Re: Changing of doctors from fm to peds

[Guest guest]

PEOPLE CHANGE FOR A VARIETY OF REASONS BUT IT SEEMS THAT THES PEOPLE VALUE

YOU BUT MAY HAVE HAD PRESSURE FROM ELSEWHERE TO GO TO A PEDS

> What a great issue.

>

> Moving a patient from your practice is an implicit statement of lack of

> confidence. If the relationship is damaged beyond repair, the pt ought

> to go elsewhere for care.

>

> Don't worry about turning away business. IMPs are very very hot

> commodities and if you keep working the basic IMP principles, you

> should not want for patient demand.

>

> I can anticipate that there are some out there saying " Yeah, but then

> why am I still wanting for patients? "

> Excellent question. Add your thoughts as to reason.

> Gordon

> At 09:49 AM 7/7/2006, you wrote:

>

>>Just a question to the family docs ( or any others, I would

>>appreciate the perspective) out there. Today something happened the

>> second time. Parents who come to me as patients and who have been

>> bringing their children to me as patients decide to take the child to

>> a pediatrician, but still want to come here themselves. I don't know

>> why, but I feel annoyed by this. In particular, today was a child who

>> I wanted evaluated for epilepsy, the father declined 6 months ago, and

>> now, finally, with my help and hard work, it has been firmly

>> established by neurology consultation. I also dxed beta thal trait

>> and explained it to them fully. I have been there for them, seeing

>> them same day (as is my policy), sometimes, same

>>hour. I am human and I feel hurt by this. Is this normal? Did this

>> happen to you? How would you handle it if the parent still wants to

>> come?

>>

>>The first time happened 2 years ago. The child had a bedwetting

>> problem and they changed doctors (to a pediatrician). They didn't

>> even give me a chance to evaluate it or discuss it with them. The

>> mother still wanted to come, however. But while pregnant, and over

>> the december holidays, she became very ill and didn't call me for 2

>> weeks. She said she felt uncomfortable calling the cell phone as

>> indicated on the message. (and I do explain to every new patient how

>> I do things and what to do in an emergency or urgent

>>situation) So, I told her that if she wasn't comfortable calling when

>> she really needed me, and she couldn't even leave a message, ( I would

>> have called her the same or next day) that this practice was not right

>> for her and that she should probably find a new physician that she

>> could work with and be comfortable calling. That time, my husband

>> felt that I was being too sensitive, but I feel that I am not a gas

>> station that people can change on a whim. He also reminded me that

>> this is a business and that I shouldn't turn people away. Of course, I

>> believe that people have a right to choose their

>>doctor. If the parent had never brought the kids to me in the first

>> place, I wouldn't feel so offended. But somehow, I feel that maybe

>> they for some reason have less trust in me for some reason and if

>> trust is an issue, then everytime the parent comes in, I will wonder

>> if they believe in what I am doing for them.

>>

>>I did notice that a similar situation happened with my own kids. I

>> took my 3 year old for a dental check up and there were all these

>> problems and cavities, so they referred us to a pediatric dentist, who

>> was very kind and did all the work and put on sealants for free on all

>> her teeth. My husband and I and our 6 year old are still going to the

>> other dentist. I had wondered if the original dentist would feel the

>> same way that the 3 year old is going to the

>>specialist or if they would be glad, especially since they had

>>referred us to begin with. I felt guilty not taking her back for the

>> original cleanings, but felt guilty not taking her back to the

>> specialist who did not charge for the sealants.

>>

>>I am rambling. Please feel free to be honest with your

>>thoughts. Naureen Mohamed

[Guest guest]

PEOPLE CHANGE FOR A VARIETY OF REASONS BUT IT SEEMS THAT THES PEOPLE VALUE

YOU BUT MAY HAVE HAD PRESSURE FROM ELSEWHERE TO GO TO A PEDS

> What a great issue.

>

> Moving a patient from your practice is an implicit statement of lack of

> confidence. If the relationship is damaged beyond repair, the pt ought

> to go elsewhere for care.

>

> Don't worry about turning away business. IMPs are very very hot

> commodities and if you keep working the basic IMP principles, you

> should not want for patient demand.

>

> I can anticipate that there are some out there saying " Yeah, but then

> why am I still wanting for patients? "

> Excellent question. Add your thoughts as to reason.

