excuse me, but doesn't your own story illustrate that non-walk-in care is just as haphazard and impersonal? your current doctor sounds great, but those types of practices are few and far between these days. better accessible impersonal care than none at all.

I got a recommendation from my ob/gyn. It is a large practice that always seems to get you an appointment that day. I did see several doctors at the practice till I found one that I was most comfortable with. My brother suggested changing doctors because she failed to see my daughters learning disabilities. But after consulting several others, I felt that it was easily missed. It took her preschool teacher 3 months to see my daughter had more significant learning disabilities. So I don't see why a doctor who sees her once a year would pick that up. Besides so much was subjective and based on the parent's description of the child's behavior. I still feel comfortable with her and have also added a developmental pediatrician to my daughter's doctors list.

Before my first daughter was born, I interviewed several pediatricians, rather than waiting until after she arrived to "experiment" with her care. This process was absolutely invaluable, and I highly recommend it, if you possibly can manage the time and expense. Weeks before my baby was born, I was able to dismiss several doctors whose communication skills were not up to snuff, or whose personality did not suit mine. It is a small fee they charge to sit and talk to you for 20 minutes or so, but I believe it is an extremely worthwhile investment. Ask about their background, their philosophies on child care, their practice size and hours of operation, etc. I recommending asking directly why you should choose his or her practice. The answer will tell you a lot about the doctor. Various parenting sites and magazines list these and other possible questions you can ask, if you are having trouble thinking about what to say or ask for 20 minutes. In the end, I found a phenomenal pediatrician whom my children and I absolutely adored, and when we moved out of state recently, it really broke my heart to leave her. She was a little farther from my home than probably is normal, but I didn't mind the drive - she was worth it!

I have no experience with these clinics in retail stores, but I imagine those who have no other options go to clinics. As one who works in the health care industry, I echo the sentiment that impersonal care is still better by far than no health care! And let me just add, finally, immunize, immunize, immunize!

It's my experience that most people don't use walk-in clinics as their primary physician. Our kids are older and the most common reason someone might go to a walk-in medical clinic seems to be for a sports injury. Someone pulls something, breaks something, gashes something at a game during a weekend, late at night or some other time when waiting to see the doctor until morning isn't an option. It's different than seeking treatement for a chronic condition. I'd probably let "just anyone" stitch my kid up, deal with a sprained ankle and so forth.

I chose a pediatrician for my daughter based on personal experience - we go to the same practice that my mother took me to when I was growing up in the area. Most of the doctors I knew have retired, although one is still there, and I'm happy with the setup of the practice.

There are 5/6 doctors in the group and as an infant we got appointments with all of them to rotate through the group and meet all the doctors. Now when we come in for well-child exams we can schedule with our favorite. When we come in for sick-visits we see whoever is working that day. I really love that a nurse answers the phone and while sometimes I do spend a bit longer on hold than I'd like, I have direct access to someone I can ask about a problem or concern and who can advise on whether or not we need an appointment. I also appreciate that sometimes when maybe it has seemed like we could have waited, the nurse will ask if "I'll feel better having her seen" so I don't feel like they are always trying to dissuade us from coming in. I guess we just got lucky.

That said, if I had a practice that was non-responsive or was in an emergency situation I would do whatever I needed to do to take care of my kid. When we traveled one time when my daughter was 10 months she was very ill and we looked up a local pediatrician and took her in.

Would you use a walk-in clinic for an adult?

When I was pregnant with my first, I selected a pediatrician based on the recommendation of a close friend. However, in the hospital, my son had a few small issues and the attending pediatrician and I just clicked. So for the next 2 1/2 years until we moved, I schlepped my son (and then my daughter) to this pediatrician's office 30 minutes away. Long ride, but worth it. I loved the whole practice. They were very supportive of nursing, which I had a really difficult time with, and just great at answering all of my questions.

I like the pediatricians I chose in Raleigh, though I cannot claim to have done any real research. I chose them because they're close to where we live. There are 7 doctors in the practice, and we've seen them all. With the exception of one, who told me when my daughter turned a year that it was time to wean her (I'll decide that, thank you VERY much), I value each one, though my kids have two distinct favorites.

Oh, and to the question about using walk-in clinics: I have only used them once for my son (when he woke up in the middle of the night with an extremely high fever during a ski trip), and my husband went to one a few months ago on a Sunday and got diagnosed with a double ear infection and bronchitis. He was feeling really, really ill, and didn't want to wait until Monday, but we also didn't want to go to the emergency room, sit there for hours and then pay a big premium for ER care.

