On December 23rd my preschooler came home from a play date with an aching, swollen foot. No one knew exactly what had happened except that he’d fallen. The next day he was still complaining about it and limping badly. (He’s not a big complainer or limper.) Normally I dread any interaction with the health care system so I would have ignored the injury and hoped it got better. But it was the day before Christmas and two days before we were leaving the country for a week.
We went to a family social function on the 24th. There were plenty of doctors there, including pediatricians. We asked one pediatrician (whom we don’t know well, but who practices pediatrics in the ER) to have a look. She took off my son’s shoe, had a look, and said she wasn’t sure. Her dad happened to be there, too. Turns out he is a pediatric orthopod! He had a look and said he couldn’t see through skin (since he lacks X-ray vision) and that he didn’t know if it was broken. Both told us that if it was a Jones fracture it could be serious and require treatment.
Then my wife saw our friend Dr. Lindeman, and asked him. He didn’t take off my son’s shoe or talk to him but said:
“It’s not broken. I can tell by the way he’s putting weight on it. Don’t worry about it.”
When we got home we called our pediatrician’s office. Our excellent pediatrician, Dr. Patricio Vives (old school, no website to link to), wasn’t around on Christmas Eve. The person covering for him said she couldn’t tell what was wrong and suggested we might want to go to the ER for an X-ray for “peace of mind.”
I took my son to Children’s Hospital and prepared for the worst. Good thing I did. Rather than complain about all the details I’ll just say it was a 5-hour experience, which included 4 hours and 45 minutes of waiting, 10 minutes in radiology, and 5 minutes with the doctor.
At one point (3 hours or so in) I was told –when I went to the desk and asked nicely– that we were next on our “track. ” (They have different tracks depending on whether orthopedic/surgical, medical, etc.). Around the 4 hour point, a staffer came out with a clipboard and after seeing our name toward the bottom of the list said, “you must have just come in.” I have to admit I almost lost my cool at that point. A few minutes later she came back and more or less admitted they’d lost track of us.
Who knows how long we would have waited after that. Luckily one of the physicians recognized our name and had us called in. It turned out to be another friend of ours. She saw my son, told us the radiology report was negative, and then had my son stand on his toes. As soon as he did that she concluded he was fine.
This experience was kind of embarrassing for me (and of course a big time waster). What I take away from it is to listen to advice from people you trust and don’t ask the opinion of people you don’t know well. If we hadn’t asked the first pediatrician and pediatric orthopod I just would have listened to Dr. Lindeman and not bothered to call the person covering for our pediatrician. (I’m pretty sure that if Dr. Vives had been around he would have steered us properly.) It also would have been nice to have a consumer-friendly decision support site, which could have taught me the tiptoes trick and saved my time and my health plan’s money.
So let me at least put in a proper plug for Dr. Lindeman (since I didn’t pay him for his quick assessment). He’s a first-rate office-based pediatrician with MD and PhD degrees from Columbia University. He’s board certified in pediatrics and pediatric pulmonology. He uses secure messaging with patients and families (though sadly he’s not using RelayHealth). He also handles call himself, rather than farming it out to someone else.
I don’t live anywhere near Natick, but anyone with kids who does should check his website or call his office at (508) 655-9699.
May 31, 2007
Yes, folks, I’m referring to the now-famous Flea blogger, so this post is getting a lot of hits today. I stand by my endorsement of Dr. Lindeman, which is based on ever-so-much-more than this particular anecdote. You’ll see a bunch of critical comments below from people who don’t have firsthand knowledge of this case and don’t know Dr. Lindeman. They’re off the mark IMHO.