Management in Pediatric Urgent Care—Leadership Perspective

PM Pediatrics
Stephaine Jones, office manager at PM Pediatrics in North Babylon

Whenever we ask students newly enrolled in any of Hunter’s medical programs why they chose health care and not something else, they invariably answer because they like to help people. It’s in their nature; part of who they are.

There are six courses of study at the school that relate to medicine and health care. Every one gives the graduate the opportunity to work with a myriad of subsets of the population, from cancer patients to surgical candidates, OB/GYN clients to cardiac cases, from geriatric to pediatric.

Hunter has built up associations with countless medical facilities across Long Island in the decades since it instituted its first health related program, Medical Assistant. Hunter’s relationships with these facilities serves both for student externships and graduate employment.

This is the first in a series of blogs highlighting these companies and their relationship with Hunter. PM Pediatrics is a huge corporation spanning 11 states that began here on Long Island, in Syosset, in 2005. Hunter has an externship agreement with PM Pediatrics, and PM Pediatrics has hired Hunter graduates.

Stephaine Jones is office manager for PM Pediatrics in North Babylon, and she was interviewed for this article. Ms. Jones worked in primary care for seven years. She started as a medical assistant and then worked her way up to lab supervisor. During that time, she went to school for her bachelor’s degree in health care management and administration.

Why an Urgent Care for Children?

When asked why parents should bring their children to PM Pediatrics, she answered, “Coming to PM Pediatrics is kind of like going to your pediatrician. We give that same type of welcoming feel, and we know how to connect with kids.

PM Pediatrics has made a significant impact in the way acute medical care is delivered to children.

“It is said in pediatrics that you’re not just caring for the patient, you’re caring for the family, too. You have to be gentle and patient, especially if you’re trying to successfully swab for strep, or now with COVID, a nasal swab, from a four-year-old or two-year-old.

“With children, you have to have added sensitivity and a welcoming approach to help them feel secure.”

Ms. Jones feels that her staff is more like a family than a group of coworkers. They always have each other’s backs.

Kalvin Cruz, a graduate of Hunter’s Medical Assistant program who works at PM Pediatrics of North Babylon, agrees.

“I love everybody there. They’re amazing people, they’re really understanding. They’re an amazing staff. I’m so blessed, you know, because not every job you get that. A lot of jobs they don’t like to work as a family.”

Part of the satisfaction Ms. Jones gets from her work is the hands-on approach with patients, the customer service, and knowing that she and her staff made a child feel better, whether it was giving him or her a lollipop or helping resolve a billing issue. In an effort to mitigate COVID-19 spread, PM Pediatrics allows their young patients and families to wait in their cars if they wish, or for those who live close by, to go home and come back.

“So it’s just the whole atmosphere of the job that helps families feel comfortable coming into the urgent care.”

The staff members at PM Pediatrics pride themselves on giving a warm welcome to everyone. When repeat patients come in, members of the team regularly recognize them and always say, “Nice to see you again.”

Hunter Business School and PM Pediatrics

When asked about PM Pediatrics’ cooperation with Hunter, Ms. Jones shared:

“Working with Hunter, we get students to shadow, show them all about working at PM Pediatrics and that working with children is great, and show them how to boost everybody’s morale. PM Pediatrics helps them get a job at work. It’s the experience that they need and, as well, helps us to teach a new generation right now.”

PM Pediatrics Urgent Care
Kalvin, a graduate of Hunter’s Medical Assistant program, is pictured at left.

What Is PM Pediatrics Like?

On a normal shift, PM Pediatrics’ staffing model includes a receptionist and medical assistants who are cross-trained, so they can handle both front desk and back. There is a nurse on staff and an X-ray tech, as well. A regular shift includes at least two higher level medical personnel, such as physicians and nurse practitioners.

The number of patients has increased a lot since the pandemic began. PM Pediatrics in North Babylon is currently seeing on average a hundred patients a day.

PM Pediatrics and COVID-19

We have tested many patients for COVID-19 at PM Pediatrics. Since the pandemic began, PM Pediatrics provided over 600,000 COVID-related tests nationwide.

There are two basic tests for COVID: a rapid antigen test and a PCR test. There is also an antibody test, which can be given to determine if a patient was previously infected with COVID-19. A rapid antigen test is best used for people who are exhibiting COVID-19 symptoms.

Even though a patient may have a rapid test that comes out negative, a PCR test is sent out to confirm the result, and in some cases, the final result comes back positive. The antibody test is a blood draw to test for antibodies against the virus. An antibody is a protein that neutralizes foreign invaders like bacteria and viruses.

Care Beyond Medicine

Since PM Pediatrics serves children and adolescents, Ms. Jones has seen both uplifting and heartbreaking cases.

“There are times where we have patients come through our doors with trauma. You might have a very young child who slammed her finger in the car door, and mom is in tears, because the finger is severely injured and the child is in pain. They know they may have to end up in the emergency department if the injury is beyond the scope of urgent care. We calm the parents down and reassure them by telling them, ‘You’re doing the right thing.’ The baby’s crying, so the best you can do is provide comfort and supportive care while they await medical transport to the hospital.

“Another time a woman brought in her grandchild while one parent was in the hospital with COVID, and the other had lost their job because of COVID. Sad situations do break my heart, and I think to myself, ‘What can I do for this family?’ I was working that evening, and because one parent lost their job, we weren’t sure if their insurance was active. I said, ‘Hey, I’m the manager and I can help. Let’s take care of the child now and worry about insurance and bills later. We’ll work with you.’ The care of the patient comes first.

