My Primary Pediatrician Is Someone I’ve Never Met In Person – Here’s How It Works For Our Family
2:17 a.m. I’m leaning against the cold bathroom tile, my 3-year-old curled in my lap, his barking croup cough cutting through the steam leaking out of the open shower behind us. My husband’s asleep on the couch, saving his energy for an early work meeting, and the nearest after-hours in-network pediatric clinic is an hour’s drive from our house. I fumble for my phone, open the patient portal, and shoot a quick message to my pediatrician – the one I’ve never met face to face.
We moved to this rural part of western North Carolina two years ago, and the local pediatric practice had an 18-month waitlist for new patients. The next closest in-network option was 65 minutes away, a drive that sounded miserable on a good day, let alone when one of the kids has a 102 fever. Out of desperation, I signed us up with a telehealth pediatric practice that had immediate openings. I went into it ready to be disappointed. I’d had bad experiences with rushed telehealth urgent care visits before, where the doctor barely looked at the screen before writing a prescription. I’d always heard you need to have an in-person provider who knows your kid to catch the little things no camera can pick up.
Our first visit was for my oldest, then 4, who had an itchy rash that covered half his arm after a weekend camping trip. I expected a 5-minute call and a generic recommendation for hydrocortisone. Instead, Dr. Lee, who’s been our main provider ever since, walked me step by step through how to check his lymph nodes under his jaw and armpit, asked me to take close-up photos of the rash from a few angles and send them through the portal, and asked a dozen specific questions about what he’d been touching, if he had a fever, if the rash blistered when scratched. She diagnosed it as a bad case of poison ivy that needed a prescription oral steroid, called it in to our local pharmacy before we even hung up, and followed up with a message three days later to ask how it was clearing up. That was more attention than I’d ever gotten from our in-person ped back in the city, where I was always out the door in 10 minutes.
A lot of people ask how we do well-child checks and developmental screenings. It’s simpler than you’d think. I bought a $12 digital scale and a soft measuring tape from Walmart, keep them in the hall closet. A week before our annual well check, I weigh both kids and measure their height, jot the numbers down in my phone notes. Dr. Lee walks through the full developmental checklist herself, asking specific questions: Can your oldest tie his own shoes? Does your toddler follow a two-step direction? When I mentioned I was worried about my oldest’s speech articulation last year, she asked me to send a 2-minute video of him talking about his favorite dinosaur, shared it with an in-network speech pathologist she works with, and had a full report back to me in three business days. She gave me three specific tongue exercises to do with him for 5 minutes a day, and we checked in two months later – his speech cleared up enough that he didn’t need formal therapy. I never had to drive anywhere, never had to sit in a waiting room full of coughing kids.
I’ve picked up a few small tricks that make this whole system work, if anyone else is considering it. I keep a folder in my phone labeled “Kid Medical” where I save photos of new rashes, videos of coughs that sound off, and screenshots of any blood work results, so I can pull them up instantly during appointments. I confirmed upfront that the practice partners with our local urgent care and a mobile lab service, so if we ever need blood work or an in-person exam for a possible broken bone, the notes get sent directly to Dr. Lee within 24 hours, no extra paperwork from me. For non-urgent questions, I use the portal messaging instead of booking a full appointment – our plan doesn’t charge extra for messages, and I get a reply within four hours on most days, which is way faster than waiting for a nurse to call back from an in-person practice. I also keep a cheap pulse oximeter in the medicine cabinet for nighttime breathing scares, so I can share accurate readings with the doctor right away instead of guessing.
I still get pushback sometimes. My mom was convinced I was being reckless when I first told her, and last month at a playground playdate, another mom looked at me like I’d grown a second head when I mentioned my main ped is fully remote. I get it – it’s not the model we all grew up with, the small town family doctor who knows every kid by name. But for what it’s worth, Dr. Lee remembers that my oldest is allergic to amoxicillin, that my toddler’s eczema flares up when we cut our Christmas tree, that we planted a vegetable garden last spring and she asked how the tomatoes turned out last month. She’s never been rushed with us, never made me feel like I was taking too much of her time with silly questions.
Obviously, it’s not for every situation. If my kid stops breathing or breaks a leg, we’re straight to the local ER, same as anyone else. If we ever need a specialist, Dr. Lee handles the referral same as any in-person doctor would. It’s not perfect. I sometimes wonder if there’s a tiny thing I’m missing, something an in-person doctor would pick up on just by being in the room. But right now, for our life – two working parents, two small kids, living an hour from the nearest large pediatric practice – it fits better than any in-person care we’ve ever had.
I don’t see many people talking about having a fully remote primary pediatrician, so I figured I’d put it out there. I know I’m not the only one who moved to a less populated area, or can’t get an appointment with a local in-network provider, or just got tired of spending half a day in a waiting room for a 10-minute checkup. If you’re doing this too, you’re not crazy. It’s not the traditional way, but it works for us, right now.
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