> Gordon

> At 09:49 AM 7/7/2006, you wrote:

>

>>Just a question to the family docs ( or any others, I would

>>appreciate the perspective) out there. Today something happened the

>> second time. Parents who come to me as patients and who have been

>> bringing their children to me as patients decide to take the child to

>> a pediatrician, but still want to come here themselves. I don't know

>> why, but I feel annoyed by this. In particular, today was a child who

>> I wanted evaluated for epilepsy, the father declined 6 months ago, and

>> now, finally, with my help and hard work, it has been firmly

>> established by neurology consultation. I also dxed beta thal trait

>> and explained it to them fully. I have been there for them, seeing

>> them same day (as is my policy), sometimes, same

>>hour. I am human and I feel hurt by this. Is this normal? Did this

>> happen to you? How would you handle it if the parent still wants to

>> come?

>>

>>The first time happened 2 years ago. The child had a bedwetting

>> problem and they changed doctors (to a pediatrician). They didn't

>> even give me a chance to evaluate it or discuss it with them. The

>> mother still wanted to come, however. But while pregnant, and over

>> the december holidays, she became very ill and didn't call me for 2

>> weeks. She said she felt uncomfortable calling the cell phone as

>> indicated on the message. (and I do explain to every new patient how

>> I do things and what to do in an emergency or urgent

>>situation) So, I told her that if she wasn't comfortable calling when

>> she really needed me, and she couldn't even leave a message, ( I would

>> have called her the same or next day) that this practice was not right

>> for her and that she should probably find a new physician that she

>> could work with and be comfortable calling. That time, my husband

>> felt that I was being too sensitive, but I feel that I am not a gas

>> station that people can change on a whim. He also reminded me that

>> this is a business and that I shouldn't turn people away. Of course, I

>> believe that people have a right to choose their

>>doctor. If the parent had never brought the kids to me in the first

>> place, I wouldn't feel so offended. But somehow, I feel that maybe

>> they for some reason have less trust in me for some reason and if

>> trust is an issue, then everytime the parent comes in, I will wonder

>> if they believe in what I am doing for them.

>>

>>I did notice that a similar situation happened with my own kids. I

>> took my 3 year old for a dental check up and there were all these

>> problems and cavities, so they referred us to a pediatric dentist, who

>> was very kind and did all the work and put on sealants for free on all

>> her teeth. My husband and I and our 6 year old are still going to the

>> other dentist. I had wondered if the original dentist would feel the

>> same way that the 3 year old is going to the

>>specialist or if they would be glad, especially since they had

>>referred us to begin with. I felt guilty not taking her back for the

>> original cleanings, but felt guilty not taking her back to the

>> specialist who did not charge for the sealants.

>>

>>I am rambling. Please feel free to be honest with your

>>thoughts. Naureen Mohamed

[Guest guest]

Naureen,

I’ve had this happen to me a couple

of times as well. Once, I was evaluating a well child and the head measurement

came out high. I reassured mom that we should follow this over the next couple

of months, but I felt it was normal for him especially since both parents had

large heads. The child was otherwise neurologically normal. The mother cried

all the way home certain her child was going to have something wrong and as

soon as she got home went on the Internet and became convinced he had

hydrocephalus. Sensing something was wrong, I called later that night to just “make

sure we were all on the same page.” Unfortunately, by then, she had

already discussed what was going on with her parents and friends who all felt

taking her child to anyone other than a pediatrician was crazy. Although I had

a relatively long clinical relationship with her and her husband, I became not

good enough for her child and she selected a local pediatric group. They saw

the child, ordered a huge number of tests (including a CT of the head with

sedation) to arrive at the conclusion he was completely healthy.

When I got the request for the medical

records to be transferred, I felt shocked and hurt, but I realize that parents

make all kinds of decisions based on what they feel is right for their child

(after all, look at the huge number of people who don’t immunize). If

what she needed was her child’s developing head to be irradiated so she

could know with 100% certainty that nothing was wrong, and she would only

accept this from a pediatrician due to a perception from her family and friends

that they give better care, then I just can’t help her. Of note, both the

mother and the father of the baby still see me and I inquire regularly how the

child is doing. They long for the easy access, high efficiency and continuity

of my office, but they remain content with their decision, and I realize I am now

pretty content with their decision as well.

