What's the protocol when it comes to speaking to your doctor by phone?
May 28, 2015 4:27 AM   Subscribe

I feel generally disempowered when I'm around doctors so i need help knowing what's expected and appropriate.

I had a spine procedure with a doctor about 7 weeks ago. I went for a two-week follow up at which point everything looked good. He told me to call him in a month, just so he could hear how things were continuing to go. He gave me his direct line.

I left him a message yesterday telling him that I was a little distressed because I was suddenly feeling slightly worse. I asked him to call me but he didn't. This is not standard, right? It's not out of line to ask him to call me -- as opposed to going in for visit, is it? One main issue for me is that it's costing me a ton to see this doctor because he's out of my network, so I'm paying out of pocket. I will go see him if I have to, but is a phone call like this appropriate and normal? I'd like to hear from anyone, and doctors would be especially good. Thanks.
posted by swheatie to Health & Fitness (11 answers total) 1 user marked this as a favorite
Expecting a return call isn't out of line especially since he told you to call, and if he feels that you'll just need to come in he can just have his office call you to schedule an appointment.

It is standard, though, for him not to have called back yet since you only left the message yesterday! You don't know whether he was working there yesterday, presumably, let alone how busy he was. If it's urgent or if you don't hear back in a few days, I would call the office and leave him a message there instead--it's possible that only he's responsible for checking messages on his direct line, whereas a receptionist will bug him about messages left with the office until they get addressed.
posted by cogitron at 4:37 AM on May 28, 2015 [3 favorites]

I agree, I would call the office today and ask if there is a nurse you can talk to right away. And when you should expect to hear from him.
posted by grouse at 5:21 AM on May 28, 2015

It's not out of line to ask him to call me -- as opposed to going in for visit, is it?

Absolutely not. You did the right thing.

I'd call his office right now. Usually when the office is closed, there's a third-party answering service that makes sure doctors get messages. Sometimes it's the on-call doctor that gets back in touch, but it shouldn't take days.

If that doesn't work, call his direct line again. Especially if you were calling from a mobile phone, it's entirely possible some part of your message got mangled, so be sure to leave your number twice.

One other thing. Does your phone block unknown or blocked-ID calls? Most doctors calling from private or personal lines keep their numbers blocked.
posted by whoiam at 5:53 AM on May 28, 2015

Response by poster: When this doc sent me for an MRI in March, he told me to call him (on his direct line) as soon as I'd had it done. He then called me that same day to tell me the results. So in that case he got the message and returned the call very quickly. I have the sense the direct line is the best way to reach him and that he checks it often. Which is why I was left wondering if THIS request was somehow different and inappropriate. In my message I was basically saying I was worried that my symptoms might indicate X, and I wanted to hear what he thought. And I'm just unclear about how much conversation doctors are willing to engage in without your coming in for a visit.
posted by swheatie at 6:08 AM on May 28, 2015

It's not unusual for doctors to have some days per week where they're in scheduled surgeries all day, not to mention sick or on vacation. If it's not an appropriate conversation for the phone, for example if he needs to see you in person to diagnose, he'll call back and ask you to make an appointment. If you don't hear today, I'd call the office, just in case he did just leave for his annual 3-week trip to Antarctica and has another doctor on call there. The office folks will know.
posted by tchemgrrl at 6:15 AM on May 28, 2015 [3 favorites]

It's not inappropriate; he gave you the number to call. Doctors are busy, and while I am sure he cares about your case they have many patients all of whom demand attention. Speaking from experience, any number of things could have caused him to not call you back. Maybe he had a conference call that afternoon. Maybe he heard the message, decided to check your chart for some detail before calling back, then had his assistant walk in and distract him long enough that it slipped his mind. Maybe he had 3 walk-ins and the PA called out sick. Maybe he had to spend another half hour on the phone haranguing the supply office about getting non-fabric chairs for the exam rooms so he doesn't get penalized on his upcoming JCAHO inspection for having unhygienic upholstery (this is a real thing).

If he doesn't call back in a day or two call again, or follow grouse's good advice to just call the clinic again and ask to speak to a nurse.
posted by Wretch729 at 7:13 AM on May 28, 2015 [1 favorite]

I was a little distressed because I was suddenly feeling slightly worse.

I would stick with calls to the official office. But also - you indicated that you were feeling "slightly" worse - which kind of downplays the need for a quick response. Not your fault: doc should call you back. Just a little communication ninja skill for prompting a response. If recovery will look like a few minor ups and downs, your call might make you look like someone who is recovering normally.
posted by vitabellosi at 7:14 AM on May 28, 2015

There's a wide range of what's normal on this. I've seen providers give out personal pagers to clients, and others who want everything sifted through the front office (and won't even return my calls as a nurse case manager).

Since this doctor gave you his number and asked you to call it, I say, take him at his word and do so.

I'd call back and ask again, being specific about the ways in which you feel worse (name specific measurable symptoms, subjective and objective, "I have a low fever of 99.1 F, and I feel a little nauseous for the first time since the surgery" or "My pain has suddenly increased. It's still manageable but I hadn't felt this way since the day after the surgery.")

Of course if you get dramatically worse (fever, marked increase in your pain, bleeding where you weren't or in more volume) talk to a nurse right away or of course there's the ER if it's severe.
posted by latkes at 7:41 AM on May 28, 2015

As a PA who often has several calls a day from patients I can tell you a couple of things.

1. If it is urgent do not call his direct line. Call his office so they can triage your call and, if it really is an urgent medical issue, get him (or covering practitioner) the message quickly.
2. If it is not urgent then do not expect to necessarily receive a call back the same day. Most medical doctors/PA/NP are not necessarily given time during the day to make calls. We do it between patients or at lunch or after the rest of the office has gone or from our homes. Why? Because most of the time we don't get reimbursed for calls and in order to keep ourselves and staff employed we must see patients. So we see patients during office hours and fit everything else in where we can. It sucks. We don't like it either.
3. Most practitioners will try to conduct patient care at the convenience of their patients when possible. If a phone call will suffice then we try to do that. But sometimes we talk to a patient on the phone and realize that we may need to do a physical exam or that it is something that is going to take 20-30 minutes of time to address. So it is not uncommon for patients to be asked to come back in for a visit in these circumstances.
posted by teamnap at 7:42 AM on May 28, 2015 [6 favorites]

In my practice (ortho surgeon), in general if I need to hear back from patients I have them call my nurse--she is more reliably reachable and an excellent judge of when someone needs to talk to me specifically or needs to come in. If he gave you his direct line & asked you to call, it is *absolutely* fine for you to do so & ask to speak to him if you're concerned; I agree with those saying it might take some time, though, for him to get the message (esp if he was operating late), think about what you said, and find time to call you back. I suspect doctors vary a lot in terms of how much we'll do on the phone rather than coming in (probably affected by experience and risk tolerance in general).

One thing, though--I believe that office follow-up visits up to 90 days after surgery are included in the cost of the surgery, so likely you shouldn't have pay an additional cost. If you call his office you could probably clarify that before you go in?
posted by n. moon at 9:37 AM on May 28, 2015 [3 favorites]

Response by poster: Thanks, everyone. I left another message this afternoon and now I'll sit tight and hope he's not in Antarctica. If I don't hear from him by Monday, I'll follow up with his assistant. It's a big hospital-based spine center.
posted by swheatie at 2:27 PM on May 28, 2015

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