Thursday, January 15, 2009

Non Billable Hours

I love how every time you call an attorney you get a bill. I guess, I need an attorney to take call with me. Last week sucked. It isn't the hospital calls or having to go to the ER that really wear you out, but all the patient calls. We have a very good answering service and they make sure that patients are told that after hours we only accept calls for emergencies and acute post-operative problems. Infact, patients are told this as soon as they call the number. This does not stop them, however. Each night on call there is a flurry of people who call because they were seen years ago for one problem but now they have a cold and want something called in. It is amazing how many patients call becuase they want narcotics or Xanax. These are the real pateints and not the ones who just pretend to be a post operative patient who ran out of their pain medications and hoping to score a fix. The answering service screens the calls to the best of their ability but unless it is an administrative call like scheduling an appointment they have to put the call through because of liability issues. All patients of course claim that they are having an emergency or that their cough is a post-operative issue from their recent surgery (6 years ago). I really love the 2am call from a patient who has insomnia or constipation and has had it for months and chose this time to call. When the service rings the calls through I always answer with this is "Dr. Throckmorton what is your emergency?" They always answer, "well, its not an emergency but I was wondering if you could call in a prescription for my excema, its been really bad this month." When I actually get a post-operative call or a real emergency it is like a breath of fresh air.

I guess I understand that they dont want to come into the office, but why dont they at least call when the office is open? Instead they call at 3am Sunday night. I wish we were like attorneys and got paid for phone calls. I bet that would cut down on all these late night and weekend calls. We could charge for the start of the call and then by the 15 minute blocks. Even better, we could charge patients for a retainer fee just to take their calls. We could learn so much from attorneys! Then again, have you ever tried to get your attorney after hours or on the weekend?

1 comment:

SeaSpray said...

Hi Throckmorton - After reading this I thought, "Oh NO! Have I done this to my doctor?"

They don't use a live service and so it would never have occurred to me that they could possibly be interrupted if I leave a message.

But I am not calling their emergency "on call" number.

It is an excellent automated service. And one of the most impressive things to me as compared to other doctors on call that when you call the main number, you are directed press the number corresponding with your need.

So, they have a lot of numbers to choose from. If you press one number you get their on call line where you leave a message and the covering doctor *PROMPTLY* returns your call. only had one occasion where the doc didn't call me back but I had also said as soon as I felt up to it I was going to the emergency room. I only called to give him a heads up. And then one other time I left a message, explained why and if I couldn't get out of something..don't have to call back. I couldn't - he didn't.

btw - I so much better prefer the way they handle their emergencies. I am fortunate that I have never had to do that much with anyone... but in my opinion...their system of taking is awesome...way more efficient.

It is always one of them. i know they will call promptly. If they didn't...I would assume they are tied up. I have never abused that..nor would I.

However...after your post...i am wondering? What I have done and did if I know I am going to need the doctor's opinion, guidance whatever...then I will call and leave a message on the weekend on the office clinic line where the nurses take the messages and give them to the docs during business hours. The reason I leave it on a weekend is I figure then the message will be waiting for them before the day starts, they'll know about it and get back to me when they can. I don't really know how they do things but I just figure it's better to start early.

But now I am wondering...could there possibly be anything in their system that alerts them that someone left a message in the office. I hope not! Because they are NOT emergencies!

I will have to ask if I think of it. I would not ever bother a doc when they are off without good reason.

I especially like their method because I feel more confident that they are getting my message directly without anything being lost in the translation.

Now...maybe this works against them when they are answering calls by people that *may have* been thwarted/screened by the operator, but they must not want to miss things or they save money because they have the man power to cover... I don't know.

But dealing with this practice has been such a positive experience for many reasons and one of the main ones because I have felt well taken care of because they are so hands on with my case and I assume all the other patients as well.

Regarding daytime office doc often takes the call even when he doesn't have to. That being said...I do understand how busy he is, so I am all the more impressed but I would never want to bother him. I assume he feels it is important and I appreciate his efforts. I am more than glad to come in and let him get payed for whatever and would never deny him that or want to take advantage. And he certainly has me come in when important.

I think that these people don't process the fact that you are getting other calls and are only thinking of their need..or what they perceive to be an emergency.

When I was first hired at the hospital... my supervisor told me, "Remember that when people come to the emergency room, they think *their* emergency is an emergency."

I never forgot that and I suppose helped me keep the stupid visits in perspective and so I never indicated my true feelings... but I had that knowledge because of the environment I worked in.

Seriously...people are clueless! (I have probably fallen into that category myself sometimes.)

And EMERGENCY *should be* obvious.

And some are just selfish if they do know better.

Your idea for 15 minute blocks would help. It must feel good to fantasize about that. ;)

Seriously...I have read/seen where there are doctors who do charge an additional yearly fee for patients that would like to have easy access to the doctor where they will take all calls and maybe even do house calls... and patients pay for it.

In answer to your last question...yes... and I wish he didn't answer..because he led us down a very expensive long path... that cost us approximately$40.000 (not including his fees) we wouldn't have lost if we retained the right lawyer.