06.52
Yamamoto
The voluntary decision to change pediatricians can be difficult, but understanding the procedures can make things move more smoothly.
We have two children under the age of four and both had been with the same pediatrician since birth. She was a very pleasant doctor, outstanding bedside manner and always great to speak with when we saw her. Unfortunately, she was part of a larger practice that was comprised of several other doctors as well as nurse practitioners and physicians’ assistants. As a result, we rarely saw our primary care pediatrician when we took the children to the office, whether it was for sick visits or well visits.
Ultimately, our older child developed consistent and fairly severe ear infections that were often not identified by the pediatricians’ office when we took him in for sick visits. It wasn’t until we finally reached an ear, nose and throat specialist that we were informed that our son had likely experienced long-term underappreciated ear infections, which had likely contributed to his mild speech delay. Eventually, he received tubes in his ears and he has been completely fine for the most part ever since. That was our first red flag.
Later, our younger child was admitted to the hospital after being sick with a fever for over a week, during which time we made three trips to our pediatrician’s office to get help. Each time, they couldn’t find anything specifically wrong with her - other than the fever, the coughing and the snot - so we were sent home with instructions to watch her and call again if the fever didn’t go away in a few days. On the 8th day of the illness and our 3rd trip to the doctor’s office, they finally said to go to the emergency room because they couldn’t find anything specifically wrong. As it turns out, our 15-month-old had a double ear infection, RSV and pneumonia. Needless to say, that was the end of our old pediatrician.
Understand the Procedures
Now we had to figure out how to change doctors, which is a bit more complex than one might expect. The first thing we had to do was find a new pediatrician, hopefully one with a bit better understanding of what ear infections look like in small children. We felt comfortable with the recommendation from several close friends and made the call. But before we could be seen by the new doctor, we had to make several things happen.
The first thing is to get all of the medical records from the old doctor’s office. That process requires filling out request forms and providing some form of payment for the administrative task of compiling and forwarding all of the medical records associated with our kids. For us, that process takes up to two weeks. For simplicity’s sake - and to avoid any confusion - I requested that the records be delivered directly to our house as opposed to the new doctor’s office. It’s easy to imagine the nightmare of having to confirm who sent and who received when neither knows what the other is doing.
Inform Your Insurance Provider
The next move was to notify our insurance carrier that we were changing the primary care pediatrician for both of our children. In most insurance plans, the primary care designation is a key piece of information that can dictate how all insurance payments and claims are processed. Fortunately, our insurance provider has an online form to request the change and that process only takes up to 7 business days. At that point, new insurance cards are issued with the new doctor’s information.
The other reason that move is important is because the new doctor’s office will not process insurance claims unless they are listed as the primary care on the insurance card. The point here is that all of this has to happen before you can be seen and covered under your current insurance plan, so make sure that you act quickly once you decide to move to a new pediatrician.
Leaving on Good Terms
Because our issue was somewhat disturbing - at least in my mind - I felt like it was necessary to write a letter to our old pediatrician and explain our reasons for leaving their practice. Nothing emotional, just an objective account of what happened and why we felt like we didn’t have much of a choice but to take our children elsewhere for care. That letter has been sent, but no word back from the doctor.
Ultimately, changing pediatricians was the right decision for us and fairly painless in terms of making a few phone calls and filling out some forms. Again, the key is to act quickly before one of your children is in need of doctor’s visit.
Ultimately, our older child developed consistent and fairly severe ear infections that were often not identified by the pediatricians’ office when we took him in for sick visits. It wasn’t until we finally reached an ear, nose and throat specialist that we were informed that our son had likely experienced long-term underappreciated ear infections, which had likely contributed to his mild speech delay. Eventually, he received tubes in his ears and he has been completely fine for the most part ever since. That was our first red flag.
Later, our younger child was admitted to the hospital after being sick with a fever for over a week, during which time we made three trips to our pediatrician’s office to get help. Each time, they couldn’t find anything specifically wrong with her - other than the fever, the coughing and the snot - so we were sent home with instructions to watch her and call again if the fever didn’t go away in a few days. On the 8th day of the illness and our 3rd trip to the doctor’s office, they finally said to go to the emergency room because they couldn’t find anything specifically wrong. As it turns out, our 15-month-old had a double ear infection, RSV and pneumonia. Needless to say, that was the end of our old pediatrician.
Understand the Procedures
Now we had to figure out how to change doctors, which is a bit more complex than one might expect. The first thing we had to do was find a new pediatrician, hopefully one with a bit better understanding of what ear infections look like in small children. We felt comfortable with the recommendation from several close friends and made the call. But before we could be seen by the new doctor, we had to make several things happen.
The first thing is to get all of the medical records from the old doctor’s office. That process requires filling out request forms and providing some form of payment for the administrative task of compiling and forwarding all of the medical records associated with our kids. For us, that process takes up to two weeks. For simplicity’s sake - and to avoid any confusion - I requested that the records be delivered directly to our house as opposed to the new doctor’s office. It’s easy to imagine the nightmare of having to confirm who sent and who received when neither knows what the other is doing.
Inform Your Insurance Provider
The next move was to notify our insurance carrier that we were changing the primary care pediatrician for both of our children. In most insurance plans, the primary care designation is a key piece of information that can dictate how all insurance payments and claims are processed. Fortunately, our insurance provider has an online form to request the change and that process only takes up to 7 business days. At that point, new insurance cards are issued with the new doctor’s information.
The other reason that move is important is because the new doctor’s office will not process insurance claims unless they are listed as the primary care on the insurance card. The point here is that all of this has to happen before you can be seen and covered under your current insurance plan, so make sure that you act quickly once you decide to move to a new pediatrician.
Leaving on Good Terms
Because our issue was somewhat disturbing - at least in my mind - I felt like it was necessary to write a letter to our old pediatrician and explain our reasons for leaving their practice. Nothing emotional, just an objective account of what happened and why we felt like we didn’t have much of a choice but to take our children elsewhere for care. That letter has been sent, but no word back from the doctor.
Ultimately, changing pediatricians was the right decision for us and fairly painless in terms of making a few phone calls and filling out some forms. Again, the key is to act quickly before one of your children is in need of doctor’s visit.
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