<p>Whatever happened to prefacing bad news with something along the lines of “Are you sitting down?” DMD77 that is one of the most insensitive things imaginable.</p>
<p>Its kinda hard for the Dr to know if the number they are calling is a cell or a land line, and many people don’e even have landlines any more, so the cell is the only way to reach a person. Certainly the person making the call has no idea where the recipient of the call is (I called a friend to remind her of an upcoming meeting and apparently she was in Canada at the time on vacation!!) Commonly Drs are making calls all at one time, often at the end of the work day, and it may not be practical to call back a patient at another time. Maybe if one is driving they can let their phone go to voicemail, and the message will be in the voicemail. Its still not news one wants to hear in voicemail, but there is no great way to hear/get bad news.</p>
<p>Thanks for your post, Jordansmom.</p>
<p>When I received the phone call to come into to office and suggested that I bring my husband I knew the results were not good. I only had to wait till the next day, but that was a very long day.</p>
<p>We have some doctor’s in our practice, not all, that will write N/C on the bill, no copay, because for some, it’s very expensive to keep coming back. 45.00 and then 45.00 plus anything their insurance might not cover. And for others, the visit is hard, some have a very hard time getting time off from work, repetitive visits cause problems.
We had one gentleman come on a busy day, doc was behind, waited an hour in waiting room, 15 minutes in exam room, to be told, “It’s fine, your MRI, just need time”. He was very angry and I understand that…some things need to be changed, but I can see all sides depending on the issue.</p>
<p>Doctors may not appreciate that the cost of the visit is not the only issue. Getting time off from work – often, without pay and at the cost of antagonizing your supervisor – can also be a major issue for some people.</p>
<p>Doctors will be hearing a lot more about this. Patients will object more to going for visits to learn that they are fine or need to be monitored twice per year. As copayments do increase, middle income and lower income patients are going minimize visits with specialists more than they used to do. The rich will continue to pay and have as much access to specialists as they like, whether it is or isn’t necessary.</p>
<p>Jym, you’re right about the cell phone, but I think what I was reacting to was the immediate announcement of a cancer diagnosis with no preamble. It doesn’t take much time for someone to say something like “I have some difficult news.” Even a sentence or two gives a person a slight moment to prepare. This poster went in for an MRI thinking there was a torn meniscus which is different than already knowing you had a biopsy and that it might be cancer. It just seems like a pretty shocking way of delivering the news.</p>
<p>i second jordansmom’s comments… often patients will start to discuss a brand new problem on the phone, or something they forgot at the visit…and the so called quick call for results turns into a full visit …ordering more tests, calling pharmacy with new meds etc. also when the charts are pulled for phone messages, oftentimes there is no answer when you call, so then they are called again, and again, until you reach them…vs an appointment is booked for followup for results…the results are gone over, time for questions, additional info, treatment options, making sure you have discussed pros and cons of treatment. Sorry that there are copays, but doctors didnt come up with that plan, insurance companies did… if it was an attorney he would be charging you for every minute on the phone, doctors in general do not.</p>
<p>People with flat copays are more fortunate than when they have to pay a coinsurance. A $10-20 copay is more palatable than a 25 or 30% coinsurance on a, say, $350 service. Yet they don’t want to pay it? Seems to be a small price to pay, and as parent56 said, thats how insurance is set up, whether its insurance on a person or a car or an appliance. And very often what parent56 said above is exactly what happens. Patients have more questions or issues they want addressed, and a 2 minute call becomes a 20 minute call. Multiply that by say 20 patients a day whose labs have come in or whose calls need to be returned, and thats a lot of time (unreimbursed and time away from work or family) on the phone. Any why would anyone think that doctors don’t understand that a person has to take time off for an appointment. Doctors are human, and have to do the same thing when they make an appointment. People want to minimize inconvenience. Understood. If you have to take your car in , sure its easier to take it in early or late or even on a weekend, but the people that work these shifts are not working every day during normal business hours as well, like many doctors are. So the patient doesn’t want to be inconvenienced, but its ok to expect the doctor to be. Really?</p>
<p>Ugh, I’m just reminded of this horrible experience. My father had a biospy for cancer. The doctor that did the test calls ME long distance, 4000 miles away, to tell me! Granted, we had already been in touch a lot over my dad’s care but he calls me instead of my dad. And was so matter of fact about it, almost like he was describing the weather. And all of this meant I was the one that ended up having to tell my dad he was terminally ill. </p>
<p>But I remember thinking at the time “there is some kind of mistake, obviously I must have heard him wrong, since a doctor would not tell someone they have a terminal illness over the phone, and would not be so cavalier about it, and they certainly wouldn’t call a relative to tell them first.” For some reason, I thought the way they did it was to call you into the office and talk to you face to face about the prognosis and answer a million questions. </p>
<p>I can only guess that this guy just couldn’t adequately deal with the worst part of being a doctor.</p>
<p>A friend’s doctor dictates a short note that she can then access with a code. Seems to be a good compromise–doctors don’t get stuck on the phone for a long time just to deliver a quick message, and patients don’t have to come in to the office if the news is good and does not require a follow-up visit.</p>
<p>Earlier this year I had an ER visit which required follow up testing a month or so later; at the imaging lab they said I would hear within about 48 hours if there was anything significant; no phone call, I assumed no problem. Fast forward 3 weeks and I had a regular screening mammogram and a few days later got a 5pm VM right before a holiday weekend from the GYN nurse that I needed to come in to go over test results. You can imagine where my mind went and then I deliberately decided NOT to get upset until I had proof as to what I should be worried about. </p>
<p>I was able to call back and get an appointment set up for the next week, but no results given.</p>
<p>I was able to contact the imaging site and get my results faxed to me and self-refer to a surgeon in the big city for the prior issue, not the mammogram; I was still at an oncology office, but it was for different stuff and involved an entirely different set of questions. Simply having the weekend to do research so I could know what to ask would have been helpful.</p>
<p>By the time I went to my local gyn for the results, I was already scheduled with the surgeon for an initial consult. When I had my prior ER visit and follow up we had discussed the fact that I would need to go to the guru surgeon if the issue did not resolve. By waiting 3 weeks to contact me after the abnormal tests and then another week to schedule the appt, I ended up with a much less convenient surgery date and an extra $1600 out of pocket as my deductible rose before I could do the surgery.</p>
<p>Sheesh, we had discussed this, so call me in 48 hours and tell me to run to the surgeon, don’t wait a month and then tell me to come in and discuss it and then suggest the surgeon. Plus I had to take a morning off of work, drive 40 minutes to the doctor & back all for something I had been able to deal with on my own prior to the appt.</p>
<p>BTW, I learned it was my fault, too; I wanted the test to be normal so I did not call 24 hours later and ask for a copy faxed to me. I have been learning the medical system as nothing has really happened medically since my kids were born.</p>