I used to love my daughter's first pediatrics practice. Then they went and totally BETRAYED us. (Sort of.)
I'm not one of those mothers who calls the pediatrician for nothing. I would say that in Melly's first year of life, I called a total of twice, one of which was for simultaneous fever of 102, diarrhea, vomiting, and bilateral ear infections. (For the record, I had to beg for an appointment that time, which the nurse only grudgingly gave me. Should have been a warning.)
When Melly was about two, she woke up one Sunday morning and one of her eyes was swollen. This had never happened to her before and I was concerned, so I called the pediatrician's office. I was met with the following message:
Due to the high cost of after hours phone calls, all calls to the advice nurse after regular business hours will be charged a $20 fee.
At the time, I was a resident and my husband was a student. I thought about the $20 and decided her eye didn't look that bad and decided not to pay the $20.
I can understand why they might do this. Even if you're not a physician, if you've ever read Dr. Grumpy's blog, you'd see the ridiculous, trivial, non-urgent things people call about in the middle of the night. I bet parents are even worse than neurology patients.
But I also think it was horribly unfair. I can understand charging parents who call excessively a copay, but I don't feel like it's fair to put a parent in the position of deciding if their kid's swollen eye is worth the $20. And what if my kid had a health problem that required more monitoring? Would I just be screwed and have to keep paying $20 every time my kid got sick and I wasn't sure whether to go to the ER?
I've used two different pediatrics practices since then and neither charged a fee for after-hours advice.
What do you think? As physicians or mother or patients, do you think it's wrong to charge for after-hours nursing advice?