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Any patient who tells me they've got to have my private number will be told that they've got to get a different doctor. It is vitally important for me to be ab

• jachee 8y ago
  With phrasing like "bottomless well of need", it sounds like you're possibly in the wrong profession. The best doctors I've ever dealt with have offered their private numbers. Saved my wife's life once. The worst have been preachy, god-complex douchebags.
  • Nomentatus 8y ago
    Chronic illness demographics - particularly for diseases of inflammation - have exploded in the last fifty years, outpacing the supply of doctors and then some. The need is now bottomless, and it is in fact a need.
  • homero 8y ago
    One patient with health anxiety will call daily, multiply that by any number. Then add family members.
  • scarmig 8y ago
    Doctors who don't set boundaries and who perform an unlimited amount of emotional labor are those who burn out. There's no medical reason for a doctor to be on-call 24/7/365, and it's stupid to expect them to. If an urgent medical issue comes up at 2 AM, the patient can go to the ER, which is what the doctor would tell them to do anyway.
    • astura 8y ago
      A lot of offices and insurance companies have a nurse's hotline available in the off hours too to handle these sorts of requests. Though I'm not really sure what kind of advice they can offer other than "go to the ER."
      • nate_meurer 8y ago
        Yes. My father-in-law's staff relay a high proportion of calls to him. The staff triage the requests, answer questions when they can, and forward questions they can't. The staff know how to use the doctors' time wisely. They ask the right questions, provide updates, no chit chat. It has to be that way. There are a few special patients he'll give his cell number to. Pregnant moms especially I think. He's a country doc and the only good baby doctor within a hundred miles, so if there's an OB patient who he thinks is higher risk, and who he knows won't abuse his cell number, he'll give it to them no problem.
    • rkangel 8y ago
      I really want to agree, but there are some situations where it does need to be that one doctor. The below anecdote notwithstanding, I do agree that any patient who demands your personal number is the last patient you should be giving it to. My aunt had a condition that causes fluid build up in her brain. She has a slightly unusual shunt arrangement, and over Christmas (we now know) it got blocked up. She started developing neurological symptoms, and the only person who knew enough about her treatment to be able to sort it out was her doctor. The actually had his home landline number, but he was away, and it was only due to luck of a call coinciding with the neighbour feeding the cat that they were able to get the number of where he was for Christmas. By that point, my aunt with unconscious in hospital, and might well have died if treatment had been delayed any more.
      • scarmig 8y ago
        Thanks for sharing that story. It's scary that sheer happenstance saved your aunt's life. I wonder how medical record keeping could be improved to help with that scenario.
        • rkangel 8y ago
          What's scary to me is that after 10 attempts at the landline over a period of time, I would have (correctly but unhelpfully) concluded that he was away for Christmas and abandoned that approach. My Uncle was more persistent. In this case I think it was less knowledge of the particular case, and more the expertise in that specialised situation. Skillset rather than records.
          • scarmig 8y ago
            Well, here's to hoping we'll all be seeing an all-knowing Dr. Google in 50 years.
  • iguy 8y ago
    Maybe the patients to whom they offer their private numbers, and the patients who "tell me they've got to have my private number" are non-overlapping sets. I'm sure that experienced doctors can spot people who are going to ruin every weekend a mile away, and also those responsible enough to call only when it really is appropriate.
  • m_fayer 8y ago
    My clients, as a whole, are a bottomless well of various IT needs. This is by design.
    • PakG1 8y ago
      Some call it job security. Fortunately, most of those users call only during their office hours. Can't say patients would have office hours, so it's more complicated.
  • nate_meurer 8y ago
    > The worst have been preachy, god-complex douchebags. Is this sideways dig really necessary? I could say the same about programmers (and I am one). I count half a dozen doctors and nurses among my inlaws. None of them will give their personal phone numbers out to patients. If a patient asks, they're politely told to call the office, who will then curate the calls. If you've ever been around a doctor, especially a GP, you know how many calls they get. My father-in-law takes dozens of calls a day from his office, several of which come at night when he's asleep. If he were expected to take calls directly from patients, he'd be completely unable to do his job. So, serious question for you jachee: is it possible that the doctor you're responding to has some insight into the challenges of his job that you don't?
    • jachee 8y ago
      It's indeed possible that there's insight there, but with phrasing like "bottomless well of need" there's also an obvious disdain for humanity which seems likely due to having never been seriously ill, scared or suffering. Having several close acquaintances, including my wife, who deal with chronic illness it set off red flags of "only in it for the money" insight or not.
      • loco5niner 8y ago
        > with phrasing like "bottomless well of need" there's also an obvious disdain for humanity I think you are wrong to make that assumption. There are tons of people with no sense of boundaries who will make contact over and over for very little reason. It only takes one or two of those people to ruin it for the rest of us.
      • nate_meurer 8y ago
        I've heard the phrase "bottomless well of need" -- exactly that phrase --from more than one of my family members in the medical profession, all of whom are caring to the point of self-sacrifice. It's a vivid, pointed, and completely accurate description of a significant minority of patients who present a real challenge to doctors and nurses. My brother-in-law is an ER doc. He treats an alarmingly high number of patients who threaten to sue him if he's not willing to give them his phone number, write an immediate referral, or prescribe opioids. These are patients with real pain, real problems, who are understandably desperate for relief, and who are easily capable of completely dominating a doctor's time and attention. The implication of an obvious disdain for humanity here is pretty uncharitable. Just as it's difficult to relate to chronic disease from the outside, I think it's difficult to relate to the challenges of treating and caring for the afflicted.