Changing of doctors from fm to peds

Just a question to the family docs ( or any others, I

would appreciate the perspective) out there. Today something happened the

second time. Parents who come to me as patients and who have been

bringing their children to me as patients decide to take the child to a

pediatrician, but still want to come here themselves. I don't know why, but I

feel annoyed by this. In particular, today was a child who I wanted

evaluated for epilepsy, the father declined 6 months ago, and now, finally,

with my help and hard work, it has been firmly established by neurology

consultation. I also dxed beta thal trait and explained it to them

fully. I have been there for them, seeing them same day (as is my

policy), sometimes, same hour. I am human and I feel hurt by

this. Is this normal? Did this happen to you? How would you handle

it if the parent still wants to come?

The first time happened 2 years ago. The child

had a bedwetting problem and they changed doctors (to a pediatrician). They

didn't even give me a chance to evaluate it or discuss it with them. The

mother still wanted to come, however. But while pregnant, and over the

december holidays, she became very ill and didn't call me for 2 weeks.

She said she felt uncomfortable calling the cell phone as indicated on the

message. (and I do explain to every new patient how I do things and what

to do in an emergency or urgent situation) So, I told her that if she

wasn't comfortable calling when she really needed me, and she couldn't even

leave a message, ( I would have called her the same or next day) that this

practice was not right for her and that she should probably find a new

physician that she could work with and be comfortable calling. That time,

my husband felt that I was being too sensitive, but I feel that I am not a gas

station that people can change on a whim. He also reminded me that this is a

business and that I shouldn't turn people away. Of course, I believe that

people have a right to choose their doctor. If the parent had never

brought the kids to me in the first place, I wouldn't feel so offended.

But somehow, I feel that maybe they for some reason have less trust in me for

some reason and if trust is an issue, then everytime the parent comes in, I

will wonder if they believe in what I am doing for them.

I did notice that a similar situation happened with

my own kids. I took my 3 year old for a dental check up and there were

all these problems and cavities, so they referred us to a pediatric dentist,

who was very kind and did all the work and put on sealants for free on all her

teeth. My husband and I and our 6 year old are still going to the other

dentist. I had wondered if the original dentist would feel the same way

that the 3 year old is going to the specialist or if they would be glad,

especially since they had referred us to begin with. I felt guilty not

taking her back for the original cleanings, but felt guilty not taking her back

to the specialist who did not charge for the sealants.

I am rambling. Please feel free to be honest

with your thoughts. Naureen Mohamed

[Guest guest]

Naureen,

I’ve had this happen to me a couple

of times as well. Once, I was evaluating a well child and the head measurement

came out high. I reassured mom that we should follow this over the next couple

of months, but I felt it was normal for him especially since both parents had

large heads. The child was otherwise neurologically normal. The mother cried

all the way home certain her child was going to have something wrong and as

soon as she got home went on the Internet and became convinced he had

hydrocephalus. Sensing something was wrong, I called later that night to just “make

sure we were all on the same page.” Unfortunately, by then, she had

already discussed what was going on with her parents and friends who all felt

taking her child to anyone other than a pediatrician was crazy. Although I had

a relatively long clinical relationship with her and her husband, I became not

good enough for her child and she selected a local pediatric group. They saw

the child, ordered a huge number of tests (including a CT of the head with

sedation) to arrive at the conclusion he was completely healthy.

When I got the request for the medical

records to be transferred, I felt shocked and hurt, but I realize that parents

make all kinds of decisions based on what they feel is right for their child

(after all, look at the huge number of people who don’t immunize). If

what she needed was her child’s developing head to be irradiated so she

could know with 100% certainty that nothing was wrong, and she would only

accept this from a pediatrician due to a perception from her family and friends

that they give better care, then I just can’t help her. Of note, both the

mother and the father of the baby still see me and I inquire regularly how the

child is doing. They long for the easy access, high efficiency and continuity

of my office, but they remain content with their decision, and I realize I am now

pretty content with their decision as well.

