Question 1

What are your hours of operation?

Accepted Answer

Monday – Saturday: 8:00am to 5:00pm

Question 2

Do you accept walk-ins?

Accepted Answer

We prefer same day appointments rather than walking in. We ask our parents to call ahead so that we can find an appropriate appointment slot to avoid disruption due to a walk in visit.If a patient walks in we try to accommodate them, but there may be a wait as we need to see those patients who have appointments first.

Question 3

Do you accept home-delivered babies?

Accepted Answer

Yes we do.

Question 4

How do you handle after-hours calls?

Accepted Answer

You call our office at  (239) 573-2001 and you are prompted to select to talk to our on-call providers for urgent conditions that need immediate attention. For non-urgent conditions we ask our parents to wait until the next business day without disrupting the providers rest and family life.

Question 5

What insurances do you accept?

Accepted Answer

We accept most major private insurances and Medicaid HMOs, along with credit cards, checks & cash. We have a sliding fee schedule for those who do not have an active insurance. Please call us if you are concerned about us accepting your health plan insurance carrier.Here is a list of the insurance plans we accept:Adventist Health SystemAetnaAetna Better Health of FloridaAmbetterAvMedChampus CignaFirst Health NetworkFlorida Blue (BCBS)GEHAGolden RuleHealth First Health PlanHumanaMedicaidMeritain HealthMultiplanOscar HealthPHCSPOMCOSelect Benefit AdministratorsSimply HealthcareStaywellStaywell Children Medical ServicesSunshineUMRUnited HealthcareUnited Healthcare Community Plan

Question 6

What is your Sliding Fee Policy?

Accepted Answer

It is the policy of Mackoul Pediatrics to provide essential medical services to all patients. No one will be denied access to services due to inability to pay. Discounts are offered to those who qualify based upon family/household size and annual income. A sliding fee schedule is available and is used to calculate the basic discount. Our sliding fee schedule is updated each year using the Federal Poverty Guidelines. Once the application is approved, the discount will be honored for six months, after which the patient must reapply.Discount Application ProcessTo apply for our Sliding Fee Schedule, the patient must provide necessary documentation along with a completed application. The required documentation includes proof of:Family SizeHousehold IncomeYou may obtain an application at the front desk, print it and bring the completed application to our office.

Question 7

What is your Non-Discrimination policy?

Accepted Answer

It is the policy of MackoulPremier Pediatrics to treat all patients and to operate in a manner that does not unlawfully discriminate against people on the basis of inability to pay, race, color, national origin, religion, sex (including pregnancy), age, sexual orientation (including gender identity and expression), marital status, disability, veteran status, or any other basis prohibited by federal, state, or local law.

Question 8

How far in advance do appointments need to be made?

Accepted Answer

We offer same day appointments, but for well visits we ask that you make those appointments in advance. If you are sick and need attention, we will be more than happy to accommodate you the same day.New healthy (not sick) patients should call at least two days in advance to schedule an appointment. All future appointments, if need be, will be scheduled with you before you leave.

Question 9

How soon after the baby is born will you be available for a visit?

Accepted Answer

It is recommended that your baby be seen within 1-2 days after hospital discharge. Please bring the hospital papers.

Question 10

What documents should I bring to our first appointment?

Accepted Answer

All hospital discharge papers with information about pregnancy, labor and delivery, especially if the baby was born in a hospital other than ___________.Please also bring all the other documents mentioned in our Forms section.

Question 11

Do you discharge patients whose parents refuse immunizations ?

Accepted Answer

We strongly recommend vaccination, based on extensive scientific data we believe that the benefits from immunization outweigh the small risks of side effects from vaccination and we immunize our children. But we respect parents’ preferences, and we do not discharge them from our practice.We also offer Dr. Sears’ alternative immunization schedule for those who prefer a delayed immunization schedule.

Question 12

What happens if parents disagree with your recommendations?

Accepted Answer

Our medical decisions and recommendations are based on our knowledge, experience, common sense and risks and benefits analysis. If you disagree, we try to explore what your concerns are, what the rationale behind you disagreement is, and try to work with you. We can only recommend. We cannot force you to accept our position.

