TELEMEDS

First posted August 31, 2013, this article, like everything else, has changed radically since the onset of COVID.  (My current mindset can be found between the parenthesis.)

Would you hire a painter and ask him to paint your house blindfolded?  Would you call your auto mechanic and ask him to repair your car over the phone?  Would you ask your attorney to draw up your will without sitting down with him and discussing your needs?  Of course not! (However, you might ask a doctor to treat you over the phone.)

So, why would you call your doc and ask him/her to treat your body over the phone?  There are reasons:

  • “I’m too busy.”
  • “I’m too sick.”
  • “I don’t have the money.”
  • “The wait’s too long.” 
  • (“I’m afraid to be around other people who might give me Covid.)

These are among my favorites!

“But, doc, it’s just a cold!  I don’t have time to come in.  The last time you gave me the Z-pack.  I promise I’ll come in if I don’t get better.”

Mr. C’s cold turned out to be heart failure.  Yes, Mr. C has a cough and congestion.  He also had swollen legs, a cough that worsened when he laid down and an EKG that suggested that Mr. C had suffered a recent heart attack.  Caring for Mr. C over the phone may well have been a fatal mistake. 

Mr. C was too busy to come in.  He had lots to do around the house and was having trouble finding time to do it all.  He also was not very productive as he was short of breath and weak. His heart was having trouble supporting any physical activity.

Mr. C was too sick to come in.  He didn’t know how right he was!  When you are too sick to be seen, you really need to be seen.  If you are too sick to come in, it may be time to call the paramedics.  

Mr. C didn’t have the money to pay his co-pay.  Mr. C drinks a lot.  His congestive heart failure is the result of too much alcohol.  At the price of a fifth a day, it’s no wonder he can’t afford to see the doc.

And yes, the wait is too long.  Mr. C called the office to get his Z-pack.  The front desk had to answer that call and take a message.  The message had to be routed to a nurse who then called Mr. C to tell him to come in.  The front desk had already told him to come in and he had ignored them, asking to talk to the doc.  Mr. C ignored the nurse’s advice, telling her he was sure that “Stu” would take care of him. For some reason, patients think calling me “Stu” infers that they are my personal friend.   My friends don’t call me “Stu.”

Ultimately, I had to call Mr. C.  By the time I called Mr. C, it was too late for him to be seen.  I told him to go to the emergency room.  He ignored me and showed up the next day.  Shortly after being seen, the paramedics picked up Mr. C.  His wait time was short.  Everyone else’s wait time was excessive.

Not only is phone medicine potentially harmful, (Still true, but practicing medicine can be harmful) it is very time consuming.  With the bad economy, patients are trying to avoid coming in to be seen in ever increasing numbers.  Patients are putting off rechecks and instead asking for refills over the phone.  Today, I had 40 refill requests and 20 phone requests for care (I’m sure it’s the same or worst today).  Some of those patients desperately needed to be seen.  

So, what’s a doc to do?  My practice is designed so that my patients can come in when it fits their schedules.  Yes, some days the wait may be an hour or more, but your needs will be attended to.  I see patients six days a week.  In return, I try hard not to treat my patients over the phone.  When my front desk tells you to come in, please don’t ignore them.  When my nurses tell you to come in, you can be sure you need to. (My front desk exists only in my dreams.  I hated making sick people wait, but I would rather they wait than having to cut patient’s visits short.)

Your doctor needs your help. Work together to provide the best care possible.

Here’s your music and a joke.

Having sex in an elevator is wrong, on so many levels.

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