The on-call labyrinth
The call schedule is hidden somewhere inside!
Dictation:
‘The patient was seen in the emergency department by Dr. Niemans, who is the acting hospitalist on call for Dr. Whitman’s group, who usually admit for the patient’s actual primary care provider, Emily Knight, PA, who works for Dr. Robelo, who no longer takes call, but admits his patients to the hospitalist.
Because the patient has COPD and an acute left-lower-lobe pneumonia, pulmonology was consulted. However, no pulmonologist is available this weekend. Pulmonary is being covered by Dr. Albertson, pulmonologist in the neighboring city. I spoke with Dr. Albertson about this and he told me he wasn’t taking call for our patients, and why did people keep bothering him.
The patient’s cardiologist, Dr. Rease, is being covered by Dr. James. I spoke to Edgar, PA for Dr. James who said that as of 7am, Dr. James was trading call with Dr. Housefield while Dr. James went to his son’s soccer game, but if I had any questions I should call Dr. Housefield’s Nurse Practitioner Michael, who would be rounding for Dr. Housefield, Dr. James and Dr. Josefson, at least until soccer was over or something bad happened.
The patient thought he would be seen by his primary physician and signed out AMA.’
Dr. Leap was tired; for he spent more time and energy dictating the names of physicians than actually caring for the patient.
Edwin
What do you think the solution is?
Is the patient okay? I doubt you would know at this point.
I passed this along to many. Many are in the medical field.
I suggested they read more on your site.
Debbie, the patient was imaginary, but a composite of many of the frustrating conversations I have had over my years in medicine. Thanks for asking! And thank you SO much for sending others to my site!
I live in Ontario, Canada but a doctor is still a doctor no matter where he practices. We, the public, tend to blame our doctor or health care provider(s) when things go wrong. After reading your “On-Call Labyrinth” article, I now see that doctors have their problems too. Never have I heard anyone tell me their doctor paid a house call, I guess that’s a thing of the past. My grandson decided this past spring that he wanted to become a doctor, he turned 29 April 30th. So he is now enrolled in his first year of university. When I asked him why he was doing this his reply was “grandma, we just don’t have enough family doctors in this country, everyone wants to specialize, so I decided that when I become a doctor, it will be a family doctor and if that involves working my ass off to get there, then that’s what I’m prepared to do”. I am praying that he makes it!
It seems the mentally ill are the ones who tend to fall thru this crack…the ones who don’t have insight into their illness when off meds. It’s frustrating as a family, and has to be to medical professionals as well.