Changing of doctors from fm to peds

Just a question to the family docs ( or any others, I

would appreciate the perspective) out there. Today something happened the

second time. Parents who come to me as patients and who have been

bringing their children to me as patients decide to take the child to a

pediatrician, but still want to come here themselves. I don't know why, but I

feel annoyed by this. In particular, today was a child who I wanted

evaluated for epilepsy, the father declined 6 months ago, and now, finally,

with my help and hard work, it has been firmly established by neurology

consultation. I also dxed beta thal trait and explained it to them

fully. I have been there for them, seeing them same day (as is my

policy), sometimes, same hour. I am human and I feel hurt by

this. Is this normal? Did this happen to you? How would you handle

it if the parent still wants to come?

The first time happened 2 years ago. The child

had a bedwetting problem and they changed doctors (to a pediatrician). They

didn't even give me a chance to evaluate it or discuss it with them. The

mother still wanted to come, however. But while pregnant, and over the

december holidays, she became very ill and didn't call me for 2 weeks.

She said she felt uncomfortable calling the cell phone as indicated on the

message. (and I do explain to every new patient how I do things and what

to do in an emergency or urgent situation) So, I told her that if she

wasn't comfortable calling when she really needed me, and she couldn't even

leave a message, ( I would have called her the same or next day) that this

practice was not right for her and that she should probably find a new

physician that she could work with and be comfortable calling. That time,

my husband felt that I was being too sensitive, but I feel that I am not a gas

station that people can change on a whim. He also reminded me that this is a

business and that I shouldn't turn people away. Of course, I believe that

people have a right to choose their doctor. If the parent had never

brought the kids to me in the first place, I wouldn't feel so offended.

But somehow, I feel that maybe they for some reason have less trust in me for

some reason and if trust is an issue, then everytime the parent comes in, I

will wonder if they believe in what I am doing for them.

I did notice that a similar situation happened with

my own kids. I took my 3 year old for a dental check up and there were

all these problems and cavities, so they referred us to a pediatric dentist,

who was very kind and did all the work and put on sealants for free on all her

teeth. My husband and I and our 6 year old are still going to the other

dentist. I had wondered if the original dentist would feel the same way

that the 3 year old is going to the specialist or if they would be glad,

especially since they had referred us to begin with. I felt guilty not

taking her back for the original cleanings, but felt guilty not taking her back

to the specialist who did not charge for the sealants.

I am rambling. Please feel free to be honest

with your thoughts. Naureen Mohamed

[Guest guest]

Naureen,

I’ve had this happen to me a couple

of times as well. Once, I was evaluating a well child and the head measurement

came out high. I reassured mom that we should follow this over the next couple

of months, but I felt it was normal for him especially since both parents had

large heads. The child was otherwise neurologically normal. The mother cried

all the way home certain her child was going to have something wrong and as

soon as she got home went on the Internet and became convinced he had

hydrocephalus. Sensing something was wrong, I called later that night to just “make

sure we were all on the same page.” Unfortunately, by then, she had

already discussed what was going on with her parents and friends who all felt

taking her child to anyone other than a pediatrician was crazy. Although I had

a relatively long clinical relationship with her and her husband, I became not

good enough for her child and she selected a local pediatric group. They saw

the child, ordered a huge number of tests (including a CT of the head with

sedation) to arrive at the conclusion he was completely healthy.

When I got the request for the medical

records to be transferred, I felt shocked and hurt, but I realize that parents

make all kinds of decisions based on what they feel is right for their child

(after all, look at the huge number of people who don’t immunize). If

what she needed was her child’s developing head to be irradiated so she

could know with 100% certainty that nothing was wrong, and she would only

accept this from a pediatrician due to a perception from her family and friends

that they give better care, then I just can’t help her. Of note, both the

mother and the father of the baby still see me and I inquire regularly how the

child is doing. They long for the easy access, high efficiency and continuity

of my office, but they remain content with their decision, and I realize I am now

pretty content with their decision as well.

Changing of doctors from fm to peds

Just a question to the family docs ( or any others, I

would appreciate the perspective) out there. Today something happened the

second time. Parents who come to me as patients and who have been

bringing their children to me as patients decide to take the child to a

pediatrician, but still want to come here themselves. I don't know why, but I

feel annoyed by this. In particular, today was a child who I wanted

evaluated for epilepsy, the father declined 6 months ago, and now, finally,

with my help and hard work, it has been firmly established by neurology

consultation. I also dxed beta thal trait and explained it to them

fully. I have been there for them, seeing them same day (as is my

policy), sometimes, same hour. I am human and I feel hurt by

this. Is this normal? Did this happen to you? How would you handle

it if the parent still wants to come?

