Wednesday, April 27, 2016

After hours/Urgent care options

Ideally I would recommend that everyone has a primary doctor for their children. Having a provider who knows your child when they are well can help affect decisions and treatment plans when they are dealing with an illness. Continuity is a real plus.
However, Murphy's Law generally seems to make certain that fever spikes  or the vomiting starts right at 5:01 pm when average doctor's office turn their phones off. While it is true that the Noe Valley Pediatrics advice nurses have the quirky but endearing habit of checking emails at all sorts of odd times when the office is closed, you can NOT count on reaching us and getting a response. Emails should never ever ever (can you tell I really mean it?) be the avenue you choose if you have an urgent matter.

One of the things that all people should make sure they are familiar with is their options for medical care after hours. Waiting until you or your child is ill is not the best time to start exploring your options. Do it now.  Does your insurance plan have a preferred option that won’t cost as much? Are there after hours advice nurses available? Where is the closest emergency room? Is it staffed with pediatricians? If you are traveling, plan ahead and figure out local options for care before the trip.

Here in the San Francisco Bay Area we have been lucky to have very good options for after hours care.

The original after hours care is the Pediatric Evening Referral Clinic run by the Physicians Choice Medical Group.

They used to be right near the CPMC California Campus ER. When they moved to the new location they also affiliated with UCSF.

The PERC clinic currently has two locations:

  • In San Francisco 3490 California Street, Suite 200    415-387-9293 
  • In Oakland  5700 Telegraph Ave #100 in Oakland     510-486-8344   

Patients are seen by  appointment:

Monday through Friday 6:00 pm - 9:30 pm,
Saturday, Sunday and holidays 8:30 am -9:30 pm

Weeknight pediatricians are made up of participating private pediatricians, including several of our doctors. Weekend doctors are fully trained and board certified pediatricians.

On weekdays the phone lines turn on at 5 pm. There is an advice nurse triage team that is available through the night, even after the clinic is closed.

As of April 2016, our patients have new after hours options that is closer for many of our patients living on the south side of town:

The Pediatrics After Hours Care at St Luke’s Hospital is affiliated with Sutter/ CPMC and is located at 1580 Valencia Street, 7th Floor #701

It is now open 7 days a week.
Monday-Friday 5:00pm-10:00pm
Saturday-Sunday 8:30am-10:00pm
Phone: 866-961-8588

This service does not currently have an advice nurse team, but the person answering the phone can help do some basic triage and help direct you to an emergency room if that is a better option. This new clinic has some other advantages besides the convenient location. They start the scheduling process as early as 2 pm, which may make it easier to make a plan if we are already solidly booked up here in our office and can’t get you in that day. They also offer weekend weight and bilirubin checks for our newborns. As a bonus, there is a special waiting area so that the healthy newborns aren’t exposed to the other sick kids.

When things are going as they should, both of the above after hours options send a report to your primary doctor's office. In our office, the nurse team reviews the reports and follows up to see how you are doing to maintain a sense of continuity.

If you are not in San Francisco, is a good option at 210 Baldwin Ave in San Mateo. Telephone 650-579-6581

This is a pediatric Urgent care facility and no appointment needed.

The Palo Alto Medical Foundation has several pediatric urgent care options:

They have a choice of appointment or drop in. The website gives info about the various locations and current wait times.

In Marin
Greenbrae Pediatric After hours clinic

1260 S Eliseo Drive Floor 2
Green brae CA
6:30 pm-9:30 pm Monday through Friday
9:00 am-9:00 pm Weekends and Holidays

There are plenty of general urgent care places popping up all over the place as well. Keep in mind, that with most urgent cares, there is no such thing as an appointment and folks just show up and get seen in the order that they come in. There is risk for a much longer wait. They are also not usually staffed with pediatricians. For a teen, this is usually not much of an issue, but for my younger kids, I would try to stick with one of the pediatric after hours clinics. If you do end up at another urgent care, please ask them to send over a report so that we stay in the loop.

Emergency Rooms
In a true emergency of course call 911. If it is less urgent, but you are certain that you child needs immediate medical attention we are lucky to have excellent options here in SF.

When given the choice I will generally opt for one of the true pediatric emergency rooms. You are not competing for care with the elderly heart attack and stroke victims that may be populating the waiting room and getting ranked higher on the triage scale. You will also be assured of seeing a pediatrician and having appropriate pediatric equipment. If an admission is needed, my preference would be either CPMC California campus or UCSF Mission Bay, so there also won’t be any transport needed if you are already at one of those ERs. I think it is worth the extra ten minute drive across town and may save you time in the long run.

The UCSF Pediatric ER in Mission Bay is located at 1975 Fourth Street:

This emergency room has scored very high in a nationwide ranking for getting patients seen in a timely manner.

CPMC pediatric emergency room is located at 3700 California Street/ at Cherry:

 Home visits
Some of my patients have used and had a doc do a house call within a few hours. They were very pleased with the entire system.


  1. This is excellent advice. Being prepared for the “what ifs” is never a bad idea. You never know when you an illness or something worse will happen. If something does happen, if there is a plan in place already, it will take some stress off of the situation and not make is worse having to plan on the fly.

    Scott Cravey @ U.S. HealthWorks San Leandro

  2. We will give you the best patient care, at sensible costs and at the area of your choice.Our therapeutic practice is included board confirmed Physicians, Physician Assistants and ARNP's, with more than 40 years joined involvement in the Emergency Room.ER2YOU is worker possessed and worked. Not at all like conventional (or urgent care) crisis rooms, our administration charges are presented front, alongside basic and clear charging.

  3. This is great. You never know whats gonna happen so at least be ready for it when the time has come. We are open everyday, including holidays and late evenings and we are here to help.
    Urgent Care Clinic