Question 13

What is your position on antibiotics use?

Accepted Answer

Due to a highly effective universal immunization program, we really do not have too many serious bacterial infections today that need antibiotics (like strep throat, sinus infections, urinary tract infections, skin infections, few cases of ear infections and pneumonias).Antibiotics cannot kill viruses, so viral infections are not treated with antibiotics. Most colds, ear infections, cough, bronchitis and bronchiolitis, pneumonias are caused by viruses and usually do not need any antibiotics.Any course of antibiotics kills our normal body flora that is part of immune defense, thus creating a transient immune deficient state when our body become more susceptible to serious infections.Non judicial antibiotic use created antibiotic-resistant MRSA and VRE like dangerous bacteria with very high mortality.Despite general belief, the color (green or yellow) of a nasal discharge doesn’t necessarily mean a sinus infection. Usually it is the duration of a runny nose (10 or more days) that matters.

Question 14

What is your position on medication use?

Accepted Answer

No medication is the best, less is better. Unless we’re convinced that your child needs medication to get better, we will not prescribe one.The younger the child, the greater the risk of medication side effect being high, and we are particularly cautious when prescribing medications.We expect our parents to understand that during most sick visits we will recommend no medications but symptom relief and education. Please do not perceive it as “our doctor did nothing”. Our role is to recognize serious conditions and manage. If we find none, that should make you happy, not upset.

Question 15

How does Allergy Testing and Immunotherapy work?

Accepted Answer

The patient gets tested for 58 allergens and 2 controls, controls are used to make sure there are no antihistamines in the body to block the test. 60 scratches are done in total: cat, dog, guinea pig, hamster, horses, feathers, 2 types of dust mites, several different trees, several weeds, molds, fungus and about 10 different grass pollens.It is called a scratch test, and is either done on the back or the arms depending on age of the child—usually 6 years of age and above will have it done on their arms. After testers are placed on child, child will need to sit still for 15 minutes. It may become itchy, but they cannot scratch area of testing.There are no needles involved to do testing—it’s like a hard bristle brush.Appointments are about 40 to 45 minutes but sometimes take an hour depending on the child and parents’ questions.How old does the child have to be to be tested/receive immunotherapy?The child must be 2 years or older for testing and Immunotherapy.What is the process? (How many visits/shots total, what span of time)Treatment lasts one year.2 small injections every other day for the first 8 months, then 2 times a week for the last 4 months totaling 280 injections in 12 months.We teach parents to do home based injections for the immunotherapy, but we do offer the service of in-house injections on Mon, Wed, and Fri if needed. Appointments are as follows: 1 testing appointment, 6 follow-up appointments (1 every 2 months) and after 1 year we schedule a retesting appointment.

Question 16

My child has ADHD and I do not want him on medication

Accepted Answer

We follow the American Academy of Pediatrics’ guidelines when evaluating for and diagnosing ADHD. If ADHD is diagnosed, you have several options:Do nothing but observe if the child is too young, not in school, and you can deal with him.Follow recommendations by your friends (not proven by any research) like eliminating sugars, red dye, using mountain dew or coffee. If it helps you are fine to continue.Can try supplements like omega-3 (fish oil), or other supplements containing L-theanine, Phosphatydil serine . If these help you continue.You can use behavior therapy.If none of those options are effective then you really have no other choice but using medications.Here’s what you need to ask yourself:If your child would have asthma (a chronic condition) would you withhold his inhaler?If your child has insulin dependent diabetes (a chronic condition) would you withhold insulin?If your child has ADHD and is having problems in school (behavior or academic or both) and you are getting complaints from school, why would you withhold his medication?There are now slow release, longer-acting medications with much less side effects than older instant release medications.In our practice we follow the golden rule “start low, go slow” – we always start medications from the lowest possible dose and titrate up very slowly until we get the desired effects. If we see side effects, we act without delay and adjust the dose and/or the medication as needed. We monitor our patients closely and see them regularly to make sure that they are on the right medication regimen.

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