How Sprout Works

Because we're different it's important you know how Sprout Pediatrics works. We want to ensure that we are a good fit for you and your family, so please review our policies and procedures. I encourage you to attend one of our open houses or workshops to learn more, and feel free to ask us any questions (see events & contact us). 

• I am open minded, minimalist, have great respect for natural processes, and firmly believe in science. I understand that parenting is hard, and I am committed to helping parents understand evidence, find answers and make their own best decisions.

• I do prescribe antibiotics but not without evaluation or when they are not indicated. Many, if not most, childhood infections are viral and do not benefit from or require antibiotics. Antibiotic stewardship is critical for your child, the population and the environment. I carefully evaluate medicines & treatments of all kinds for safety and effectiveness before making recommendations, and will provide many comfort care suggestions.

• I work hard to support breast-feeding. However my priority will always be the health of your child. This may include supplementing with formula if needed for growth concerns.

• I have special interests in environmental, alternative and complementary medicine but I am a Medical Doctor. I am committed to treating the whole child, integrating medical care with educational, social, and emotional health in the context of her or his family and culture.

• The art and science of prevention is fundamental to pediatrics. Pediatricians aim to support children’s growth and development to give them lasting health and wellbeing. Our best tools are well child care, including screening and immunizations, and ongoing care of chronic & intermittent illnesses. Patients interested only in sick and urgent care will find other resources more suitable.

• I follow the American Academy of Pediatrics and ACIP recommended vaccine schedule. I am well trained to evaluate research, and the vast amount of data on vaccine preventable diseases and vaccination is unequivocal. I am happy to discuss vaccination and help families get or get back on schedule, and I do not accommodate alternate vaccine schedules.

• Advice is easily accessible at all times. I am usually available for urgent questions and appointments. If I am out of cell phone range patients can reach my backup provider directly for advice about urgent matters. Online appointment booking, refill requests and other communication will be available as usual. I will notify patients in advance if I'm unavailable for longer than two days, and my schedule will be arranged to meet patient needs ahead of time and maximize appointment availability when I return.

• I make every effort to have appointments available on short notice and after hours. Please contact us first if you need urgent care as we can treat most minor emergencies (lacerations, cuts, mild fractures, sprains) in the office. For life-threatening emergencies, call 911 or go to the nearest hospital emergency department.

• Keeping appointments open for short notice and scheduling appointments that are two to four times longer than at most doctors’ offices significantly increases the repercussions of missed appointments. Please be aware that missed appointments without cancellation in advance jeopardize this appointment structure and access.

• In order to provide personalized, thorough care efficiently Sprout makes considerable use of technology. I insist that all patients use the online portal, and use of the portal, website, email and text messages is our primary method of communication & scheduling. I have great confidence in the security and reliability of my service contractors and have chosen carefully for features and ease of use. I am happy to assist anyone who needs extra help setting up or using accounts; please ask.

• While virtual communication is convenient, there are times when a visit or phone call is necessary. Don’t hesitate to ask. Please follow your instincts about communication and trust mine as well, as email is not the same as face-to-face discussion and examination.

• To best use our time together I strongly encourage you to use the online portal to complete forms, surveys, and screening questionnaires in advance of appointments.

• Being small will allow me to provide extraordinary care but will also require cooperation from all Sprout families. Messages are preferred for all non-urgent matters, and do-it-yourself online scheduling, payments and record access will help me be fully present for everyone in the office by preventing excessive interruptions to answer the phone.

• I believe care coordination is central to high quality primary care. Communicating directly with specialists and other referral providers keeps me in the conversation and gives me additional information and insight into your child’s care outside of Sprout.

• Especially in pediatrics, administrative services (such as coordination of referrals, handling refills outside of office visits, after hours calls, phone consultation with specialists & schools, obtaining medical records, managing the patient portal and filling out school, work and other forms) consume a remarkable amount time. Most physicians are forced to hire additional staff for these tasks, which increases overhead, in turn requiring the physician to see more patients to generate revenue to cover costs. To avoid the cycle caused by the current healthcare system we rely on advanced portal and communication programs to free us from the need to add staff.