I am sure with a child who has chronic health problems, you are absolutely right to go to your pediatrician for everything, lest their be a complication. For a child with no particular issues needing just a quick fix (like my daughter's nailbed splinter), the walk-in clinics are great.

I have used various walk-in care facilities in my life, generally its when I felt bad or was injured and needed to go to a place that had enough facilities to diagnose. I also use a nighttime place for my children, wife and myself that is associated with our pediatrician's group. BTW, WorkingmomX, a doctor offer you his medical opinion and advice about breastfeeding and you got angry? Not saying that you have to accept the advice, but it is pretty much standard practice to begin moving kids away from the breast after age 1, not mandatory of course. You could have nicely said, thank you, but I plan to continue this for another x months/years. The problem with doctor's offices anymore is that too many people take themselves and their kids to the doctors when they get "sick" with the cold or flu as soon as it happens with no underlying problem such as a sore throat or ears that seem to hurt. The doctor can't do anything for colds/flu. The best reason to go to the doctor is for wellness visits and physicals/bloodwork while you seemingly are healthy.

I chose my prediatrician's office on the recommendation from several friends. We absolutely love our regular doctor, but are not so thrilled about the rest of the practice, espcially the so-called lactation consultant whose told me "I'm not actually pro-breastfeeding." But the office is clean, it has a separate "sick kid" waiting room, and they always, always, makes time to answer my questions or make DD an appointment.

I do have a problem with pedicatricians giving advice on issues that are not medical in nature. For some reason, it's in vogue down here for people to Ferberize their kids, and I've been told several times that I should "sleep train" my daughter. I just take that kind of advice with a grain of salt and do what I feel is right.

I have used a walk-in clinic myself, because I woke up one morning with a severe ear infection and wanted to get help asap. I'm not against the concept for DD, but it hasn't ever been necessary. Our Ped. offers a walk-in clinic every weekday morning, and Saturday appointments on an emergency basis.

My health plan doesn't pay for walk-in clinics. They are an HMO and run their own. For kids that works really well because their records are all on-line. You still have to explain your kids history, but they can pull it up and look at it. You can also call and talk to someone 24/7 without thinking about whether you are rousing the Ped from his slumber.

I have used walk-in clinics while on vacation. It seems like my kids always manage to get sick then. Otherwise I think it's a bad idea. It's better to keep all your events in the records of your main care givers.

I have used walk-in clinics myself several times, and would take my daughter as well. If someone becomes acutely ill over the weekend (like with strep throat or an ear infection), all you really need is for someone to take a look and prescribe some medication. They are also useful for minor injuries.

I have not been thrilled with my pediatrician, either, and we are shopping for a new one. We picked them because they would allow us to vaccinate off-schedule, but they have turned out to be very alarmist. I swear, every time I go in there they tell me there is something terribly wrong with my daughter, and nothing they have said has ever turned out to be true. The amount of money I have spend on special tests/specialists because of their crazy diagnoses is appaling. The dr even talked about autism during out last visit just because my 2-year old was having a tantrum in the office (after we had been locked in an 8x10 exam room for over an hour). Plus, the wait times are outrageous... an appt there usually ends up lasting almost 2 hours because we have to wait so long.

I went with a recommendation from a friend. It's a large-ish practice (6 docs, 1 NP) and we've liked most of the doctors and have one we request for well visits. There is one we avoid because she is an alarmist, perhaps due to the fact that she is young and less experienced. Our friends avoid her too, because her first thought when confronted with a potential symptom is to send the patient to a specialist immediately. The older docs have been more measured and will say, "Let's keep an eye on X and see if it goes away on its own before we go further." All of these little things have gone away and we're glad we didn't put our daughter through many rounds of diagnostic tests for nothing.

As for walk-in clinics, I had my first experience with one recently when I contracted conjuntivitis from my daughter the day before an important meeting. I thought it was quite well-run and would take my daughter there for minor after-hours problems that would be better treated quickly.

I used the Minute Clinic at the local CVS a few weeks ago - had a sinus infection, I've had a ton so I was certain that was the problem, and my doc said it would be two weeks before she could see me. The clinic was great - they confirmed it was a sinus infection and wrote me a prescription for antibiotics (which is what typically happens for sinus infections), and I was in and out in a half hour. They don't treat big stuff at the CVS clinics - just infections, sprains, strep, etc. It's particularly convenient if you don't have health insurance, because the rates are set and very reasonable. I had health insurance, though, and still found it to be very easy and convenient.

