Secure Message Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2024-07-07 Encounter: Spruce text message CC: Severe sore throat with inability to keep water down and high fever. HPI: Jack presented with a throat that was 'killing him,' very red and swollen, with inability to keep water down. He was very tired and sleeping repeatedly. Dr. Hobbs was traveling (serving as camp physician) and arranged for a home strep test kit to be picked up from his house. The parent-administered rapid strep test was negative, but Jack subsequently developed fever of 101-103°F and runny nose. Urgent care visit the following day confirmed strep positive. Assessment: Dr. Hobbs initially considered the runny nose as making strep less likely but remained appropriately cautious. The home strep test was negative (likely due to inadequate swab technique by parent). Urgent care confirmed strep the next day and treated appropriately. Plan: Home rapid strep test kit provided. Test was negative (inadequate technique). Parent proceeded to urgent care on 7/8 — strep confirmed positive and treated by urgent care. Dr. Hobbs acknowledged being available remotely even while out of town. Key clinical quotes: "Runny nose makes it less likely to be strep" "I do have some strep tests 'to go' at my house if you feel up to doing the test yourself." "I'm sorry you had to go out. Happy to try to help anytime, even when I'm out of town." Source: Spruce conversation t_226ST10QO3800