Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

How To Drive Your Doctor Crazy

In an effort to provide round-the-clock emergency care for their patients, physicians often share an on call schedule.  The physician on call makes him or herself available for emergency consultation for 24 hours or more at a time.  Unfortunately, patients seem to misunderstand the role of the on call physician – believing that being on call is a form of extended office hours for their convenience.  Here’s one doctor’s account of the non-emergency services he provides on-call, and the attitudes that drive him crazy:

One of my biggest challenges is
understanding why patients consider an emergency as anything that they
don’t want to wait until Monday, or even daylight. They want lab
reports. They want advice on whether to get a flu shot. They want to
know what that green cough medicine was their doctor recommended 3
years ago. They want their medicines— that they only seem to know by
color—refilled. And, of course, they are not satisfied with a few pills
to get them through the weekend. They’re not going to pay a “full”
copay for less than a “full” prescription.

A related challenge is that, when I call a phone
number after being paged, the person answering the phone is almost
never the person who paged me. Sometimes it is a teen who answers the
phone with a “Yeah” or a “What?” That there is an important call
expected and that there is an emergency going on in the house is beyond
them. Eventually, I persuade them to find the sick person, and from the
amount of time they are gone, the house must be a mansion.

Sometimes a man answers the phone, and says, “Here,
I’ll let you talk to my wife.” Funny, he’s the one with the problem,
but he somehow cannot talk. I imagine him sitting in the background
like a king who cannot be expected to do his own talking, while his
servant/wife explains his symptoms. Sometimes, if the person having the
emergency is a teen, I have to talk to the mother, because the teen
won’t come to the phone (an interesting twist). The teen won’t tell Mom
exactly what the problem is either, so I have to ask the mother my
questions, then she yells them down the hall, listens for the answer,
then relays the answer to me. Example: “My daughter Susie has a cough.”
“Does she have a fever?” “SUSIE, DO YOU HAVE A FEVER?” “NO.” “No,” “Is
she bringing up any sputum?” “SUSIE, ARE YOU BRINGING UP ANY SPUTUM?”
“YES.” “Yes.” Well, I don’t need to go on, but it can, interminably.

Sometimes the person having the problem is not
available at the number when I call. “Hello, this is Dr. Constan.”
“Hello, this is Mrs. Smith, I’m calling about my mother, Mrs. Jones,
and she wants to know what to do about her abdominal pain.” “Could you
please put her on the line so that I can talk to her?”

“She’s not here, she went shopping.”


Sometimes the person doesn’t answer, at all. I’ve
called back promptly, yet “there’s no one home.” What gives? They call
back later to fill me in on what happened at the ER, like I need to
know. They had called me then decided it wasn’t necessary to talk to
me, they wanted to go to the ER anyway. Then, why did you call?
Sometimes when I call back, I get a busy signal. How does that happen?
You page a doctor then tie up the line so I can’t call back! I imagine
that you figure you should first seek advice from the doctor then seek
advice from all your friends and relatives, whomever you can get on the
line. Later you say to yourself, “I wonder why that darned doctor never
called me back.”

The advent of Caller ID has produced its own set of
challenges. The person pages me, leaves their number, but when I call
them, they won’t answer the phone because they don’t recognize the
number displayed by the Caller ID. I imagine them standing by the
phone, staring at the number, and reasoning: “Now, I’m having a serious
emergency here, but I don’t want to take the chance of answering this
call and having to talk to a telemarketer. What do I do? Best not take
the chance.” Later: “I wonder why that darned doctor never called me

If I talk to an answering machine, I usually offer
that the patient can call me back later if they still need help. One
lady called me back and told me that she was home when I called, heard
me leaving the message on her machine, but couldn’t come to the phone
because she was doing her vacuuming. How has outrageous fortune
relegated my services below those of a vacuum cleaner?

Although all the above challenges tend to wear on me
toward the end of the weekend, I try to be professional and caring
about each call (just ask my family). It’s my job to stay the course
with no laurel wreath expected on Monday morning. It was a surprise and
joy to me recently when, at a party, I was introduced to a nice young
couple. “You’re Dr. Constan! We called you 2 years ago about our sick
child. You were so helpful. We’ve always appreciated what you did for
us.” The challenge of weekend call should have more such awards.

For a complete version of this article, please visit www.PMDLive.comThis post originally appeared on Dr. Val’s blog at

You may also like these posts

Read comments »

Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »