in the family should be up-to-date on the rest of their regular vaccines before travel.

Does your child take any prescription medications on a regular basis? It sounds silly, but remember to take them! Every summer we have to help frantic families by sending a new prescription to a pharmacy at their destination, and no one wants the expense and hassle of having to do that. Pack medications in carry-on luggage, and pack them early on in the process. Remember that there are restrictions on liquid medications on aircraft. Keep liquid medications in their original packaging with the patient label clearly showing. Consider asking for a note from our office if your child takes critical liquid medication such as meds used for seizures or heart conditions.

Consider your destination and method of travel. Small children grow bored on airplanes; take plenty of amusements. Car travel allows for more flexibility and greater comfort but watch out for those twisty-turny roads on the way to the coast! They are famous for upsetting little kids’ inner ears and bringing on car sickness. Over-the-counter motion-sickness remedies can be helpful and there are chewable forms suitable for the little guys. Other strategies: lots of water, light and non-greasy food, plenty of fresh air, and encouraging them to play games that involve looking out the window rather than staring at books or tablets. If someone feels queasy, pull over as soon as traffic conditions allow and give the victim a rest for a few minutes, with a brief walk if possible. Get bad smells out of the car right away and keep the temperature on the cool side.

If an unexpected illness does strike, try to plan ahead a few steps. Is there a drug store/pharmacy near where you will be staying, in case you need acetaminophen, ibuprofen or Benadryl? Is there a store that sells Pedialyte or Gatorade? Most acute pediatric illnesses don’t need anything else. If you are going to be in one location for several weeks, or if you have a child with special health care needs (or little Johnny has a track record of getting strep throat every time you go to Disneyland), it’s worth knowing about your other local resources. Is there a pediatric practice nearby that is willing to see a ‘guest’ patient in a pinch? Is there an urgent care nearby? Where is your nearest hospital? Make sure you have our phone number with you, as we can advise you and help you find local resources such as physicians and pharmacies.

Be aware of what we can and cannot do for you. We can help you replace a lost or left-behind prescription for a non-controlled substance -- but your insurance may not pay for the new batch. We can advise you whether or not to seek medical care at a local office, urgent care, or ED, and can often help you find one. We can try to problem-solve with you to make your child comfortable until you can get to definitive care. We can get on the phone with local doctors and answer their questions about your child’s health record and needs. We CANNOT diagnose conditions over the phone. We won’t be able to call in prescriptions for antibiotics without seeing your child; that’s no different than if you were home. We also cannot call in orders for lab tests or x-rays. If your child is sick enough or injured enough to need labs or x-rays, then they need to have Someone Local checking them out.

So there you have it! Have fun working on those summer vacation plans, and remember to ask us for help with any of the issues discussed above.