As long as the clinic is clean and the condition not severe, I'd rather go there for my self or for my kids than go to a virus clogged doctors waiting room much less an emergency room. I'll bet Wal-Mart does this right.

bloody stools, falls, asthma, geez, what's going on in your house?

Kate,
What you describe about your visit to the minute clinic is exactly why they are a poor choice--sinus infections are NOT treated with antibiotics most of the time. did your practitioner do a CT scan to confirm the "sinusitis"? I'm guessin you had a cold that caused sinus pain which it often does for many people. We need to stop treating colds with antibiotics so we prevent drug resistent organisms. These clinics are staffed by nurse practitioners who are very good when working with physicians, but I believe you got bad care.

To I am the Doctor -- then I guess that it is not true that you can tell a sinus infection by the color of the mucus??

The advice I typically give to parents about choosing a pediatrician is to interview a few to see who you feel comfortable with. You want to make sure that your values mesh with him or her. I think talking to friends with children can work to, but you need to ask the right questions. Like--why do you like your pediatrician? Is he or she available to you when you need him or her? What is his or her view of breastfeeding? Is he or she judgemental, etc.?

With regard to the poster above who said that "I do have a problem with pedicatricians giving advice on issues that are not medical in nature"--you are wrong actually. Pediatricians are trained in child development and are experts on infant and child behavior. If you don't like the advice--to sleep train your children, as a pediatrician, I'd advise you that you are entitled to not train your child and leave it at that (but being open to discuss if you wanted to discuss). If I were your friend, I'd tell you to stop complaining about your child not sleeping through the night then. Many infants are able to sleep through the night on their own by age 2 1/2 months, some don't and others need to be "trained". It doesn't mean you have to "Ferberize" the child, but doing simple things as keeping the room dark, speaking softly and keeping the home quiet and not playing or engaging the child at night can help. Personally, I think parents who don't want to help their child sleep through the night are not only doing themselves a disservice, but the child as well. I know of school age children who can't sleep through the night and I can't imagine that that is very healthy.

Tony -- Never said I got mad at the doctor who told me to stop breastfeeding at a year. I just didn't care for his dictatorial manner. The decision to breastfeed or not, or to stop and when, is a discussion that a woman can have with her pediatrician or ob, but by no means should the doctor dictate a timetable unless there's a potential of harm to the mother or child (highly unlikely).

No, you cannot really determine a sinus infection by the color of the mucous. It is true that with nasal allergies, it is typically clear and runny, but can be with a cold as well. And colds can produce yellow or green mucous. There are studies that confirm this.

If I have a patient who has had symptoms for over 2 weeks, I will consider getting an imaging study to confirm that there is sinusitis. This is because sinusitis is considered a "deep" infection and merits a 14-21 day course of wide spectrum antibiotics. And further, there are studies that show that sinusitis, especially chronic sinusitis, is not caused by bacteria, but other organisms such as fungus.

You'll get people who swear they have "sinusitis" after a cold for a few days because they have sinus pain. They take a z-pack for 5 days and get better so they assume they had a bacterial infection. The truth is, they would have gotten better in the same time frame anyway. People just want a pill to take and dont' consider the consequences.

I interviewed our pediatrician while I was pregnant with DD. She was the first one I interviewed, and I love her! Unlike what a previous poster mentioned, my ped didn't charge a fee for the meeting. It's a small, 3-doc practice that has Saturday appointments available for sick kids. They are GREAT about returning phone calls, which is always a big plus!!

I like her because she supports my decisions, even when she might not agree with them. For example, I initially did not want to breastfeed. She told me why she thought it would be a good idea, and then let the matter drop. (For the record, I did end up breastfeeding). Also, I decided against the rotavirus vaccine for my daughter (the vaccine has only been out one year and I'm not convinced of its safety, espec. for a virus that is more a nuisance than a danger). Again, she told me why she thought it would be a good idea, but then let the matter drop. :)

I had planned on interviewing some pediatricians while I was pregnant, but my son was born prematurely before I got around to it.

I had gotten some recommendations from people at work and chose a small practice. The 2 doctors there were great, as well as the nurses, but the office was pretty disorganized. We waited 45-60 minutes almost every single time we were there.