“I began by comforting the grandmother.

“We give them the best possible customer service, treating this family like this grandma could have been my grandma, the parents could have been my dad or my mom. Making them feel like they’re part of our family at PM Pediatrics is one of our core values.

“It’s important to let the child know it’s O.K. and that we’re going to take care of them. We gave the child the care they needed, and we did everything we could to make both the patient and their family more comfortable.

“We have TVs in every exam room so our patients can watch their favorite shows. We give the best care we can from there.

“After this visit, the parent even called to thank us for our care and willingness to work with them on their bill.

“It was the least we could do to take one thing off of their backs.”

Balancing Work and Home Life

When talking about keeping the work stress separate from personal time, Ms. Jones says that she and her staff try to separate work life from home life.

Sometimes working in a medical office can get to feel overwhelming. At Ms. Jones’ location, she has a huddle with her staff before starting a shift. They review the previous day: Were there any obstacles or difficulties? How can she help?

What to Know About Entering the Health Care Field

Regarding advice to anyone entering the health care field, Ms. Jones says make sure you ask a lot of questions and be very attentive to the information that’s given. You’ll learn a lot. She learns something new every day, especially in these times, even about the proper PPE.

She feels that right now is the best time to be in the medical field. The health and safety of the public is uppermost in her mind, but while the pandemic is ongoing, she and her staff learn so much. For instance, if you don’t work in a hospital, you may not know how to put on your PPE or even take it off properly. You may learn that in school, but dealing with something like the pandemic, you have to make sure you don and doff properly.

Staff who join her PM Pediatrics office should feel safe, as proper PPE is enforced. Face shields are used with every patient. PM has the whole kit, head to toe.

Clinical employees learn how to collect COVID specimens and how to give the proper information to parents before their children are discharged. PM Pediatrics provides higher acuity care than most urgent cares, including wound repair, X-rays, and IV hydration.

All clinical activities of an urgent care are performed at PM Pediatrics, including the drawing of blood, flu testing, and stool cultures.

The Field of Pediatrics

There is a lot that’s different between PM Pediatrics and primary care. In primary care, there is a proper schedule for vaccines. Then there’s the height, the weight, hearing, vision, and so on. Urgent care, especially pediatric urgent care, is a whole different field. PM Pediatrics serves as a complement to the primary care provider, caring for its patients when they are ill or injured and then sending a report of their visit to their primary care provider.

Starting in pediatrics is a great building block for people beginning their career in health care. You learn customer service and the patience that you need to go forward. Customer service is paramount in pediatrics. Ms. Jones says she can’t teach that. She can teach hands-on skills, but compassion and bedside manner are innate qualities.

Which Pre-Adult Age Group Is the Most Difficult?

One would think teenagers would be the most difficult age group to handle, but not according to Ms. Jones.

“I think it just depends on the child more than the age. We see birth to 26. You can have a challenging 21-year-old and an easy toddler. You know, it just all depends on that person. I don’t think age matters.”

Is It More Challenging Dealing With the Parents or the Children?

The age of consent in New York State for medical decision making is 18. Is it more challenging with parents who are making choices for their children than adults who are able to give consent for their own selves?

“I think it can be difficult with the parents because you may see them on their worst day ever. For example, if the child is having breathing issues and their sats [blood oxygen level] are significantly low, we try to explain to that parent that they really need to go to the emergency department. Sometimes they don’t want to go to the hospital and we need to help them understand the severity of the child’s illness.

“In a situation like this, PM Pediatrics calls an ambulance for transport and explains the importance of the need to go.”

Ms. Jones explains, “Encountering that versus a 22-year-old, telling them you have to go to the emergency department. It’s up to them to go. We hope they go.

“If they refuse to go in an ambulance, then we have the proper paperwork for them to sign.

“So it can be challenging to communicate the importance of escalating health care with parents when they’re scared, you know, especially more during a pandemic. Even if it wasn’t COVID, we still had that same problem where they might think, ‘O.K., you can give me a nebulizer and some medicine, and they’ll be fine.’

“Another challenge can be getting parents to understand the severity of their child’s illness.”

Getting Hired at PM Pediatrics

When evaluating a candidate for a position at PM Pediatrics, Ms. Jones looks for a number of qualities. She doesn’t judge candidates solely by their résumés because not everyone will present a refined product. It’s the first interview that goes a long way toward making a decision. She can teach skills, but the customer service and the candidate’s presence are what she looks for.

She always likes to present a mock scenario with the candidate. For instance, a parent comes in and says her baby has a fever. And you take the temperature, and it really is not a fever. What would you do?

The candidate might say, “Well, tell them to wait, that the baby is O.K. right now. You might explain to the mom what a fever is and when it isn’t a fever. Perhaps give the baby Tylenol if the parent hadn’t given any medicine.”

If the baby was on medicine, that’s probably why she doesn’t have a fever. How long ago did the parent give it? Certain things like these are questions the parent would want to know. Does the parent want to get more information?

It’s all about that customer service. This is a key feature for Ms. Jones. There are other skills she can teach, but overall, it comes down to the candidate’s overall approaches. This is what she really looks for.

And is the candidate going to mix well with the rest of the staff and be a good asset? Is this person going to learn something? If hired, is the applicant going to benefit from a career at PM Pediatrics, and will he or she add value to the work climate at PM Pediatrics?

Next Article in This Series

This blog post gave a perspective from the management side of PM Pediatrics. The next article in this series will look at things from the viewpoint of a Hunter graduate who works there.