June 9, 2020 – You may now call and schedule your child’s well visit – previous restrictions on which well visits we can schedule have been removed.
Let’s review where things are now with RCAM Pandemic Mode:
UPDATE: SCHEDULING A VISIT
All well visits are scheduled to be seen at our Duraleigh office
RECENT CHANGE: Now scheduling well visits for children of any age
Medication follow-up visits are scheduled for out Duraleigh office
RECENT CHANGE: We are moving these from TeleHealh visits back to in-office visits
Examples of this type of visit: ADHD follow-up, Asthma follow-up, follow-up of any condition where our pediatricians are prescribing ongoing medication
Any illness – any symptoms that need evaluation: there are 2 ways to initiate an evaluation
Option 1: call and speak to one of our nurses
Option 2: call and schedule a TeleHealth evaluation with one of our Pediatricians via a video link
If further evaluation is needed following one of the above options, the nurse or pediatrician may recommend an in-person visit at the Brier Creek office
In person inside the Brier Creek office (illness without typical symptoms of COVID-19)
In person outside the Brier Creek office in the Curbside Clinic (typically if symptoms include fever, cough, or shortness of breath)
UPDATE: FOR YOUR SAFETY, THE SAFETY OF OUR STAFF, AND THE SAFETY OF OTHERS
Wear a Mask: everyone coming inside our office over the age of two years is expected to wear a mask
We know there are some situations where wearing a mask is impossible – we understand and that’s okay
Sick individuals may not accompany a visit (no sick siblings; no sick parents; everyone in your party needs to be well)
When possible, only one parent accompany the child being seen
To limit your time / exposure while in our office, call from the parking lot when you arrive – when your room is ready, we will call you to come into the office
We appreciate everyone’s cooperation. Your support of our office during a challenging time has meant a lot.
WE WOULD LIKE TO ADD THE FOLLOWING…
At this time, we will begin to also schedule well visits for all children ages 11 years old and up.
[SIDE NOTE ABOUT SICK VISITS – Sick visits will continue to follow the plan set up in this post from March 22nd – NOW BACK TO WELL VISITS]
These are the well visits we are now scheduling:
Any well visit associated with a required vaccine (that includes most well visits under 2 years old and the 4 or 5 year old who need their pre-kindergarten vaccines)
Any well visit ages 11 years old and up
ABOUT YOUR WELL VISIT APPOINTMENT
To try and limit exposure to illness for your child and our staff, we will require the following with all well visits:
Sick individuals may not accompany the well check (no sick siblings; no sick parents; everyone in your party needs to be well)
Everyone above the age of two years oldneeds to wear a mask or face covering when they come to our office (we know it may be a challenge for some, but do the best you can)
April 20, 2020 – This past weekend RCAM lost one of our giants.
Alan Goldman, MD passed away late Friday night after battling an extended illness.
RCAM Pediatrician from 1971 to 2007
I have been lucky to have worked with some talented, good people. Alan most definitely was one of the most talented and one of the best.
He worked as a pediatrician at RCAM for 36 years.
He went to Harvard University for his undergraduate degree. Anyone who knew him found that easy to believe, because he was smarter than the rest of us. You picked up on that because it was obvious, not because he ever flaunted it.
He was an accomplished pediatrician. He was the first pediatrician in Wake County who had specialty neonatology training and helped to advance neonatal intensive care in this area.
Never a Negative Word
Alan had a very pleasant and calm demeanor. I never saw him frazzled, and I never heard him say a bad or even negative word about anyone the entire time I knew him.
I will write that again just to be clear. I never heard him say a bad or even negative word about anyone.
We worked together for 11 years. There was a time when we shared an office. I saw him plenty away from work – typically, it involved some carpentry (one of his many talents).
Never. A. Bad. Word.
He Brought the Party
Alan was fun, and he was almost always working on something that would bring people together for the sake of entertainment.
So many of us have been regaled by something Alan planned: Poker nights, Christmas party games, Super Bowl games, March Madness brackets. The list goes on and on…
I knew Alan to always be preparing for the next gathering where everyone would be entertained by some sort of quiz, riddle, or trying to remember the words to “Good King Wenceslas” (How many Jewish men know all the words to “Good King Wenceslas”? Alan did.).
Our Hearts Are Heavy
Words are difficult at times like this. Alan was truly one of the RCAM greats.
He set a high bar for excellence in skill, attitude, and community.
Alan meant so much to our office, but – also – he meant so much to so many others.
Our hearts ache for the Goldman family.
UPDATE 4/21/2020: Dr. Goldman’s family wrote a beautiful remembrance that you can find here
April 13, 2020 – So imagine that today is your birthday.
Imagine that the candles are already lit when you realize that you’re in the middle of a pandemic, and – as a pediatrician – your whole day has been about limiting the spread of germs.
In other words, there could be no “blowing out the cake.”
At that moment, we needed a hero…
…Someone needed to save the day…
…And it was that someone’s birthday.
Happy Birthday Dr. Gessner! You are just as quick on your feet as you ever were!
