Frequently Asked Questions

m Do you have separate waiting rooms for sick and well patients?

Yes and No. We have a designated area for sick children and a designated for well children in each of our waiting rooms. Toys are provided in the well child area only. We provide antiseptic wipes for wiping down the toys before and after play. We also provide antiseptic hand gel for you and your children. Parents are asked to do their part and keep an obviously ill child away from the toys and well children. Studies have shown that keeping separate waiting rooms do nothing to reduce the risk of transmitting infection, for a variety of reasons, but we can use some common sense strategies to lower our risk. We encourage you to have your children wash their hands in the sink before they leave the exam room. Bring your own toys and books for younger children who mouth their toys, and encourage your children to avoid mouthing toys and books in the waiting area/exam rooms. We also try to block our visits so that well children are coming more often in the morning, and the sicker kids come later in the morning and afternoon.

m If my child needs to be hospitalized, who will be their doctor?

Austin is blessed to have an excellent Children’s Hospital and excellent Pediatric Hospitalists who care for our children when they need to be hospitalized. If your child needs to be admitted to the hospital, it would be at Children’s Hospital under the care of the Pediatric Hospitalist team. They provide communication with us about your child’s progress and then discharge them back to our care. We would love for you to keep us informed directly, as well, about your child’s progress and any concerns you might have.

m What hospitals do you recommend for emergency care?

If a child needs admitted, or we suspect that a child will need to be admitted, we suggest you proceed directly to Dell Children’s Hospital for an evaluation. In Austin, we only admit children to this hospital to provide the very best pediatric care possible. Newborns should always be seen at Children’s Hospital except in rare circumstances. We welcome your call, even after hours, to discuss which hospital you should use, should your child need emergency care.

On the other hand, for more minor concerns, we usually suggest an Urgent Care Center or the Seton Southwest Emergency Department. Generally we do not receive any documents from these facilities after you have been seen, so please ask them to forward the records or a summary to us as soon as possible.

m Will doctors call in antibiotics for my child?

Generally, no, and for a variety of very good reasons. Obviously we make exceptions to these from time to time when the situation warrants it, but typically we try to stick to these rules of thumb for the overall health of your child. Here are some of those very good reasons.

1. Antibiotic resistance is on the rise and overuse of antibiotics is a major health concern. We need to know exactly what we are treating and make judicious use of antibiotics whenever possible. Generally it is considered inappropriate practice to prescribe antibiotics for a condition that can not be specifically examined.

2. Not all ear pain is an ear infection. Parents often assume that if their child complains about ear pain, or if a younger child/infant "tugs" on the ears, it must be infected. This is simply not true. Other potential diagnoses include swimmer’s ear (otitis externa) allergies and colds that cause pressure in the middle ear space, and jaw/teething pain. It is important to make the correct diagnosis before we decide to treat for the worst case scenario.

3. Not all ear infections need to be treated with antibiotics. We are definitely trying to treat many more infections with supportive and comforting measures than with antibiotics than ever before. The truth is, most ear infections will completely clear without us doing anything at all. Certainly, we want your child to be as comfortable as possible, so we recommend adequate doses of analgesics (Tylenol, Motrin) and numbing drops. If we can allow a child to successfully work through an ear infection without antibiotics or complications, we consider this a little victory in the war against antibiotic resistance – both for your child and society as a whole.

4. Not all “pink-eye” is pink-eye. Eye drainage sometimes masks a deeper infection that can involve the sinuses and ears. We truly feel it is in your child’s best interest to have them seen before we blindly try antibiotic eye drops. Many times we diagnose an ear infection, use oral antibiotics to take care of both infections, and save you the battle of trying to put drops in an unwilling child’s eyes.

o What are Your Views on Breastfeeding?

All of us were very committed breastfeeding moms. We feel very strongly that breastfeeding is not only the very best first food that your baby can receive, the benefits of breastfeeding continue for both of you. We know that babies who breastfeed are less frequently ill than formula-fed babies, have less risk of allergic diseases, and may even add a few IQ points. As you prepare for delivering a baby, we strongly recommend you have a goal for how long you would like to breastfeed, a plan for how you can get help if you have difficulties, and a determination to succeed. We don’t like to hear that moms are going to “try” to breastfeed, but rather that they plan to breastfeed and have made arrangements to guarantee their success. A breastfeeding class is a great compliment to prepared birth classes. Having the vocabulary and some knowledge of the potential difficulties will help you as you start your breastfeeding relationship.

We recommend that mothers breastfeed their babies until 12 months of age, and exclusively so until 4-6 months of age. Thereafter, your decision to continue breastfeeding is truly your own.

Of course, not all women can or desire to breastfeed, and we want these mothers to know that this decision is absolutely fine with us. Mothers do not need to breastfeed to be wonderfully bonded with their infants, and children thrive under a mother’s love and nourishment whether that love is expressed through breastmilk or infant formula. We will not criticize your choice, though we may encourage you to consider all your options.

o What are Your Views on Vaccinations?

This is a bit of a loaded question.

We believe that vaccines are extremely safe. We believe that vaccinations are one of the most important public health victories of the last 100 years, ranking right up there with handwashing and good nutrition. We believe that a fully immunized population makes it safer for everybody, especially those who can't be immunized, for example, young infants, the elderly, children undergoing chemotherapy and children with genetic immune deficiencies. It makes it very uncomfortable for us to think that a child whose parents have declined immunizations are parked next to our newborns in our waiting room, possibly spreading pertussis (whooping cough) or Haemophilus influenzae (a bacteria that causes meningitis).

However, we understand that most parents try to make good decisions for their children and those that question routine immunization practices are generally trying to make informed decisions. We also agree that a partially immunized child is better than an unimmunized child. As in all areas of practice, we strive to take a collaborative approach with our families, so we can match our medical knowledge with the parents' knowledge of their individual child. Please feel free to ask questions - we don't mind.

In our booklet, "Taking Care of Your Newborn," we have a vaccine philosophy and policy statement that should give you some more information. In this section are some good websites that we feel give objective, non-inflammatory responses to some of the controversies in the media, etc. We especially recommend the American Academy of Pediatrics (www.aap.org) where you can get the latest information on a variety of subjects, but up to date information on vaccines as well.

If you choose to decline any or all vaccines, we respect your right to do so, even if we disagree. We will ask you to sign a waiver form with each opportunity to vaccinate, indicating that vaccines were recommended but you have chosen to decline.

Will I See MY Doctor With Every Visit?

We make every effort to have you see your chosen physician with each visit, especially for Well Child Exams, also called "physicals." It is as important for us to get to know you and your child, when sick or when well, as it is for you to get to know us. We enjoy building the relationship and trust with both parent and child.

However, there will be times when a physician is on vacation at a medical conference. At times, especially during peak illness seasons, the schedules get too full for one physician to handle all of their own patients. At these times, we are happy to schedule your child with another provider.   Remember that we do not employ nurse practitioners or physician's assistants, so you will always see a pediatrician for sick and well visits.