The prescription calls for the personal touch
Sunday, June 01, 2003
A Highland Park doctor takes her practice home By Ashley Ernst
Frank Pinc / Chicago Parent
A patient receives the personal touch from Nussbaum's home office during a routine visit.
A visit to the pediatrician can be a frightening experience for a child but not for patients of Dr. Sara Nussbaum. When her patients arrive--whether at her office or clinic--there is no waiting, they come right in. If they visit her home office, they may even get to play with her family's dog. A mother of three, Nussbaum knows what races through a parent's mind when a child is sick. When parents call her with questions or concerns, she can offer advice based not only on her training as a doctor, but on first-hand experience as a mother. "I've gone through it," she says. "Me being a mother has helped me being a doctor, and me being a doctor has helped me being a mother." Nussbaum has two Highland Park offices--one in a medical building and one in her home. She has a small number of clients, so she can spend 30 minutes on a routine check-up, answer all parent's questions, respond to phone calls and respond to emergencies no matter what time or day of the week. She's not your normal doctor. "Being a pediatrician is not just about taking care of kids. It's about educating the parents, too," she says. Bigger wasn't better Before she began her own practice, Nussbaum worked in a large practice with offices in Evanston and Buffalo Grove with seven or eight other doctors.
Doctors were directed to limit a check-up to 15 minutes or less. To Nussbaum, that was not enough time. "You have to put them at ease. Most people get nervous naturally, "she says. At her home office, a child's nerves might be calmed by the family dog--who wanders in and out of the office. At the end of her day in her old office, Nussbaum says she would receive a stack of phone messages--many from parents with questions about their children--that she did not have time to answer until the end of business hours. "There were too many people," she says. "I was not feeling I was doing my best." Now, Nussbaum is in control of her appointments. She schedules check-ups in 30 minute blocks. First-time clients usually get an hour to give Nussbaum time to get to know the child and learn the family history. Mostly referred by word of mouth, her 250-300 patient load is considered small for a pediatrician. She likes it that way. She says a larger number would force her to change the way she practices. "I think this works better," Nussbaum says. She even says she would stop taking new patients if she reaches a point where she can no longer offer the same personal service, such as ensuring patients don't wait longer than 10 minutes to see the doctor. Her clients come from all over the Chicago area. "They'll drive 45 minutes for an appointment because they know they'll get right in. They won't have to wait 45 minutes to see a doctor," she says. Robbie Grant, a labor and delivery nurse, has been taking her two children, ages 9 and 6, to Nussbaum for almost two years. "She understands that she needs to communicate with her patients the way she would her own children," Grant says. "She communicates with them, doesn't talk above them. She wants to hear exactly how they're feeling, in their own words," Grant says, "like a mother would." Nussbaum took a pay cut when she left the big practice but never considered raising fees to make up for the lost income. "I actually have lower fees than most pediatricians because I have less overhead," she says. While patients pay about the same for vaccines and check-ups as they would if they used a large practice private pediatrician, she charges significantly less for sick visits. "There are a lot of people who don't have good insurance or insurance at all. I want them to be able to come to see me too," she says. She says the home office has changed the way she practices medicine. "It can be stressful. It's crazy sometimes. Its also so rewarding," she says. "I love my work again. I didn't for a while." Dr. Mom Nussbaum's other full time job is managing her family. "She's very active outside her practice and the family," says her husband, Dr. Steve Nussbaum, associate medical director of the spinal cord injury program at the Rehabilitation Institute in Chicago. To add to her hectic lifestyle, Sara Nussbaum also is a board member at her family's synagogue, part of the PTA, a columnist for the local newspaper and she also gives body development talks to the local 4th- and 5th-grade classes. Her husband is also a physician but with less flexible hours. Steven Nussbaum leaves the house as early as 5:45 a.m. and returns at dinnertime. Once he's home at night or on weekends, he helps where he can. "To juggle three children and patients at the same time--she does it well," he says. The day begins at 6:15 a.m for Nussbaum and everyone is out of the