This Friday, Saturday, and Sunday we will be available by phone and in the RCAM TeleHealth Clinic
After 8:00am, our answering service will begin to take messages for the weekend nurse working with the Pediatricians on-call
Our nurse will begin returning calls at 9:00am
Newborn Clinic
We will plan a morning clinic to follow-up with some of our well infants born over this past week
TeleHealth Visits from Home
We’ve added an option that is popular and consistent with current goals of “social distancing”
You can see an RCAM pediatrician via video chat for a TeleHealth visit for a sick visit or a well concern
The RCAM pediatrician will use methods available to them at that time to assess and make recommendations about how best to treat your child
There is a charge for using this clinic; typically that charge is covered in some way by your health insurance plan (usually similar to how that plan covers in-person visits)
Beyond the TeleHealth Visits, we do not plan to have our typical in-person sick clinic this weekend
April 8, 2020 – Spring began a few weeks ago and – particularly after this past weekend – it became clear it was time to say Goodbye to Three Girls on a Sled whose carefree ride in the snow takes us back to a time before we had ever thought much about coronavirus and COVID was NO-VID.
Typically, our spring banner includes outdoor, spring activities (duh), but Young Girl and Online School seemed – given our present circumstances – to be a better fit.
[Aside: Of course, if your home is more like mine, this picture would need to include another, younger sister and some dispute about one of them “breathing too loud” and a father – numb to the sibling conflict – working feverishly to be sure the WiFi will produce enough bandwith for school and his office’s Zoom meeting that is scheduled to begin now.]
Over the last month, we have been gathering as much information as possible and processing it as a group. We have made plans and then remade plans as new information came available..
Medicine is always changing – changing plans is not necessarily a new thing. We always try to do things based on the best and most current information available.
The new thing was the speed of the changes – typically happening over years – these changes were happening over days and in some cases hours.
Let’s review all the changes at RCAM that are still current:
All well care is moved to the Duraleigh office – only well children accompanied by a well adult are seen for well visits at Duraleigh
If you had some pressing things you wanted to discuss at a well visit that is on the delayed list, consider scheduling a TeleHealth visit (see below)
All sick child care was moved to the Brier Creek office – with a few twists:
Twist #1 – Curbside clinic was initiated for children with symptoms suspicious of possible coronavirus
Twist #2 – TeleHealth visits are becoming our new normal as a way to safely evaluate patients without the fear of increasing potential exposures
All RCAM staff are now wearing masks and gloves – at both offices – add to that lots of hand washing and not touching your face and cleaning rooms after every patient
All of these changes were made to be as safe as possible yet still available to our patient families, to reduce exposures, and to slow the spread of coronavirus / COVID-19.
TeleHealth Medicine
TeleHealth Visits have some limits though I am surprised at how typically they can identify something treatable or rule out the need to come to our office or the Urgent Care or the Emergency Department.
Good Friday is an official RCAM office holiday, so this Friday the 10th we will operate like we have on recent weekends:
We will have an early clinic for newborns who need to be followed up from the past week
All sick patients will be evaluated through TeleHealth visits
Meanwhile, The Brian Carter Era Began at RCAM
Brian Carter is our new office manager.
He began to learn the RCAM secrets when he started in December but he didn’t take the reins completely until after February 28thwhen Debbie Maness retired as our office manager after 42 years (!).
He hit the ground running. Brian would probably describe it more like a chase – as in it felt like he was being chased by a lion – as his first week on the job was highlighted by a pandemic.
Brian has been great. More about him later, but it is about time we introduced him to our extended RCAM-ily.
If you see someone in our office wearing a tie that doesn’t feature Sponge Bob (Dr. Sena) – that is more than likely Brian – give him a big Hello and Welcome.
Given the circumstances of his first month, he could probably use the encouragement.
Thank You
I am sure that everyone could use some encouragement.
The response of our administrative staff and nurses has been spectacular. The general day-to-day pressure on a pediatric staff is underrated, and now they quite suddenly have found themselves on one of the front lines of a pandemic.
They have handled some tough circumstances with a lot of grace and professionalism.
As pediatricians, we’ve had to work together even more than we usually do – Zoom meeting almost daily – making new plans and changing protocols that we just wrote. We have found another gear with how we work with and relate to one another and personally that has been great.
Patients and their families have even asked if they can help.
We have been gifted at least one box of N95 masks and numerous homemade masks.
Finally, the Raleigh pediatric medical community really stepped up. Specifically, Oberlin Road Pediatrics and Carolina Kids Pediatrics both sought us out directly. As it turns out, we didn’t need the help, but it meant a lot to hear from them, and we hope to return the favor sometime.
That’s how we’re all going to get through this – finding ways to help each other out.
Epilogue: Somewhat Related
For anyone still reading this, I had this post all ready to go late Sunday night.
I saved it to my computer and walked upstairs to say good night to my daughters.
When I returned, my screen looked entirely different.There were characters I had never seen before – and about 80% of my original post was completely gone. I tried to pull up the post I had saved, yet somehow that had been updated to the now-80%-gone post.
