Phone Calls and Communication
There have been lively conversations this week in several of my support groups about telephone communications with doctors. Some of the talk has focused on hearing bad news (see 6/7 blog) and some has been more general. All of us feel that it is very important that we can easily reach our doctors and that they will return our phone calls in a reasonable length of time.
One immediate problem is the definition of "reasonable length of time." When we are worried about our health, that means we need an answer within the next half an hour. For our busy doctors, that may well mean within a day or two. Clearly, we need an understanding and a system for triaging our questions, recognizing when we really do need a quick response and when we can wait a few days for a call. Virtually all doctors' offices or answering services automatically say something about what to do in an emergency situation. We, too, know when the right response is to call 911 or just head for the nearest Emergency Room. Fortunately, that is the rare situation, and generally we have a less urgent problem.
Talking with your doctor about how to reach her and what to anticipate about a response should be part of the very first appointment. I have known some women who chose their medical team based on answers to this question. Here are the important questions:
1. What is the best way to reach you when I have a problem or a question?
2. Is someone available/on-call 24/7 to take my call? (At BIDMC, we have Oncology Fellows on-call 24/7 and midnight phone calls will go to one of them. They call back immediately.)
3. When I know that my question is not urgent, would you prefer that I call your NP, Physicians's Assistant, or my chemotherapy nurse? Or would you prefer that the first call always go to you, and you can then pass it along if more appropriate.
4. May I email you?
If your doctor does not give you straight answers to these questions, that is a red flag. It is vital, both for your safety and your peace of mind, that you can reach her easily and quickly. There is great variance in how busy physicians manage patient calls. Some give all their patients their cell phone number and, occasionally, their home phone number. Others rely completely on an answering service. As long as you can be assured of a speedy response, the system does not much matter. What does matter is that you are clear on the rules, the expectations, and can trust that your calls will be answered in a reasonable period of time.