Day care centers offer 'virtual doctor' visits

MSNBC ^ | May 4, 2005 | AP

[LadyShallott]

ROCHESTER, N.Y. - Marilyn Gonzalez worried that her 2-year-old was coming down with an ear infection. Rather than miss work for a doctor visit, the 25-year-old single mother of two dropped her daughter off as usual at the day care and went to work.

Little Jaeda was examined soon afterward by a University of Rochester pediatrician and given antibiotics. Using telemedicine tools wielded by a day care staffer, the diagnosis was done through the Internet.

“When I picked her up, everything had been taken care of,” said Gonzalez said with a sigh of relief. “At least for those common things like ear infections and strep throat that most kids get, I’m comfortable with the diagnosis. Telemedicine has done wonders for me.”

'Virtual doctor' visits A federally backed project offering “virtual doctor” visits at seven child-care centers in this city of 220,000 has proven so successful since 2001 that it is being expanded this spring and summer to five more centers and 10 public schools throughout the city and suburbs.

The expansion will create the biggest metropolitan network of its kind in the nation, covering 8,500 children in all, and provide a tantalizing glimpse into the future of medicine. Though there were some technical problems, sickness-related child absences dropped on average by 63 percent at the pilot centers. They serve about 950 children of mostly low-income families with little or no health insurance, according to a study published this week in the journal Pediatrics.

In addition, it said, 92 percent of parents said the hassle-free option allowed them to stay at work when they otherwise would have taken their children to a family doctor or an emergency room. Telemedicine has evolved since the 1990s chiefly as a way to bring medical care to rural communities across America.

[WV Mountain Mama]

One less responsiblilty for a parent to take care of their kids. Where do they find the time?

[kiki04]

WElcome to state run child rearing... parents are just breeders...

[wyattearp]

Virtual medicine? What the heck is a "telemedicine tool"? How exactly does a doctor look in a patients ear?

It sounds like you log in, jump through a few hoops, and get some antibiotics. It doesn't appear to matter if you actually need them or not, as I don't see how the 'virtual doctor' can actually tell.

[ShadowDancer]

This is sickening.

[starfish923]

One less responsiblilty for a parent to take care of their kids. Where do they find the time?

Abdicating parental involvement and handing it over to ANYONE else is just a sign of the times. So is the secularism.
When you have a society as wealthy and spoiled as ours is, you get the tendency to forget religion, values and ethics. The self-absorption, self-centeredness and absolute selfishness of these parents will come back to bite them on their fat butts. Their children will be exactly like them and will abandon THEM when they are old, gray and needy.
Those oldsters may not even be needy, but they will want their children and grandchildren around them and those folks won't be available. This will happen when the oldsters start realizing that there really something missing from their lives. There will be a hole in their lives, in their souls, which even their spoiled rotten children can't fill.
Sadly, they won't know where to go to fill that hole. They WILL be unhappy and not know why. And when the aches, pains and depression of old age come, and they will, they will suffer.

Nothing changes. Their attitude of mememe was TAUGHT to them by their parents, family, community and society. They bought into it and will reap what they will sow.

[Mfkmmof4]

This is so wrong on many levels.

[WV Mountain Mama]

I have taken many a virtual tour on the internet when looking for houses. I would never buy a house by that alone though. I can't believe that a parent would let someone not only diagnose a problem that way, but also prescribe medicine?!?! When I worked at a daycare, I was amazed at how sick kids would be, yet their parents would still bring them. We would have a message waiting for them when they got to work that their kid threw up and they needed to get him immediately. In a short 4 hours, they finally came. I don't know why some people have kids.

[EmilyGeiger]

While I was getting my college degree I worked for a private daycare. That was the most eyeopening experience for me. There were some good parents(who had to work, but still tried to put their children first) and then there were the people who put their jobs first. We had a brother and sister at the center who had parents that worked for the state and who got all the state holidays. On those days the children were still there by 7:00 and left at 5;30 while the parents "enjoyed" their day off. These parents were upset when the center closed on Christmas eve because they needed the day to shop. The children came sick often and when would call for them to come and get them, like you stated they would wait many hours, exposing their child's germs on all the other kids. Needless to say these children behaved very badly. This was just one case, we had so many others. This was a center for the more elite. Not many single parents, just parents who were not wanting to bother. I vowed to myself when I had my own children they would know how much they were loved and wanted and that their father and I would make any sacrifice for one of us to stay home. I have 3 now and I proudly say I am a stay at home mom! :)

[EmilyGeiger]

The sad thing is we know that giving a child too many antibiotics can be a problem later on. Their bodies become immune to them and they are no longer effective. Our society is quick to demand antibiotics for every malady, even a cold, so that the child gets "better" and the parent can go on to do their own thing. My pediatrician rarely will subscribe antibiotics, unless it's an ear infection or it's an infection that is not viral. And he will only prescribe if he first does an exam, you cannot call and request. My children can throw off infections much faster than other's because they have a strong immune system because they have not been loaded down with anitbiotics. This is really scary, because a new strain of flu or germ is going to harm many children who have been overloaded with antibiotics will not have a strong immune system to throw it off.

[Gabz]

You are absolutely correct. at almost 7, my daughter has only been prescribed antibiotics once in her life, when she was about 18months. Like your children, she is quite able to shake of quickly whatever ails her.

[wyattearp]

Doctors nowadays are getting more and more reluctant to give out antibiotics. Recently, I got very ill, and they didn't give me antibiotics until I had tried two different series of steroids first. I was given antibiotics once the steroids failed to solve the problem, but they didn't take care of it either. I was sick for two and a half months.

