Thursday, September 23, 2010

Dr. Mom to the Rescue!

We recently got wind about a very cool local mom who is not only doing good in our community but also being quite innovative and generous while making this difference.

Meet Dr. Mom Hawaii aka Dr. Deb Nojima, who is also a pediatrician with Castle Medical Center. She has been offering home visits in lieu of parents taking the standard route to the Emergency Room. Since we here at Baby A love old-fashioned traditions (i.e., cloth diapering, for example), we applaud anyone who also brings a bit of retro-culture back to life. We on Oahu are so lucky to have the option of having house calls by a doctor once again because of her.

Below, Dr. Nojima kindly took time out of her busy schedule to have a conversation with us about her new medical service as well as thoughts about being a mom.

BA: We love the idea of revisiting the days when a doctor made house calls. You shared a bit about how you were inspired in your personal message, but was it like a revelation you had one day to try it? How did you start this service?

I really was inspired by the incident with my croupy 2 year-old, which was really scary for me even being a physician! I also take the "mom" part of Dr. Mom Hawaii as seriously, if not MORE seriously than the "Dr" part. We moms are really, really BUSY. Not only are we caring for our kids, but we often do most of the housekeeping, financing, shopping, cooking, cleaning, etc. If you work outside the home, then you must fit that into the mix also. Our schedules are tight and sometimes an important need like a sick child can throw our lives into chaos! The last thing that you want to do after a hard day's work is pack up a sick, feverish, tired child into the car and rush down to an ER where you might have to sit for hours for treatment that may have been urgent but NOT a true emergency. Then, after all is said and done, you come back home and try to get everyone fed, watered, and to bed to start another day at the crack of dawn.

I was hoping that I could be of some help. Imagine the same scenario, except that your child can stay home and rest while you are still able to care for the rest of your family's needs. I show up at the agreed upon time and diagnose and prescribe treatment for your child AND to write an on-the-spot doctor's excuse note for school and your place of employment. On top of that, you are able to ask all your questions and feel absolutely comfortable with your child's condition and what you can do to make it better without feeling rushed or harried.
BA: What's been most gratifying about offering this service?

Meeting people and families where they are the most comfortable is extremely rewarding to me. I also feel that parents are more likely to ask questions in a familiar environment which is conducive to learning and exchanging vital information. I love to talk story with other moms. I find I learn a lot from them and find each interaction invaluable!

BA: Do you foresee a trend to bring home visits by doctors again, or are you pretty much the only one (on island or elsewhere) doing this?

There has been a small but growing movement of concierge type services where a patient pays a "yearly fee" for the right for visits from their doctor at any time during the year. Most of these memberships are quite pricey in the thousands to tens of thousands of dollars. The yearly membership fee ensures that the doctor keeps the number of patients low so he/she is available for her or his exclusive clientele. I "tweaked" this model a little. There is no membership fee but I only see "ill" children. I don't do well child check-ups or vaccinations. These very important appointments are best provided by a patient's primary care physician who may chart a patient's physical, emotional, and intellectual development over a long period of time.

I don't think other physicians will be interested in doing this type of work UNLESS a yearly membership fee was involved because the "take home" pay per hour of work is less than 50-75% of what an office-based physician can make. Most pediatricians these days see between 5-8 patients in an hour. I can only fit in about 4 patients in a typical "8 to 5" work day and that is only provided that the visits are geographically close to each other. Throw in the extra cost of insurance, gas, and wear and tear on a vehicle and many docs would say it's not worth it.
BA: What's your favorite part of being a mom?

Being a mom is JUST fun. I credit my boys for making me a much better person and in turn, a much better physician. It takes more than knowing how to use medications and diagnose illnesses to be a good doctor. Communication and LISTENING is the KEY. Before a physician asks themselves how to treat a particular patient, they must ask why the patient (or rather the parent of the patient) is seeking care and prioritize a patient's and the parents' concerns. Being a mom helps me to do that as a doctor.

On a more personal note, I love the fact that my boys treat and live each day in the moment. They teach me every waking moment that "the here and now" is invaluable: so laugh, joke, jump, play, make weird noises, be yourself, cry, run though the mud, make your hair crazy, LIVE IT ~ life is NOT a spectator sport!

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