A few weeks ago I briefly mentioned my bad experience at an urgent care with Grant. I have finally calmed down enough to put together a coherent letter of complaint to Goodnight Pediatrics concerning the way I was treated. Here is what I sent them.
To Whom It May Concern,
I brought my son to the Goodnight Pediatrics office on Green Valley Parkway in Henderson NV, at 4:10 am on 03/08/15. There was one other patient in the office at that time and she was being discharged. I was greeted by a male nurse at the front desk and then by Dr. Noah Kohn. My 4 month old had had a cold for a week or so and that evening he vomited twice after coughing and had been inconsolable for awhile which had me concerned. I had already called my pediatrician’s office early in the week about his cough. They told me what warning signs to watch for and suggested I go to urgent care if symptoms worsened at any time outside of office hours. I made mention when I checked in at Goodnight Pediatrics, that I just wanted to make sure it was nothing serious “like pneumonia.” Dr. Kohn and the nurse began frantically talking over each other, saying that the X-ray technician had already left. Dr. Kohn threw his hands in the air and said since he couldn’t do a chest x-ray and I should just go to the ER. I was surprised by the outburst and quickly listed Grant’s symptoms. I explained that I had taken his temperature and there was no fever, I was only concerned now because of his change in behavior. (I was diligent about checking his temp over the previous week and it was always below 99 degrees. I knew that for babies between 3-6 months, a fever 101 or over was cause for concern.) He said if there was no fever the baby didn’t have pneumonia. I thanked him, and said that was the information I was looking for; and just wanted confirmation that I was doing everything that I should be doing. I asked if he could examine Grant, as I much preferred to avoid an ER visit if at all possible. Our last ER visit resulted in a very hefty bill of more than $800. He laughed at me and questioned if that was after insurance. I said yes it was and he told me I “should probably get new insurance.”
We have pretty decent medical coverage through my husband’s employer. Dr. Kohn must be fairly out of touch with reality if he believes that emergency room visits are equal in cost to office visits, or that you can easily acquire insurance that covers everything without paying a substantial amount for it each month. Like most people, we do the best that we can with what is available to us. After doing a little research, I see that Dr. Kohn works with a free clinic here in Las Vegas. Maybe he believes everyone is able to use those services, but I assure you that our family does not qualify for free or discounted benefits in any capacity.
My baby was sleeping and content at that point. Dr. Kohn rolled his eyes at me, gestured toward his glasses and said, “Well, these are reading glasses, not x-ray glasses so I can’t look at him and tell you if he has pneumonia.” I replied that I supposed I shouldn’t have mentioned the word “pneumonia,” since that seemed to be where the communication hang up was happening. I am not a doctor and did not know whether he had pneumonia or not. I was concerned about his behavior and would like him examined. Dr. Kohn threw his hands in the air again and walked away while saying, “I’ll just walk away so I don’t influence your decision, I’ll see him if that’s what you want.”
At that point I was confused, offended and exhausted. I had been awake all night with a screaming baby, was worried, and completely shocked by the way I was being treated. I still, however, hoped to avoid an ER visit. I wasn’t sure what to do. The nurse behind the desk offered no apology or information as I stood there for a few minutes trying to sort through what had just happened. I decide to fill out the paperwork and have my son seen. I presented my ID and insurance card, as well as the completed paperwork and after awhile the nurse called us back.
He was rude, short with me, and seemed annoyed that I had chosen to stay. He took my son’s temperature. In a very snide manner, he said, “Well, he’s running a fever.” I was surprised to hear that and asked how high it was. He said it was 100.4. He then said I should fire my pediatrician for not having me bring the baby in sooner. I explained that he had not had a fever, was very happy, was eating normally and had plenty of wet and soiled diapers. He had been congested and coughing like the rest of the family. Up until that evening, I was not at all concerned. The nurse shrugged, said the doctor would be in and left the room. I had a gut feeling at that point that things were going to get worse. Dr. Kohn came into the room a few minutes later and said in a very accusatory tone, “Well MOM, he does have a fever.” It was as if he was suggesting that I had intentionally lied to him about my baby’s temperature. He then said he would not see the baby and that he needed a chest X-Ray. He did not look at or listen to Grant at all. I felt like he purposely allowed me to waste my time. If he wasn’t going to do anything at all, he should have said: “I refuse to examine your baby.” Not, “I’ll see him if you want but I can’t diagnose pneumonia with my reading glasses.”