When I was a kid, I had pneumonia and bronchitis a lot. Ear infections as well. I practically grew up on penicillin, amoxycillin, etc. Antibiotics are pretty much useless to me anymore. I am proof of what giving a kid antibiotics like candy can do to the kid's future health.

Internet 'doctors' prescribing antibiotics to kids without being able to even conduct an examination is so far beyond irresponsible that it is pathetic. That these parents not only allow it, but actually think that it is a good thing is indicative of some really bad parenting.

[WV Mountain Mama]

You sound exactly like me and our family, right down to the number of kids. I had the same experiences at the day cares I worked for, and learned the exact same lessons. It really is a shame. I was always amazed at how many kids came to daycare too when I knew the parents had the day off!!! Pathetic!

[texasflower]

HI EVERYONE. I'm posting the for information only. No flames please. As I say later on in the post, this is not to considered condonement of this, but I do see how it might be useful.

I worked at one of the top ten hospitals in the nation and we had a virtual medicine program. It was highly effective.

Our doctors were connected to rural hospitals and clinics that did not have the proper specialists.

This program was almost always physician to physician, but not always. Sometimes it was a PA, RN, LVN or paramedic. I have been the paramedic on the other end of the telemedicine setup.

They also often guided other surgeons through tricky operations with great success.

I would imagine in this day care situation, they are dealing with common child illnesses. In that situation, it's not any different at all from you calling your pediatrician on the phone and describing your child's symptoms. The doctor asks you questions, gives instructions and calls in an antibiotic etc.

Surely you have had a doctor do the same thing for you.

Anyway, in a telemedicine set up, the doctor can actually see the patient on the video screen and any trained person can follow the doctor's instructions.

For instance, the doctor may ask to see the patient's rash, or take a look at the chest to see if there is respiratory distress, a camera connected to the terminal can be inserted into the child's mouth to see if there is any swelling, redness etc.

Likewise the camera can be placed in the ear to check for redness or fluid. Just like the thing your doctor uses to check your ears in the office. This one is just connected to the terminal and has a camera on it.

The trained day care worker can take any needed vital signs. A well trained person can do almost anything that the doctor would need to have done. A school nurse or a paramedic or EMT at one of those locations would be outstanding. Some day care centers do hire EMT's or send their own staff for EMS training.

NOW, having said all of this, personally, I disapprove of the parents not being more involved in this. The idea of dropping a sick child off and not being there to speak to the doctor bothers me as a mom.

If they stayed at the daycare and participated in the telemedicine session, then went to work, I think that would be okay.

Having seen telemedicine in action, I am confident that it is a very effective tool and has advantages, even in a school or daycare situation.

Furthermore, be ready for the web cam from home "doctor's visit". I think that is coming.

This is of course only going to really work for minor sort of things, like ear infections, etc.

Any good doctor is going to advise bringing a child in if they find anything concerning in the telemedicine exam.

[Old Professer]

It ain't bad enough that 90% of common childhood infections are spread at pre-school, day-care and elementary locations, now they want to encourage parents to send their kids to school knowing full well they are sick.

[WV Mountain Mama]

1. If I am paying $150-$250 per week for child care, I don't want anymore encouragement given to parents to bring in sick kids. They are exposed to enough crap, give them a couple of days off. The day cares I work in had guide lines for fever, vomiting, even the color of the snotty nose, and children were to be sent home immediately if they met the criteria. I wouldn't want sick kids around mine, bottom line.

2. My physician has never and will never prescribe antibiotics over the phone. Maybe if we were on vacation out of state, but not across town.

3. Working parents miss enough of their kids lives. When kids are sick, they want their mom or dad, not the day care worker. If they aren't willing to take a day or two with their sick child, than they shouldn't have had kids.

I just feel it is another cop out on the parents part to not be involved in the kid's lives. It may very well be accurate, but come on parents, give your kid a hug, share a popsicle and cuddle on the couch for an afternoon!!!

[texasflower]

I wouldn't do my own child that way, but I can see this in a bit of a different light, since I've participated in telemedicine patient care. Just about the only thing that the telemedicine doctor can't do via video link, is personally feel the patients skin temp or palpate a mass, but the things like thermometers, scopes for the throat, nose and ears, pulse oximetry, blood pressure cuffs, etc are all relayed directly to the physician.

As far as the sick kids being brought in to day care, the centers that do allow sick children to come have a separate area for the sick kids, like a school clinic. Often they even enter via a different door. They also always have dedicated sick bay staff, to prevent cross contamination via day care worker.

I'll bet you that your doctor certainly would call in medications in certain situations. For instance, it is the middle of the night and the symptoms are clearly something like an ear ache, etc. That would save you, the parent, from an unnecessary trip to the ER, which wouldn't even be warranted.

Another situation that he might do it is when there is something going around, his office is packed and everyone has the same symptoms.

Especially if you have a good relationship with the doctor and they trust you and are confident that you are relaying information properly. From your posts, it's very easy to tell that you are a very bright woman who is right on top of their child's care and who probably has an exceptional relationship with their doctor.

You may be right, that your doctor won't, but most docs I know do it in certain situations.

Admittedly I'm very lucky since my doctor trusts what I tell him, because I am a paramedic. It's saved me from having to drag sick kids into the doctor's office for minor things.

Childhood sicknesses are not rocket science and in the vast majority of cases a doctor can take the symptoms you relay, ask pertinent questions and figure out what is wrong.

[texasflower]

Oops, I forgot to say that I agree with you completely that too many parents don't give the kids enough attention and as I said in the original post, I think it's horrible for the parent to drop the kid off and let the center "take the kid to the doctor".

I always stayed home with my kids and did the popsicle on the couch thing. :-)