Sitting two feet away from me was the cause: Buddy, our orange tabby cat.
He has a penchant for getting comfortable in odd places – for example, he loves climbing and lying on top of backpacks.
He is also well known in our house – as pictured here in what I call “Exhibit A” – for getting comfortable on my computer keyboard.
The post finally got done and I believe I have been forgiven for the words that came out of my mouth that night.
Happy Easter to everyone!
Try to enjoy what you can about being locked down with people who are likely pretty important to you – and try to ignore all of their loud breathing.
“CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”
We wish our office could offer all patients a mask but supplies are limited. Therefore,,,,
…RCAM is asking families who come into our office to bring their own masks if at all possible.
There is a lot of information available online about how to make and use a mask.
Brief method – Here’s a 2-minute video that offers another method for making a mask:
More Involved, No Elastic – here is a much more involved mask that is made without any elastic – like toilet paper, elastic has been recently become hard to find
Thank You
We’ve seen a lot of generosity – families have donated masks to our office – both medical grade N95 masks as well as homemade masks.
Bonnie, one of our nurses / lactation consultants / multi-talented individual, has sewn and donated herself an untold number of masks made from all kinds of fabrics.
Have a face-to-face conversation with your RCAM Pediatrician – like Dr. Gessner, pictured here – without having to leave your home
March 30, 2020 – Like most things, there are some steps to be sure to follow for a successful TeleHealth Visit.
The First Step is to Call RCAM and Schedule
For many people today, telemedicine is a convenient and effective way to see their healthcare provider. Before beginning your TeleVisit, make sure that you:
Call us at 919-781-7490
Have an active Patient Portal account, with username and password (you can set or re-set that up when you call to schedule)
Set aside a secure, private location
There are Two Options for Beginning your TeleHealth Visit:
1. Log in to your Patient Portal and click “Join Televisit” in you patient dashboard
…OR…
2. Begin through the reminder link sent to your email (where you also click “Join Televisit”)
After Beginning your TeleHealth Visit, Follow these Steps:
Fill out any patient questionnaire, and provide requested personal information.
Click “Proceed” to check your computer’s speed and ability to support a TeleVisit. If your computer does not have a webcam (most do), you will need to attach one.
Click “Start TeleVisit” to enter the virtual waiting room.
Your physician will soon afterwards begin the face-to-face TeleVisit, and disconnect when the visit ends.
March 25, 2020 – You may remember this now out-of-date post from 6 days ago:
UPDATE: For anyone still interested, the individual in question that led to our office being shut down for 2 days tested negative for coronavirus disease 2019 / COVID-19.
March 22, 2020 – The Wake County Health Department this weekend gave RCAM the go ahead to open both offices.
Therefore, we will open at 10:00am on Monday morning after finishing some office cleaning (after Monday we will open at our regular time each day)
We will continue operating similar to our previous pandemic plan but with a few twists that include the addition of TeleHealth Visits.
Sick Child Care:
1-Nurse Phone Triage
If you have a concern about your child – like usual – call the office and our front desk will take a message and one of our nurses will call you back
If our nurse can’t help you, she will schedule you to see one our doctors for an online TeleHealth Visit
2-Nurse Triage to TeleHealth Visit
As described in earlier posts, this is a video chat with an RCAM pediatrician who will use methods available to them at that time to assess and make recommendations about how best to treat your child
The TeleHealth Visit is proving to be very important in our effort to limit our patients’ exposures
The TeleHealth Visit typically ends with the pediatrician’s plan for treatment
In cases where the pediatrician decides that the patient will need an in-person assessment, they will be scheduled to be seen in the Brier Creek Sick Clinic or the Brier Creek Curbside Clinic.
[NOTE: You may schedule a TeleHealth Visit without talking to nurse first; just call and ask for a TeleHealth Visit]
3a-Nurse Triage to TeleHealth to Brier Creek Sick Clinic
All sick care will be seen at Brier Creek
3b-Nurse Triage to TeleHealth to Brier Creek Curbside Clinic
All acute illnesses with cough and or fever will be seen curbside in your car
Well Child Care:
1-Urgent Well Child Care
The RCAM pediaricias feel like these are the well visits that should be completed as close to regular schedule as possible:
Children under two years old who need vaccines
The 4 or 5 year old who needs vaccines
2-Non-Urgent Well Child Care
All other well child visits are considered non-urgent and could be put off for now
TeleHealth EXCEPTION: if you have a concern that often gets discussed at well visits – things like sleep problems, constipation, focus issues, anxiety, etc., a TeleHealth Visit can be scheduled. Because that is done online via a video chat, it can be done at just about anytime.
3-Follow-Up Visits for Asthma, ADHD, Birth Control, Anxiety, Depression, etc.
These visits would be scheduled as a TeleHealth Visit
Thanks for hanging in there with us.
Having our clinic shut down due to an individual with an indeterminate result was a bit jarring. We support our health department wholeheartedly though and admire the important work that they are doing right now.
We are all in this together, and your child’s health and safety are our number one priority.
