I <3 Children’s

Presidential visits wreak havoc with traffic, and I try to avoid them.  I envisioned spending untold hours inhaling exhaust fumes as we sat in stop-and-go traffic backed up from Seattle.  A phone call to try to reschedule for a different date left me having to choose between dealing with the traffic or waiting another month.

After some discussion, we decided not to postpone it.  We need answers.  My daughter’s appointment at the pediatric rheumatology department of UW school of Medicine/Children’s Hospital clinic was on the same date as the president’s visit, and only a few blocks away from where he spoke.  My husband took half the day off work so he could drive and sit in on the appointment to figure out what’s going on with our child.  It was great having him there, because somehow he’d not comprehended the extent of the problem.  Finally he understands.

Children’s Hospital in Seattle was incredible.  Compared to the place we went last month… wow!  What a contrast!

Two weeks before my daughter’s appointment, we received a letter in the mail reminding us of the appointment.  The letter included our insurance information for us to verify (which they’d gotten from our referring doctor’s office), the appointment date/time/location/physician, a list of things we needed to take to the appointment, tips on how our daughter should dress for the exam, parking details, and an explanation of what to do once we arrived.

Four days before the appointment, we received a phone call from a live person (not one of those annoying telephone trees) who confirmed the appointment date and time, reiterated the parking details, and explained the procedure for check-in.  I have a calendar, so didn’t need the reminder, but the other tips were really nice.

Free parking is available, and it was very close to the clinic.  There were plenty of parking spots, but it was nice to learn that valet parking is an option in the future.

We’d allowed plenty of time for traffic to be awful, but instead it was the lightest I’ve ever seen.  We were an hour early.  There was no question about where we should go, since there’s a greeting booth just inside the building entrance, staffed by two smiling people.  They verified that we were there for a scheduled appointment, scanned our photo identification, took a picture of our daughter, and printed security passes for everyone.  Once we were properly identified, we were directed to the reception center, which was clearly labeled and very easy to find.

The reception center is where patients check in.  A very cheerful woman was watching for people to arrive, then assigning them to one of the check-in desks.  I wish I’d gotten the lady’s name because her boss needs to know what a fabulous job she does.  If all eight check-in desks are busy, people take a number and have a seat; even if there’s a wait, at least nobody has to stand in a long line.

In fact, no standing was required at all.  So many doctor’s offices have patients stand at a counter to sign in.  The clinic at Children’s Hospital had chairs at the check-in desks so we were able to sit.  I handed over our appointment confirmation letter (required) to another smiling person, then the insurance card, co-pay, and check-in form as she needed them.  Since they’d kindly mailed us a list of the things they’d need, I had everything ready and the process went very smoothly.

As the final step of the check-in process, the doors we would be called to were pointed out and we were given a pager.  All the doors are color coded.  Instead of “left/middle/right” being the designation, the doors were painted bright yellow, pink, and apparently I’ve forgotten the third color.  We weren’t required to stay where we could see those doors and hear when they called; we could go anywhere – even downstairs to the cafeteria.  Since we’d eaten in the car and were an hour early, we settled in to the comfortable chairs for a long wait.

About fifteen minutes before our appointment time, the lights on the pager started flashing, then the pager started vibrating, and the little display screen spelled out, “YELLOW door.”  I think there were other words, too, but “YELLOW door” is all I recall.  We reported to the yellow door, where a smiling MA met us and showed us to an exam room.

They had a special room for taking vitals, and it was kinda cool to first go to the exam room, then step away for height/weight/temp/etc.  I don’t know if the sequencing depends on which room the patient is assigned, but it was a really nice subtle touch for my daughter.  I think adults might like that approach, too.  At most doctor appointments, the first thing they do is put you on a scale, as if your weight is the most important thing about the visit.  Here, the first priority was getting into an exam room.

I gave the meds list to the MA (who entered it into the computer wrong; apparently they specify whether a person takes calcium carbonate or calcium citrate, and if you only list “calcium” then they choose the first one (alphabetically) in the list instead of asking if you know what kind).  Still, she was nice and that correction was made later without incident.

When the doctor arrived (smiling), she introduced herself to our daughter, then to us.  Usually it’s the other way around.  The doctor sat and talked to our daughter while we eavesdropped.  It seems that usually past medical history is taken first, but this doctor started with the current problem.  That gave her a chance to establish good rapport with the patient and my daughter loved being center stage instead of an observer at her own appointment.  What she had to say mattered.  Only later did the doctor ask about other history (at which point my daughter started shrugging her shoulders and saying, “I dunno.”)

My husband recalled bits of history that I’d forgotten, and added history from his side of the family that I never knew.  During all this time, the doctor had been taking notes on paper, paying attention to our daughter, completely ignoring the computer in the room.  After the history-taking was complete, the rheumatology nurse came in.  She sat at the computer, and I expected her to take notes of the exam, but the doctor never dictated any findings.  Maybe the nurse was entering the history notes.

Once the exam was complete, the doctor shared her findings.  There was a dry-erase board mounted on the wall of the exam room, and she used it to make a little sketch to explain what’s going on.  The nurse, simultaneously, found a medical drawing in her computer and printed that so our daughter would have information to take home.

The nurse had been typing away while the doctor talked to our daughter, then showed the doctor where to sign-off on the notes and prescription, and printed.  Another nice touch was a printer right there in the exam room.  No running out of the room to grab printouts.

It’s been incredibly frustrating to keep hearing, “There’s something wrong, but I don’t know what.  Go see another doctor.”  Our daughter was starting to feel hopeless, and kept saying, “Nobody’s ever going to figure this out. We should just stay home.”  Now she feels like she got a diagnosis and a plan for how to feel better.

The kid doesn’t actually have a diagnosis.  She has a medical word describing her symptoms (no reason why it’s happening), but she’s okay with that.  The doctor told her she’d like to use as few medications as possible – another plus since the kid sees the zillions of pills that I take and was afraid she’s facing the same thing.

In addition to the rx, she has a referral to the PT/OT department, and the doctor was clear that we’re to make that appointment the same day as our follow-up with the rheumatologist so that we only need to make one trip.  The therapist at Children’s is obviously experienced in working with kids, so that should help.  He’s also supposed to communicate with the local PT we’re already seeing so that we don’t have to drive back and forth so frequently.

Medical problems in kids are difficult to deal with, but the procedures in place at Children’s Hospital made things go as smoothly as possible.  It looks like my daughter is on the road to feeling better :)