They did same-day scheduling ONLY. It wasn't a problem when I was on maternity leave, but when I returned to work it was a pain. Even routine well-child visits could not be scheduled in advance. You had to call in the morning the same day that you wanted to come in. For a person working full-time who is supposed to ask for time off 2 weeks in advance, it was a big hassle. They did have some evening hours, but they were on the same nights that I worked late. One day when I knew I could leave early (because my last couple of patients had cancelled) I called them and they said they were taking only sick kids that day because one doctor wasn't there. I explained my situation and they did end up calling me back and squeezing us in at the end of the day. But it was the last time I went there.

I then asked the parents of my patients (I am a speech therapist) about their pediatricians, and one practice really had a lot of positive comments from everyone. That is where we have been going for the past 2 years and we have been much happier with them. Well-child visits are always with our primary doctor, sick visits are with him if he is there that day or with someone else if he is not. If our son is sick we can get him in the same day. We've seen 3 or 4 other doctors there and have liked them all. The nurses are always happy to answer questions on the phone and they can also help decide if we really need to come in or not. The wait times are much shorter as well.

I interviewed my Ped while pregnant, but not in a smart way. I didn't really know what to ask. I was like, "Uh, you seem nice. Are you really?" I was lucky that she's turned out to be totally awesome, and all the docs in the practice are great. In retrospect, it was great to have a multi-person practice, and they have an overnight nurse answering service with a doctor on call and that has been really awesome.

Pediatrician,

If I'd been complaining about my kid not sleeping through, then I'd agree with you. I tend to agree that one shouldn't complain if one doesn't want suggestions. But what happens here is that the ped. asks about her sleep schedule, and tells me I need to sleep train. It's not like I throw a hissy fit when he says it, I just nod and do my own thing. I figure as long as DD is getting enough sleep and is otherwise developing normally (and she is), then the fact that she still wakes up a night just isn't that big a deal.

For me, what it comes down to is that there are many, many theories on the best way to raise kids. I think it's an abuse of trust for pediatricians to present just one of those ways as the only "right" way to do things.

Just a thought for those on the market for a pediatrician: don't completely overlook the option of going to a family doctor. They can take care of your whole family and really get to know you as an organic whole and as individuals. We love ours!

Why would the doctor recommend stop breast feeding at one year of age? The WHO recommends breast feeding up to two years. I BFed my daughter till she was two. No health problems. BTW, on the topic of BFeeding, the WaPost has an article today saying BFeeding does not prevent obesity in adults. Again, a lot of false claims of the benefits to BFeeding. Even with the same risk of being fat, I think BFeeding was great and don't see why a baby should stop just because they hit age 1. The rule I heard was breast milk was a complete food for babies up to year one. After age one, they need other types of food but can continue to nurse. I believe up to age 5.

I agree fan. We only had family doctors growing up and it was great--our doc knew all of us and he was wonderful when we had to deal with the terminal illness of a family member. That said, I've used the walk-in clinics in this area because I can never get appointments with my GP until 4 days later.

Thank you doctor for answering the mucous question. You just confirmed that my mother was a nutjob and so was the "allergist" I saw for 10 years as a child. I was constantly on prednisone, cortizone and antibiotics for my "sinus infections." Amazing where some people can find md licenses. Sorry for the rant.

I never had a ped either. I wasn't sickly as a kid, so maybe that helped (still not at 33 thankfully). And I usually didn't care who I saw at that office (NP, DO, MD, etc.) either as long as they could write a Rx!

Since I moved here several years ago and was good on my prescriptions, I didn't find a doctor until recenly. I went to a CVS mini clinic last fall for allergy meds since the OTC stuff wasn't cutting it for pets and I was going to be staying with friends who had them. It was great -- somehow they never billed me or my insurance!

I switched to a single-doctor pediatrician practice and I love it. He has one nurse -- who answers the phone and has been there for 30 years (which should tell you how happy she is there). There is never anyone else in the waiting room when I go there. I never wait more than a few minutes -- even if I come in for an "emergency."

And, get this -- my doctors office answers e-mail! So, if I don't know if I should be worried about something, I just shoot them an email and usually get a response in less than an hour.

When I call with a question, the nurse answers it & if she doesn't know...she checks with the doctor and calls me back in minutes.

The large practice I was at was a nightmare. We'd play phone tag for days and I never actually got to talk to the doctor.

