How many of you AC friends and family have aggravating patients? Well one of mine called me 3x tonight.
The 1st call was a message from a patient visiting out of state. I'm in Maine and she was visiting in North Carolina.
On my web based answering service, she left a message claimed she had a bladder infection and needed antibiotic called in immediately. If she were a frequent customer of mine, I'd have done it in a second. But in 6 years I've seen her 4 times. So I ignored the call and continued working out at the gym.
Then she called later and I ignored it again, figuring if her bladder infection was a true "emergency," she could find an E.D. somewhere in N.C.
Then she called me a third, so I figured I couldn't refute the call. I was polite and she begged me to call in antibiotics. Keep in mind this was 10:30pm, and I ask "where do you want me to call in at this hour?" She didn't know. Then she asked if I even have reciprocity to prescribe there. I said my license is for the State of Maine. So while many of you will tell me that I can call in Rx's out of state (which I know I can), I didn't want to.
Why ? Bad medical care to treat a bladder infection over the phone especially when she had fever and flank pain (i.e. probably pyelonephritis) and she needs to go to E.D.
You know what she said to that??? "I went to the E.D. at 6pm for an hour and there were people waiting since noon. I'm not waiting there all night long."
I WANTED to reply, "So fine, get an abcess in your kidney or urosepsis because you don't want to wait a few hours to get antibiotics. Instead stay home to SPITE the E.D. and prove a point, then bug me all night long because of your emergency that I can't fix! Then end up getting admitted for 4 days to treat the infection."
I ACTUALLY said, "Please go to the E.D. so that you don't suffer complication like a life threatening infection or abcess and die." She said "I'm no doing that." I said "Then just drink lots of water, take OTC pyridium, and hope for the best. But this won't treat your infection and you could still have major complication, and you need to be seen and probably need antibiotics."
Why do we have to be nice??? If I went to the grocery store and said, "Hey can I have this bread for free?" They would politely say "NO," or "are you out of your mind?" Then I would ask again and make a fuss, so the manager would come out and I'd ask again, "I want this bread for free, can't you just give it to me?" And he would probably more sternly tell me "we are not in the business of giving out free bread, give it back."
So why am I in the business of giving out free medical advise?? That's a question I ask myself more and more when patients call, especially for stupid things. Every day I move closer and closer to the concierge practice model, fire all my staff and have 300-500 patients who want to PAY me for services.
What is a traditional FP to do??? I role with the times for now, but concierge practice is essentially what I do for 2,300 patients and I don't charge them all $1,000 for it.