house by 8:30. After getting the kids ready for school, she walks the older kids down the street to the bus stop, where she waits with other parents. Then she walks Hannah to preschool, down the street in the other direction. Once the kids are off to school, she makes the seven minute drive to her office in a Highland Park medical building. If urgent, she can see patients as early as 9 a.m. at her home. After school, a babysitter watches the children from 3 to 6 p.m. Nussbaum says, "Everything is here. It's not a difficult situation." And in between, she also juggles her children's schedules. Her oldest, Mara, 10, plays piano and violin and attends Hebrew school twice a week. Her son, Daniel, 7, is part of an after-school science program. The youngest, 4-year-old Hannah, loves the Disney princesses. "I think of myself as a doctor who is practicing modern medicine in an old-fashioned way," Nussbaum says. "I can offer my patients the personal touch." She consideres what she does a reverse house call. Parents can come to her any day, at any hour when their child needs help. Once, Nussbaum treated an infant at 2 a.m. while still wearing her bathrobe. "I don't want to make a child wait who's in pain," she says. It's not even difficult when her own children get sick because of the home office with its own entrance. "If I got a kid at home, I can still see patients," she says. "My patients have their privacy, my family has their privacy. It's pretty fail safe." But it's still not completely seperate and that is good. Having the home office means her children see her as a doctor and a mom. When she was working in a large practice, she was a mom at home and a doctor at the office. Now, she says, her children watch how she helps others, see her as a professional and learn responsibility. Operating on patient's time Before Grant started taking her children to Nussbaum, she found dealing with pediatricians frustrating. She met Nussbaum when they worked together at Highland Park Hospital and heard through talk in her car pool that Nussbaum had set up her own practice. After a difficult experience with other pediatricians, Grant called to discuss her daughter's medical problem with Naussbaum. "She called me back without prompting her," Grant says. Nussbaum helped them get in touch with the right people. "She didn't care that I wasn't her patient," Grant says. "She really helped us pull it all together." As a solo practitioner, Nussbaum does everything. She answers the phone at any time of the day or night, makes her own appointments and speaks to and sees her patients. "I think I found the perfect balance here," says Nussbaum. "I can change things at the drop of a hat." She can also respond when needed. Mindy Stern, a mother of three in Highland Park, says she called Nussbaum on a Saturday because her 9-year-old son, Josh, was sick. Stern reached Nussbaum while she was at a party with her family. Nussbaum told Stern to give her 20 minutes, time enough to get home and put her kids to bed. Nussbaum saw Josh--at 11 p.m. The next day, Nussbaum called Stern to check on Josh's progress. "That's when I fell in love with her," Stern says. A friend referred Stern to Nussbaum, and their first conversation--about her family and their medical history--lasted more than an hour. The next day, she recalls, Ellie awoke with a fever. Nussbaum agreed to see her, even though Ellie's medical records had not yet been transferred. "I was hooked, and I have never looked back," Stern says. "She makes you feel very, very comfortable. "Besides being a great doctor, she's a mother of three children and lives in the community," Stern says. Another Highland Park mother, Karen Falberg, has been taking her children to Nussbaum for three years. "She's always willing to go that extra mile to give you what you need," she says. "A lot of other practices are getting quite large. With so many doctors, the chances of seeing your doctor when your child is sick are very slim." Now, when Falberg calls the doctors, she speaks directly to Nussbaum who is always available. When Falberg's 5-year-old son, Jacob, broke his arm, Nussbaum was on the phone with the emergency room doctors. "She didn't want just anyone working on him," Falberg says. "Her empathy is a little greater because she does have children. Chances are her kids have gone through the same." Because Jacob was so young, Falberg worried the broken arm would affect his growth and development. Her fears were calmed when Nussbaum related the story of her son Daniel's broken arm--he had no long-term damage even though he was 9 months old. "I didn't notice it for three days," Nussbaum says. "I'm a mom, too. I'm human. I don't do everything perfectly just because I'm a pediatrician."
Ashley Ernst is a recent graduate of Roosevelt University, a former Chicago Parent intern and is currently searching for a full-time job. She can be reached at Ashley5079@excite.com.