• To make this style of practice sustainable, we charge a fee to cover our costs for these systems. Our communication and portals fee $10/month for one child, and each additional child is $5/month, billed annually.

• The most cost-efficient care is the right care at the right time. I work to balance the highest level of medical care and service with its cost. We will discuss cost openly when I believe it is important in decision-making & whenever you have concerns. The current healthcare payment system drives physicians towards faster visits, more staff to handle specific incentives and qualifications, and further separates patients and their physicians. I prefer to take your calls & emails and make plans without being driven by reimbursement. Reduced need for additional staff due to our portals & messaging systems enables me work with you directly and have the luxury to recommend you ‘try this first’ and often skip an inefficient, premature or unnecessary office visit.

• Before your first appointment we will do a brief orientation to the office, help you sign you up for the portal, invite you to our secure messaging system, create website & secure email logins, complete registration, consent, release of records and medical history forms, and set up payment accounts.

  
  
  

  I look forward to providing your children with individualized, comprehensive healthcare and your family with unsurpassed access to your pediatrician and our lending library, classes, and extraordinary office.

Immunization policy

Improving and protecting the health of our patients is Sprout Pediatrics’ purpose. It is our goal never to have one of our patients contract a disease or develop a disability that could have been prevented with an immunization.

• In order to provide safe, equitable care for all of our patients Sprout Pediatrics does not accept families who do not vaccinate their children. 

• We strongly discourage alternative schedules and we have minimum immunization requirements for patients to continue care in our office. 

• We administer vaccines in accordance with the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control (CDC) guidelines  and American Academy of Pediatrics Committee on Infectious Diseases (AAP COID) recommendations. 

• We stock our vaccines with the intent to fully vaccinate our patients on schedule with the fewest injections possible. 

• We do not separate individual vaccine components as it is unnecessary and subjects the child to greater distress and risk. 

• We do not routinely administer ‘extra’ vaccinations to decrease ‘pokes’, but we offer parents choices when they are available and medically appropriate. 

• We use several tools in the office to minimize pain, fear and distress when giving vaccines. Parents are expected to help to maximize the benefits of these distraction and comfort measures.

• All parents have in office and online access to vaccine information and resources and have the opportunity to discuss immunizations at a scheduled appointment. 

• We submit all immunization records to the Oregon State Immunization Registry. 

Regarding alternative schedules

The volume of information about vaccines from a broad range of sources is overwhelming. We understand that leads to uncertainty and fears about immunization, and we respect parents’ right to make decisions about the care of their child. We believe that shared, informed decision making is critical to good medical care, and are willing to discuss concerns about the recommended immunization schedule with parents who plan to immunize. We are willing to accommodate alternate schedules on a case by case basis if they meet our minimum requirements for the safety of everyone involved with Sprout Pediatrics. 

Patients whose parents choose to alter the vaccine schedule will need additional visits with Dr. Kemmerle to manage and administer immunizations because deviating from the standard vaccination schedule is complex. While nearly all vaccinations are covered in full by insurance, visits for this purpose are rarely covered by insurance. As with all non-covered services the charges will be the patient’s responsibility and payment will be expected at the time of service according to our financial policy. Dr. Kemmerle may permit nurse-only visits for some vaccine-only visits according to a plan already created. Changes to or questions about the plan will not be possible at nurse visits. If Dr. Kemmerle is available, your visit may be changed to an appointment with her, or the patient will be rescheduled for a later date and the schedule altered as required. The full cost of any vaccines agreed upon or special ordered in advance and later declined will be charged to the patient’s account. 

New & Prospective Patients

Prospective new patients who are hesitant about vaccinations are welcome and encouraged to schedule a visit with Dr. Kemmerle to ask questions and discuss choices. Discussions about immunization involve significant professional work whether or not the family chooses to become Sprout Pediatrics patients so visit charges apply as above.