NICOLE ANNE LIVESCU, R.N. ,does everything; answers the phones,
gives injections, calls in prescriptions, handles billing and sends out insurance
forms and provides medical education. She is a Registered Nurse, very
sweet, smart and more than happy to help you with your medical
and non-medical problems.
Ellen helps out and knows most everything about everything. She also functions as my wife.
WHAT I DO
I am a Family Doctor and I personally care for my patients - infants, children, adults and senior citizens.
I am always available. 24 hours a day seven days a week to see patients that need to be seen and I rarely take vacations or days off. the general office hours however are: Mon-Thurs.- Fri. 9-5, Wed. 12-8. We are often here additional hours but you must call to be sure (212-957-8256). On beautiful days we occasionally go fishing, so always be sure to make an appointment before you come in.
I am almost always available. I rarely take vacations and answer my phone myself. My office number rings in my house. Everyone has my cell phone number so if you call the office number and I don't answer then call my cell phone. If I don't answer in 15 minutes call me again. The only time it is hard to reach me is if I am in the pool but that is usually during the day and I rarely swim for more than 60 minutes. REMEMBER always call the office number first because I only use my cell phone if I am not home.
All appointments are scheduled. I make a concerted effort to see patients on time, and am almost always successful. However, I also expect patients to show up on time.
ANSWERING MACHINE/TELEPHONE/VOICE MAIL
Call my office, listen to the message; and then leave your name, phone number and a message after the beep. If you need to speak with me immediately hang up, wait for a dial tone and call my phone/voice mail at 1-917-414-3201. If I do not answer leave a message with your telephone number. If I have not called you back in a half hour something is wrong call me again. Remember, Do not forget to leave your telephone number! If you cannot wait a half hour then it is an emergency and you should to directly to the ER.
As most of my patients know, I try not interrupt my office visits to answer phone calls. I do, however, respond to emergencies. If you have an emergency, simply say so and I will get on the phone. If you are not sure if it is an emergency ask my nurse(Nichole). If it is not an emergency, I will call you back either between patients, or at the end of my day. That may be quite late. All calls will be returned. If your call is not returned, please call back no matter what time, since there has obviously been some mix-up. The phone rings in my home after hours and I can always be reached.
PATIENT CALLING HOURS
Every weekday morning from 8AM-9AM, I answer the phone myself. You can always reach me personally during these hours. I am happy to speak with you about anything you like. If the phone is busy it means I am speaking to another patient. Please keep calling until you get me. If there are many calls I will extend the hours. If you still do not get me leave a message and I will call you back. Remember-if you want to speak with me- I want to speak with you. I am accessible!
PATIENT EDUCATION AND MEDICAL HANDOUTS AND THE WEBSITE
I make a concerted effort to explain medical things slowly and carefully and as all my patients know I write out instructions for virtually everything. I rarely use handouts anymore because of the website but the topics are listed on page one of the website under "topics". Before you take any medications you should click on drug info and look up any drug you are taking or about to take. It explains proper use, precautions, and side effects of your medicines and other important information. The website is for my patients only. I have gone to great lengths to hide it from Google and other search engines. Please do not give out the website address to people unless you have a good reason. The less popular it is the more I like it.
If any test results are abnormal, we will make every effort to contact you. I encourage patients to call and discuss results so that there is no chance of an error. You may phone during calling hours to either check on or discuss a test result or can call my nurse. Test results will not given out by anyone but me or my nurse under my specific instructions.
When I'm unavailable, which is almost never, there is always a covering doctor. It is often Dr. Caggiano (517-6210). If you call and get the machine and for some odd reason I am not available, it will give you the name and number of the covering Doctor. Generally I am available 24 hours per day 7 days per week 365 days per year(except leap years) But occasionally something comes up.
While I am now affiliated with Mt. Sinai Hospital, this is an interesting issue. Medicine has evolved in such a way that hospital chauvinism has become less and less important and hospitals have become worse and worse places to be. Most things are done on an out-patient basis now. Additionally, hospitals are no longer full service institutions. Even very large hospitals cede expertise in certain areas to other hospitals. This is very different that the way it used to be which was that every hospital wanted to do all things. As a result I use different hospitals for different things and even different ER's for different things and even vary hospital or ER's by what day or season. Also I change hospital that I use depending on whether a particular doctor or group of doctors move to a different hospital or whether a new doctor gets hired from out of town. I am no longer loyal to a particular hospital, I simply send my patients to the place that I feel offers the best care at that day and time.
In-patient hospital care has also changed with the advent of intensivists. They are always available in the hospital and patients family doctors no longer control the patient care the way they once did. In some ways this is good and in some ways bad. I think that patients prefer to see their own doctor, but truthfully having intensivists or hospitalists provides more even care in the hospitals. It is in many ways better than having the hospital call me during the day for orders. On the upside, the intensivists and hospitalists are more responsive to me than they ever were in the old days.
If you require an emergency ambulance, call 911 and they will take you to the nearest hospital. Have the Doctor in the Emergency Room call me so that I can discuss the case with him. If you are able, go by taxi or private ambulance. With the shuttering of St. Vincent, Cabrini and Beth Israel North, the ER experience in every hospital has drastically deteriorated, though this is not necessarily an indictment of the hospital itself. In an emergency you should go to wherever is closest and fastest. In general I use Lennox Hill for cardiac, and opthomology, MT. Sinai for most other things. Nevertheless remember that I use particular doctors for particular things at virtually all the hospitals in New York. I think this provides the best care for my patients.
RECOMMENDED PHARMACIES 24 OUR PHARMACIES
CVS most likely to be 24 hour but only certain ones are. You always need to call the pharmacy because sometimes the store is open when and the pharmacy section is closed. When possible I suggest to stay away from Rite-Aid which I have found to have generaly poor service and even Duane Reade. I do have some pharmacies that over the past three decades I favor because of their service. Zitomer, Apthorpe, Goodrich, Mckay,Carlyle, A full list is available from my office with telephone numbers and some are on the website.
I make home visits for patients who are truly debilitated or whose conditions prevent them from going out. The charge is quite high and even more so for places like Greenwich, New Jersey and Brooklyn.
We prefer that people pay their bill when they come in. If that is not possible, we ask that you send it to us. If you have an insurance form, Nicloe will mail it in for you. If you need assistance with your forms or company, we will be glad to help. If you are having a problem with your ability to pay, speak with either myself, or my nurse and we will attempt to work something out.
I have completely withdrawn from the Medicare system. Anyone who has ever had anything to do with Medicare will understand why. This allows me to give the attention and time to my older patients that I feel is necessary.
This also means that Medicare will NEVER reimburse for any care provided by me and no bills may be submitted to them. It also means that my office charges are the same as that for any private patient. This has no impact on hospital or outside lab costs, which are usually covered. Also almost any specialist I refer to accepts Medicare. If you have secondary insurance we will mail your bill in with a For Denial Only sticker on so that your secondary insurance will kick in. Remember, no bill of mine may be submitted to Medicare without this sticker.