We Need To Talk

Will a phone call do?

Physicians have always been reluctant to give healthcare advice by telephone. In the less personal, more litigious state of current doctor-patient relations, phone advice is practically non-existent.

Snail mail is too slow, and hardly any offices utilize e-mail. Thus, an office visit is the only "approved" timely method of transmitting information from doctors to patients.

There is always the nurse, or doctor's assistant, who can be a source of some help, but all too often that person is simply a barrier between the two principals. "Doctor X wants you to make an appointment", or, "Doctor says you are to keep taking the medication even though you're getting sicker."

We've recently witnessed two difficult situations in which the patient and the doctor, for practical purposes, never addressed each other, not by phone or any other method. In one case, it was a long, multiple mammogram study of a questionable breast abnormality (which turned out to be of minor concern). The other involved a patient on vacation in another State whose personal BP monitoring revealed a distinct rise in her numbers.

The reasons for this loss of direct communication are all in the provider's court, and include fear of malpractice litigation, the overworked doctor syndrome, and, perhaps worst of all, a general de-personalization of the relationship.

To be sure, there are offices, likely in smaller communities, where patient requests are answered more personally, often by the physician himself. These doctors are no less busy than their big-city brothers and sisters, and face the same malpractice liabilities, so what's the difference? Is there a big-clinic bureaucracy that lays down rules against being user friendly?

If so, we present here the AzCountryDoc Golden Rules for "Proper Response to Patient Questions":

1. If a regular patient with a non-emergent but worrisome problem calls from another city, the physician WILL answer the phone (or promptly call back if he / she's too busy at the moment).

2. It is acceptable for a doctor's assistant, who may not even be a nurse, to respond ONCE to a request for information, but the SECOND request about the same topic must be handled by the physician.

3. When in doubt, think like patients instead of clinic staff members. Someday, you, too, may be on the other side.

Happy summer solstice to all of you!