The first time happened 2 years ago. The child

had a bedwetting problem and they changed doctors (to a pediatrician). They

didn't even give me a chance to evaluate it or discuss it with them. The

mother still wanted to come, however. But while pregnant, and over the

december holidays, she became very ill and didn't call me for 2 weeks.

She said she felt uncomfortable calling the cell phone as indicated on the

message. (and I do explain to every new patient how I do things and what

to do in an emergency or urgent situation) So, I told her that if she

wasn't comfortable calling when she really needed me, and she couldn't even

leave a message, ( I would have called her the same or next day) that this

practice was not right for her and that she should probably find a new

physician that she could work with and be comfortable calling. That time,

my husband felt that I was being too sensitive, but I feel that I am not a gas

station that people can change on a whim. He also reminded me that this is a

business and that I shouldn't turn people away. Of course, I believe that

people have a right to choose their doctor. If the parent had never

brought the kids to me in the first place, I wouldn't feel so offended.

But somehow, I feel that maybe they for some reason have less trust in me for

some reason and if trust is an issue, then everytime the parent comes in, I

will wonder if they believe in what I am doing for them.

I did notice that a similar situation happened with

my own kids. I took my 3 year old for a dental check up and there were

all these problems and cavities, so they referred us to a pediatric dentist,

who was very kind and did all the work and put on sealants for free on all her

teeth. My husband and I and our 6 year old are still going to the other

dentist. I had wondered if the original dentist would feel the same way

that the 3 year old is going to the specialist or if they would be glad,

especially since they had referred us to begin with. I felt guilty not

taking her back for the original cleanings, but felt guilty not taking her back

to the specialist who did not charge for the sealants.

I am rambling. Please feel free to be honest

with your thoughts. Naureen Mohamed

[Guest guest]

I used to have this happen when I was delivering babies. The patient would be very happy seeing me and suddenly switch to an ob because their mother talked them into it. It still happens on rare occasions with peds patients because I don't admit to the local peds hospital. It takes a while for people to realize that FP'S do pediatrics. I like pediatrics and have made it very obvious that we like kids with a very obvious peds table. , childrens books and toys and when I do my new patient intake I ask if they have kids. If they do I let them know that we would be happy to see them. If they say that they already they a pediatrician I suggest that if the kids are ever sick and can't get in to see their regular pediatrician, I would be happy to see them on an emergency basis and send a report to their regular pediatrician. Usually after a few visits with me they switch their kids over to me. I also have age specific handouts that parents get at every well visit. I think that if you can convince not only your patients but the community in general that you can give better care than your average pediatrician that Your peds practice will grow rapidly.Larry Lindeman MDJust a question to the family docs ( or any others, I would appreciate the perspective) out there.  Today something happened the second time.  Parents who come to me as patients and who have been bringing their children to me as patients decide to take the child to a pediatrician, but still want to come here themselves. I don't know why, but I feel annoyed by this.  In particular, today was a child who I wanted evaluated for epilepsy, the father declined 6 months ago, and now, finally, with my help and hard work, it has been firmly established by neurology consultation.  I also dxed beta thal trait and explained it to them fully.  I have been there for them, seeing them same day (as is my policy), sometimes, same hour.   I am human and I feel hurt by this.  Is this normal? Did this happen to you?  How would you handle it if the parent still wants to come?The first time happened 2 years ago.  The child had a bedwetting problem and they changed doctors (to a pediatrician).  They didn't even give me a chance to evaluate it or discuss it with them.  The mother still wanted to come, however.  But while pregnant, and over the december holidays, she became very ill and didn't call me for 2 weeks.  She said she felt uncomfortable calling the cell phone as indicated on the message.  (and I do explain to every new patient how I do things and what to do in an emergency or urgent situation)  So, I told her that if she wasn't comfortable calling when she really needed me, and she couldn't even leave a message, ( I would have called her the same or next day) that this practice was not right for her and that she should probably find a new physician that she could work with and be comfortable calling.  That time, my husband felt that I was being too sensitive, but I feel that ! I am not a gas station that people can change on a whim. He also reminded me that this is a business and that I shouldn't turn people away. Of course, I believe that people have a right to choose their doctor.  If the parent had never brought the kids to me in the first place, I wouldn't feel so offended.  But somehow, I feel that maybe they for some reason have less trust in me for some reason and if trust is an issue, then everytime the parent comes in, I will wonder if they believe in what I am doing for them.I did notice that a similar situation happened with my own kids.  I took my 3 year old for a dental check up and there were all these problems and cavities, so they referred us to a pediatric dentist, who was very kind and did all the work and put on sealants for free on all her teeth.  My husband and I and our 6 year old are still going to the other dentist.  I had wondered if the original dentist would feel the same way that the 3 year old is going to the specialist or if they would be glad, especially since they had referred us to begin with.  I felt guilty not taking her back for the original cleanings, but felt guilty not taking her back to the specialist who did not charge for the sealants.I am rambling.  Please feel free to be honest with your thoughts.  Naureen Mohamed

