24/7 access

[Guest guest]

i am concerned that as we promote this model, we don't fall into the trap of being all things and always available to our patients. i think 24/7 care/access leads to burnout, can promote inappropriate patient behavior, and can potentially delay urgent/emergent treatment, and result in increased liability. we do what we do in the office; if something happens that requires additional care outside of office hours, and is such that it can't wait, patients should go to urgent care or the emergency department, or call 911. that's why those services exist. we are not lone rangers. if there is a question about liability, the standard used, from what i've read, is the layman's perception and understanding of the situation. who's going to stake their license and malpractice insurance on their ability to diagnose over the telephone, other than to say, i think you

need to be seen; go to urgent care or the hospital emergency department? when the patient says, i don't want to, it's too expensive, i just want you to reassure me, you're "it". good patient education, in the office, about potential complications and worsening symptoms, with the recommendation to either return during office hours, or to go to urgent care/emergency department/call 911 outside of office hours, is the responsible and appropriate thing to do. certainly, with certain patients, where one's knowledge of the patient can help to avoid expensive and needless additional work-up, it would be appropriate to be contacted, or to have that information available. circumstances will be different in different areas and with individual preference. nonetheless, i question what i perceive to be the underlying theme, that the system is screwed up, i do things the way they should be done, and i am the

only one who can do my patients right. it's a setup for expectations which can't be met, and will ultimately lead to frustration, for us and for patients. LL

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