DD's pediatrician was recommended by a colleague. I interviewed one of the doctors in the practice before she was born. Office hours are good--well visits M-F, sick visits M-F and Saturday mornings; I understand that a doctor also comes in on Sunday mornings to read the results of tests and if there is urgent need will see a patient, but I've never had to take advantage of that.

DD (then 9 mos) was hospitalized by a rotavirus infection and they came to the hospital before office hours to check on her, even though there was nothing they could do to add to her care since the hospital's staff pediatrician was calling the shots at that point. We even discussed the vaccine, which was on the verge of approval then.

StudentMom, I hope you don't have to go through what I did. Considering the history of the previous vaccine, I understand your hesitation to use it, but please don't underestimate the virus. Rotavirus is so contagious that practically everyone has been infected with it by age 2. It can cause dehydration so severe that it is life-threatening. If this vaccine can prevent that without the adverse side effect of the previous one, that is a good thing.

"I think it's an abuse of trust for pediatricians to present just one of those ways as the only "right" way to do things."

An abuse of trust? Oh please. People do this all the time -professionals and not. If that is their philosophy on sleeping, BF'ing or whatever, then so be it. Why not just ask them questions and engage in a discussion over your different philosophy (and then agree to disagree if you must) instead of complaining about it here.

I look back at the stupid things my pediatrician did--like treat me for "bronchitis" with antibiotics when I probably had asthma (I was diagnosed as an adult). And there is really not an entity of bronchitis in children (bronchiolitis from viruses; in adult smokers with lung disease yes there is bronchitis and it is often treated with antibiotics).

Still some doctors out there who don't practice evidence based medicine, but there are those that do (I'd like to think that I do). The truth is we treat a lot of things in ways that are not entirely proven.

And I'm sad to read that people have issues with their pediatrician. In my line of work, I interact with a number of them and many seem very caring and responsible. Our family's pediatrician is wonderful and very accessible. I trust his judgement completely (even though I am a pediatrician, I still go to a colleague for my children).

Now it's OB-Gyns who think they know internal medicine who get me started....

Those of you interviewing doctors, one really good test to see if you're compatible is to bring in something you've read on the internet about child development or the like and ask the doctor what they think about it. If the doctor basically tells you to leave the researching to him/her, then you know something definitive about his/her outlook. I ended up with a really paternalistic OB/GYN who didn't think I had the right to have opinions about my own body. Wish I'd known about the newspaper article test before we signed on with him.

Oh, sorry, Anon at 6:11. I thought realize that when Ms. Garfinkle posts questions on her blog about what we look for in a pediatrician, that she is asking for feedback about what we like/dislike about our pediatricians. My mistake.

That aside, I don't care what Joe Schmoe down the street says about how I'm raising my DD. I have no reason to believe anything they're saying. But people listen to doctors, and trust them. For a doctor to use that position of trust to pass their own opinions off as fact is wrong, whether they're telling someone to wean before they're ready to or claiming that a kid "needs" to be Ferberized.

As I mentioned in my first post, I love DD's main pediatrician. I put up with having to see someone I don't like as much occassionally because our regular doc is so good. That doesn't mean I'm going to keep my mouth shut and pretend everything's hunky dory all the time.

Thanks Jen. I'm sorry your DD had to go through that. It's such a tough call - unless it's something incredibly life-threatening, I feel very uncomfortable with meds that have only gotten recent approval (within 3-5 years), because of the massive numbers of warnings and recalls issued within those timeframes. Two weeks before DD was scheduled for her shots, the FDA came out with a paper that mentioned that Rotateq might have the same link to intersusseption as the last vaccine. Improbably, but potentially - that really scared me away from giving it to her. Better the enemy you know than the one you don't, I guess :(

I couldn't read all of the comments, but I have had a few experiences with walk-in clinics. Every time it was while we were traveling. The first time I had mastitis, the second time my daughter was sick ( this was a few years ago, so I cannot recall exactly what she had), and the third time I think it was bronchitis. They were unremarkable, useful tools to help me get what I needed.

I did see someone mention interviewing doctors and not knowing what to say--you were too funny. But here is an answer for you--get the book by Dr. Oz called "YOU-the smart patient". It is a little cheesy in that the voice is a bit hyper, but I have read most of it and learned a lot. It was recommended to me by a professional health educator. Even if you are healthy, you should read this. Get it before you get sick!