[Guest guest]

I used to have this happen when I was delivering babies. The patient would be very happy seeing me and suddenly switch to an ob because their mother talked them into it. It still happens on rare occasions with peds patients because I don't admit to the local peds hospital. It takes a while for people to realize that FP'S do pediatrics. I like pediatrics and have made it very obvious that we like kids with a very obvious peds table. , childrens books and toys and when I do my new patient intake I ask if they have kids. If they do I let them know that we would be happy to see them. If they say that they already they a pediatrician I suggest that if the kids are ever sick and can't get in to see their regular pediatrician, I would be happy to see them on an emergency basis and send a report to their regular pediatrician. Usually after a few visits with me they switch their kids over to me. I also have age specific handouts that parents get at every well visit. I think that if you can convince not only your patients but the community in general that you can give better care than your average pediatrician that Your peds practice will grow rapidly.Larry Lindeman MDJust a question to the family docs ( or any others, I would appreciate the perspective) out there.  Today something happened the second time.  Parents who come to me as patients and who have been bringing their children to me as patients decide to take the child to a pediatrician, but still want to come here themselves. I don't know why, but I feel annoyed by this.  In particular, today was a child who I wanted evaluated for epilepsy, the father declined 6 months ago, and now, finally, with my help and hard work, it has been firmly established by neurology consultation.  I also dxed beta thal trait and explained it to them fully.  I have been there for them, seeing them same day (as is my policy), sometimes, same hour.   I am human and I feel hurt by this.  Is this normal? Did this happen to you?  How would you handle it if the parent still wants to come?The first time happened 2 years ago.  The child had a bedwetting problem and they changed doctors (to a pediatrician).  They didn't even give me a chance to evaluate it or discuss it with them.  The mother still wanted to come, however.  But while pregnant, and over the december holidays, she became very ill and didn't call me for 2 weeks.  She said she felt uncomfortable calling the cell phone as indicated on the message.  (and I do explain to every new patient how I do things and what to do in an emergency or urgent situation)  So, I told her that if she wasn't comfortable calling when she really needed me, and she couldn't even leave a message, ( I would have called her the same or next day) that this practice was not right for her and that she should probably find a new physician that she could work with and be comfortable calling.  That time, my husband felt that I was being too sensitive, but I feel that ! I am not a gas station that people can change on a whim. He also reminded me that this is a business and that I shouldn't turn people away. Of course, I believe that people have a right to choose their doctor.  If the parent had never brought the kids to me in the first place, I wouldn't feel so offended.  But somehow, I feel that maybe they for some reason have less trust in me for some reason and if trust is an issue, then everytime the parent comes in, I will wonder if they believe in what I am doing for them.I did notice that a similar situation happened with my own kids.  I took my 3 year old for a dental check up and there were all these problems and cavities, so they referred us to a pediatric dentist, who was very kind and did all the work and put on sealants for free on all her teeth.  My husband and I and our 6 year old are still going to the other dentist.  I had wondered if the original dentist would feel the same way that the 3 year old is going to the specialist or if they would be glad, especially since they had referred us to begin with.  I felt guilty not taking her back for the original cleanings, but felt guilty not taking her back to the specialist who did not charge for the sealants.I am rambling.  Please feel free to be honest with your thoughts.  Naureen Mohamed

[Guest guest]

It could be that your successful relationships with the majority of your other patients makes things like this stand out. I think if you practice long enough almost anything can happen a couple times.Mike Barron, MD St. Louis University Family Medicine Residency Program 180 South 3rd Street, Suite 300 Belleville, IL 62220