  • normal_man 8y ago
    I mean, a "bottomless well of need" is basically exactly what a chronic illness is. Have some compassion; doctors and medical professionals deserve to clock out at some point just like the rest of us. It doesn't mean they are in the wrong profession.
• homero 8y ago
  I try not to bother my doctors for this reason. I'm the opposite.
  • trapezoidion 8y ago
    I think everyone should avoid interacting with doctors unless it's absolutely necessary (in the US). They have to diagnose hundreds or thousands of patients, and it's unreasonable to expect them to care or deliberate about your specific needs. They are running or working under a business, and are incentivized to minimize patient time and maximize billing. Even a phone call to their office can be converted into an insurance claims if you're asking them to correct a mistake, which I found out when I looked at my health insurance online. This also means that you should always be skeptical if doctor recommends a certain procedure, especially if he's involved. You have to assume he's acting in his or his employer's best interest under our current model of health care.
    • jrochkind1 8y ago
      How could I know if it's "absolutely necessary" without being a medical professional or consulting one? What a terrible system we've got.
• shakna 8y ago
  Looking over the article, and guessing, here. This isn't likely to be a what a phone appointment is. A phone appointment is what it sounds like. A set time, generally within normal office hours, pre-arranged, for the doctor and patient to speak. It's simply a way of not taxing the patient with travel, especially if they need to travel any significant distance like to the next town.
  • naner 8y ago
    That is a pretty big leap from just a single statement. I've noticed the same problem and I'm not in the medical profession. Many people don't have good judgement when given direct 24/7 phone access.
  • _dark_matter_ 8y ago
    The parent comment was reading from a different line: `I made lists of questions for my doctors and insisted they give me their personal phone numbers.`
• wolco 8y ago
  Why did you get into this profession? Were you looking to serve others?
  • UnpossibleJim 8y ago
    Service to others doesn't mean lackey to all. Boundaries have to be set for sanity's sake, for both patients and doctors. There are emergency lines if the situation is truly dire, and this is coming from someone who is both a brittle diabetic and an epileptic.
    • wolco 8y ago
      As a developer I wouldn't give out my home number but I would be coding away from work. I got into programming because I liked it. Do people get into medicine for the same reason? Do they go home and continue practising medicine?
• unclebucknasty 8y ago
  >patients and their potentially bottomless well of need That's worded with a tinge of contempt. Not saying it's undeserved--I've never walked in your shoes, and I can imagine the medical profession being exhausting and one of high-burnout. But, it does make me think of how things have changed in this regard, for both doctors and patients. Time was that doctors made house calls, knew every patient personally, and frequently cared for multiple-generations of a family. There seemed to be a certain intimacy baked into the profession. Of course, that's pretty much impossible today with insurance, medical costs, etc. making medical practices more of a numbers game. On the other end, patients are consumers like any other. And, after running a consumer-facing business for many years, I can say that there seems to be an unreasonably high-expectation of service and outright deference to the customer--sometimes bordering on a sort of pathological entitlement. The result is that there seems to be a lot of hostility baked into transactions and other professional interactions. Given the personal nature of one's health, I can only imagine this to be amplified.
  • saiya-jin 8y ago
    Imagine you have 7 minutes for a patient, and off to the next one. Imagine 90-95% of your work time is spent in front of computer, filling in forms for every patient coming in, getting any treatment or leaving hospital. Each one takes 60-90 minutes (no kidding). My fiancee's daily/nightly routine, every single day, in biggest hospital in Switzerland. Our romantic views on what it is to be a doctor are long gone, unless you go with orgs like MSF to ie Africa. Reality is, most of doctor's work these days is pure bureaucracy (maybe apart from surgeons). Any job that gets into this 'corporate work' state will have any positive energy drained out of it. Do you know any doctors personally? Most of them end up pretty disappointed bitter with their work right after school - those rosy expectations meet reality. In fact, in our circle of friends where there are many young doctors, there is 0 happy with their work.
    • unclebucknasty 8y ago
      Yeah, I know. That's pretty much what I said.
  • 8y ago
• Bartweiss 8y ago
  I'm curious how this varies by speciality. It's pretty obvious why you'd want this space. Constant on-call status is rough enough for technical roles, I can't imagine how much higher the burden would be when people's health is at stake and 'false alarms' are human fears instead of automated notices. Long hours and high emotional burdens scream for boundaries. But... I've also seen doctors who seem to consider this standard practice. Not that they're obliged to respond immediately, but they even offer phone numbers unprompted. (I hope for their sake they have a different number for those calls.) What stands out to me is that this article is about Crohn's, a probably lifelong condition for which a doctor might see a huge number of patients. The doctors I've seen giving out personal phone numbers are oncologists and similar, who see people for long but finite stretches and have relatively low patient counts. (And, of course, are dealing with a disease where "is this serious?" is not-uncommonly met with "go to the ER immediately".) I'm not sure what your specialty is, but I'd be really interested to know whether this is just a per-doctor preference or has broad patterns between fields.