Dr. Kohn said he would refund our copay if we paid one. I asked a few questions, and his attitude magically improved – just a tiny bit – when it became apparent that I was not only angry, but also somewhat intelligent and not afraid to question his authority. (Dr. Kohn is maybe used to dealing with bigger push-overs than me. He was probably a little humbled by the fact that I wasn’t willing to happily accept being bullied.) He left the room, and I almost went home. I was so put off by this man’s demeanor that I was extremely hesitant to risk seeing another doctor other than our own friendly pediatrician. My son’s well being obviously trumped my own discomfort, so I did take him to the ER at St. Rose Hospital. I’m glad I did since they were wonderful and also confirmed my belief that Dr. Noah Kohn is a complete, well for lack of a better word, jack ass. They knew exactly where I came from and who I had seen within two seconds of me explaining why I was there. A nurse heard me say, “I was sent here for a chest x-ray…” and she popped up from the desk and said, “Someone came from Goodnight Pediatrics!”
There, in the emergency room with my child in a non-emergent situation; it took the on call pediatrician three minutes to see that my son had double ear infections probably caused by the congestion from his cold. There was no chest x-ray performed, just use of a boring old stethoscope. He prescribed ear drops and antibiotics and we were on our way. I am so grateful for appropriate medical care, but not looking forward to receiving the bill. I also feel bad that time may have been taken away from someone who was truly experiencing a medical emergency, since my son was not. I am under the impression that urgent care clinics exist for this very reason.
I have had awhile to mull over what has happened. I have come to a few possible conclusions regarding Dr. Kohn’s behavior, one being the fact that it was less than an hour away from closing time when we arrived and maybe he just didn’t feel like seeing us and risk running late. Or maybe he was “punishing” me for being outspoken and disagreeing with him. I guess I’ll never know, but I do know that it is never ok to treat a patient the way he treated me. I work in the medical field as well, and would never dream of treating a patient in such a condescending and disrespectful manner. It should be a top priority to put a parent’s mind at ease, answer questions to the best of your ability and do everything in your power treat their child. It is not appropriate to push a patient out the door when you haven’t even attempted to diagnose them! I really hope he doesn’t treat patients at the free care clinic the way he treated me. I have the ability to pay for decent care, and those patients do not have that option. I hate the thought that they may be stuck being shamed and talked down to by a man on an ego trip because of their financial situation.
I informed our regular pediatrician of this encounter at Grant’s four month well-visit and she too was horrified; though not surprised! She also knew who we had seen before she looked in Grant’s chart to confirm. It is worth mentioning that she was in complete disbelief that a chest x-ray would even be mentioned given Grant’s symptoms, and literally laughed at the notion that 100.4 (though in the chart, it is documented that his actual temperature was 100.2) would be considered a concerning fever. My doctor actually pushed me to write this letter, and said patient complaints are the only hope for change. After speaking with her and reflecting on the comments made by staff at the ER, it is obvious to me that Dr. Noah Kohn is infamous for his smug and unprofessional behavior toward parents and their sick children. Maybe he should have chosen a profession other than medicine if it is beyond his skill set to diagnose an ear infection, and beyond his capability to treat people with some degree of humanity. Being a doctor does not automatically make you a superior human being. Perhaps he would be better suited for a desk job away from the public? I sincerely hope no other parent has an experience like mine, and I will do everything in my power to dissuade my friends and acquaintances from visiting Goodnight Pediatrics as long as Dr. Kohn is on staff. They may as well save their time and head straight to the ER.
Annie M. Yeoman