One more thing--I had a doctor tell me that it was time to wean my baby when she was one. I ignored him and continued to nurse her for 6 more months, when she did it herself.

I love my ped. It is a 3 doc practice with 2 phone nurses who always answer the phone. The docs know me and my kids and the nurses really know me. No question is too stupid to ask and they were an immense part of my support team when my kids were little (preemies with reflux). I left our first practice because they didn't know my kids and because they were super happy to prescribe antibiotics (z-pack as 1st step for a 12 month old) for anything even when I said I was a SAHM and happy to wait and available to come back anytime if the ear didn't improve. It is a blessing to have providers that respect my opinions and concerns and that are available to me. I usually have a wait when we have an appointment, but I don't mind because every time I have needed my kids to be seen for something urgent they get me in so I know that sometimes my wait is because someone else's kid shut the car door on his sister's arm and they got them in that time. My friends think I'm crazy to drive 35 mins. to the ped, but after every visit on the way home I know it is totally worth it!

I have a ped that I love who sees my children for the well-child visits, immunizations and serious problems. We've been with the same doctor (who practices with his brother) for 9 years.

However, for those ear infections with high fevers that come on after work or on the weekends, we go to urgent care. Same thing when my daughter fell and hurt her elbow while playing with our dog. I've also been to one when I cut my leg and needed a few stitches. It's quicker than the e.r.

Do you want to know what is wrong with the US medical system? The fact that I have to go see, and my insurance company has to pay for, an actual MD to treat minor, routine health issues. These should be treated by nurse practitioners on staff at pharmacies.

Under the current system, if I have a routine issue, I have to:
1. Schedule an appointment with my doctor
2. Maybe be seen that day, maybe not
3. Take 3 hours off of work for the appointment (thank you DC traffic and waiting room purgatory)
4. Take another hour off of work to go pick up my prescription

My insurance company has to:
1. Pay for this appointment, which includes my doctor's several-hundred-thousand-dollar salary and tens-of-thousands-of-dollar malpractice insurance policy
2. Pay for my prescription

If I wrote the rules, you'd just go to any pharmacy, see a nurse practitioner right away, he/she would tell you either: "you have X", or "something's fishy, go see a doctor", and then dispense the treatment right away.

30 minutes, max, and would be so much cheaper for the system (nurse practitioners make like 1/5 what an MD makes, and CVS could negotiate their own company-wide malpractice insurance).

And yes, I would visit such a place, and yes, I would take my children there. And yes, we have regular health insurance coverage.

I was much more dictatorial when I was an idealistic young graduate. Since then I have grown a little gray hair and learned a thing or two from parents too. But sometimes I still have to be dictatorial when a child's health or safety is at risk.

As a specialist employee of a Children's Hospital most of the clinics were recently "ordered" to double the number of patients we were seeing in the same time period. It has been a disaster, staff are quitting, tempers are flaring, parents are unhappy, we don't have time to teach students and residents anymore, and the quality of care we deliver is suffering. We don't like not being able to spend time with our patients either but this is the reality of life today. The hospital makes $7 for every Medicaid patients I see and they're trying to cut reimbursements again. You may think your doctor owes cut rate humanitarian service. But the nurse, receptionist, electric company and bank holding the doc's 130,000 (average) student loan debt expect to get paid.

Bob,

It's interesting that my experience is so completely opposite from yours. At our practice, first visit is ALWAYS with a PA, NEVER with my MD. If I just a have sniffle, fine, but I can't tell you how many times I've had to make two visits - one for the PA to tell me to come back if I don't get better, and a second to see a real doc.

My kids are teenagers. I have gone through multiple peditricans through the years. Practices who started out well, sometimes didn't end up well -- too busy, insurance, etc. I finally gave up & went to Kaiser. Yes, we have gone through more doctors there since they leave too, but the aftercare is worth every thing that we spend. I wish I had done it earlier -- they are almost always available & the price is great!!

Oh my, Kaiser Permanente had terrible follow-up when I was still using them. I went there after several months of stomach aches and intestinal problems, got the usual spectrum of tests done, and was told that they all came back negative and that I was fine! Except for the fact that I was still having symptoms. No follow-up, no referral to a gastroentereologist, nothing.
I remember them being similarly crappy when I was a kid going to their pediactrics office, when I had a cold for 2 months and was told that I definitely had a sinus infection (that antibiotics did nothing for) or that I was allergic to cats (which we did not own).