It’s 2 a.m., your child is screaming with a fever, the pediatrician’s office is closed and you have two other children asleep in their beds. Who do you call?
Dr. Debbie Wagnild-Nojima
WHEN TO CALL 911
» If your child has difficulty breathing (is taking more than 50 to 60 breaths per minute) or is turning blue around the mouth.
Debbie Wagnild-Nojima — aka Dr. Mom — is a board-certified pediatrician who specializes in making house calls in just these kinds of urgent situations. An experienced pediatrician who used to run her own private practice on the windward side, the mother of two now specializes in making house calls.
She arrives with a full doctor’s bag, which includes a stethoscope, a pulse oximeter to monitor oxygen in the blood, a strep test and assorted medications, as well as pretty much any tool you would find at a doctor’s office.
Wagnild-Nojima, 40, can make diagnoses, take samples for the lab, answer questions, write prescriptions, and, when done with the visit, forward the report to the child’s regular pediatrician. She does not, however, perform routine vaccinations or routine checkups, and encourages parents to maintain a relationship with their regular pediatrician in a more conventional setting.
"I’m strictly urgent care," she said. "Your relationship with a pediatrician who can see you from birth all the way through is sacrosanct. I will be in very close communication with the primary-care physician."
She does, however, provide urgent care on a 24/7-basis islandwide for such cases in which a parent might end up waiting in a hospital emergency room for ailments like ear infections, fevers and sore throats.
When this happened to Wagnild-Nojima’s 6-year-old son, Parker, a year ago, her husband said he was glad she was there so he didn’t have to wait in the emergency room with their two kids. That’s when a light bulb lit up in Wagnild-Nojima’s head, and the seeds for Dr. Mom were planted.
Wagnild-Nojima says she is the only pediatrician on Oahu who makes house calls, and that visiting a patient at home is a more satisfying experience for the pediatrician than being bound to an office.
"We have to go back to the basics, which is patient, doctor and the patient’s family, which is what it’s all about," she said. "It’s very simple and it’s old country doc-style."
Tiffany Nakada of Kaneohe, mother of a 4-year-old girl and 22-month-old boy, says Dr. Mom has been a lifesaver.
When her daughter Laney had an ear infection, Wagnild-Nojima arrived to make the diagnosis and provide pain medication and a prescription for antibiotics Nakada was able to pick up a half-hour later. The situation was under control to the extent Nakada was able to get a night’s rest and go to work the next day.
"It’s easier to just call her, having two kids," she said. "Otherwise, you would have to go to the emergency room and take the other child, too. It always seems to happen after the doctor’s office closes."
Nakada recalls spending four hours waiting at the emergency room when her daughter had an allergic reaction.
Wagnild-Nojima, a Punahou graduate who holds a medical degree from the John A. Burns School of Medicine at the University of Hawaii, said besides providing convenience, she is able to spend more time and better communicate with clients in a casual home setting rather than in a doctor’s office, where there are often long waiting lines.
She offers most appointments within a two-hour window after receiving a call, and is available on the phone for follow-up questions. Fees for weekday home visits are $120 from 9 a.m. to 5 p.m.; $160 from 5 to 10:30 p.m.; $300 from 10:30 p.m. to 7 a.m., plus auto expenses. Fees on weekends and holidays start at $200. Dr. Mom also accepts HMSA coverage.
Once a week, the pediatrician works at the Mother-Baby Unit at Castle Medical Center to keep her skills fresh assisting with newborn resuscitations, for example.
Part of her mission is to empower parents by arming them with information so that they feel confident knowing how to respond to their kids’ ailments. Another goal is to keep out of clogged emergency rooms those nonemergency cases that can be taken care of by a house call.
When she became a mother six years ago, Wagnild-Nojima said she also became a better pediatrician, part of where the name "Dr. Mom" comes from.
"I was a pediatrician for a long time before I became a mom," she said. "When I became a mom, I became a much better pediatrician and communicator. I get it; I truly get it. I take both jobs very seriously."
Her house-call practice also allows her more scheduling flexibility to spend time with Parker and 2-year-old Zachary.