Changing Times in your Doctor’s Office.
This week my friend Brett Newcomb and I are talking about changes in the way doctor’s offices work. When I first went into practice thirty years ago, I used to get calls at home at all hours of the night and on weekends. Sometimes these calls were for me, for the things I was treating patients for, and sometimes they were for things the other doctors a woman saw were supposed to treat. When I asked why they called me for those things, I was told “I did not want to wake him up!, so I called you”. My patients never thought about how that sentence would make me feel!
Anyway I no longer get those calls because my practice has changed. It has changed both in the focus of my medical work, but it has also changed in ways that many if not most other medical offices have changed. Let me tell you about some of those changes.
Most doctors who are private practitioners do not see their patients if the patient goes to the hospital or to the emergency room. Now there are specialists called hospitalists who see you in the hospital and then send you back to your personal physician when you get out. Doctors used to maintain an exchange for “call”. After regular office hours if a patient needed some information, a prescription, or directions about what to do, they would call their doctors office and their call would be routed to an exchange where a physician who was taking call for the office would take the call help the patient and then forward that information to the regular doctor.
Medical offices are doing this less and less today. There are several reasons for this change. Some are driven by liability issues, some are driven by the expectation that a patient will just go to the emergency room for an emergency rather than call a doctor and say, “My son cut himself and is bleeding, what should we do?”Now most offices are using recorders which take messages. If you call during the day, you get the phone tree that says if you want to schedule an appointment, press 1, if you need a prescription refill, press 2, if you…….. ect. Etc., This makes the process so much more efficient for the patient and the physician, although it does frustrate some patients.
If you call at night you will get one of two messages: call back during office hours or if this is a true medical emergency go right to the emergency room.
When you do call during office hours and get your doctor on the phone, do not waste the opportunity. Be prepared and focused. Have information at hand that the doctor or you might need, such as your pharmacy phone number. Remember the doctor may not be looking at your chart. You may need to remind her of things you know, such as the fact that you are allergic to Tylenol or something. While you have them on the phone, do not think you are having a social conversation. Be focused, be quick, be gone. Tell the doctor what you are afraid of, what you are experiencing, what you want. Try to have no more than three focused points to discuss. When the doctor tells you what they want you to do, if you do not understand, ask specifically about what you do not understand. Then, follow the instructions. One of the biggest difficulties that happen is when non compliant patients deteriorate and get worse because they did not follow doctors orders.
There have been many changes in our culture. Our doctors offices have changed as well. Brett and I discuss how you can get the most out of your interaction with your doctor. These ideas are in service of getting the most efficient results and the best help. Please listen and give them your attention. See if it won’t help you be a better consumer of medical help.