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Evening Pediatrics provides care, comfort

The son of a respected pediatrician opens a clinic to fill an after-hours niche.

By PAUL SWIDER, Times Staff Writer
Published January 2, 2008

Medical assistant Marcia Pyne tends the front desk of Evening Pediatrics last week. The clinic, which opened in September, allows parents to avoid the wait and expense of an emergency room.
	[EDMUND D. FOUNTAIN | Times]

ADVERTISEMENT [EDMUND D. FOUNTAIN | Times] Nurse practitioner Natalie Madar examines Siddharth Sriram, brought in by his parents, Sriram Ramanathan and Saranya Krishnan, at Evening Pediatrics. Madar prescribed an antibiotic.

ST. PETERSBURG - New in town, Sriram Ramanathan had yet to choose a family physician when his 16-month-old son developed a fever and started vomiting.

Worse, it was after business hours asSiddharth's symptoms got worse, so Ramanathan did an online search for an urgent-care pediatric facility and found Evening Pediatrics.

"At that point, you don't know how bad it is," Ramanathan said. As it happens, young Siddharth was not seriously ill, but his father was happy to hear that from a professional. "It's reassuring when a trained person tells you it's not so bad."

Comfort and confidence were the aim of Evening Pediatrics, said president Michael Cibran, who is also the business manager of the chain of St. Pete Pediatrics clinics owned by his father, Dr. Mariano Cibran.

Having seen plenty of late-night calls from worried parents about children who often weren't that ill, the younger Cibran, the father of an 8-month-old, started Evening Pediatrics.

"We're just trying to keep them out of the ER," he said of the clinic that opened in September. "People don't want to wait hours in the emergency room, but you feel guilty if you don't do anything."

The clinic is open from 7 p.m. to midnight on weekdays, and noon to midnight on weekends. It's even open on holidays, Cibran said.

Serious cases are still referred to an emergency room because the clinic doesn't have a doctor on site. Evening Pediatrics' seven exam rooms are staffed with medical assistants and pediatric nurse practitioners, who are registered nurses with a master's degree or greater, training in the diagnosis and management of common medical conditions, and the ability to prescribe most medications.

"We know our boundaries," said Natalie Madar, a nurse practitioner who works for Cibran. "But most of what we get here is fairly routine, a lot of earaches and sore throats."

Madar, a parent herself, said moms and dads walk a fine line when their child is ill.

Going to the ER can be an expensive overreaction, but waiting too long to be sure the child is ill can be dangerous. The clinic is a middle ground between the two.

Cibran said the clinic accepts most insurance. But even an uninsured patient would pay only $100 for a clinic visit, which is less than the cost of an emergency room visit.

Cibran said the goal is not to steal patients but to fill a gap in medical care. His staff sends a report to each patient's regular doctor and recommends parents take the children the next day so there is continuity of care. Cibran's staff also calls the next day to check on the child's condition.

Michelle Smith needed the clinic's services the day after Christmas when her 14-year-old daughter broke out in a rash.

Fearing not only the expense but the long wait at the ER, she remembered seeing Evening Pediatrics and took her daughter there. "I'm glad to see it here," she said, adding that her 5-year-old has asthma and sometimes has difficulty breathing. "It's a big relief to know it's there."

The clinic has seen more than 1,100 patients since it opened. Some parents come from as far away as Holiday because they couldn't find a closer after-hours facility.

"A lot of them come just for the comfort," said Quiana King, a medical assistant, the clinic's manager and mother of two young children herself. "It's frustrating when a parent is not able to help their own child."

The clinic sits just across the street from one of the elder Cibran's offices, which Michael said was just coincidence.

He said he searched all over Pinellas County, but this site came available at the right time.

Weekends have been busy, as have some holidays, Cibran said.

As a business, the clinic is doing well and he hopes to add more sites, but the success is a mixed blessing from the vantage point of any parent.

"People ask how you're doing and you reply, but it's hard to say you're doing well because that's based on kids getting sick," he said.

"But then, kids are going to get sick anyway. If we can get them seen quicker, that's all the better."

Paul Swider can be reached at pswider@sptimes.com or 892-2271.

FAST FACTS

Evening Pediatrics

4040 49th St. N

526-6483

eveningpediatrics.com

[Last modified January 1, 2008, 22:33:01]