Volume 2 - Issue 8
General & Vascular Surgeon, Halsted Surgical Clinic, Chennai, Tamilnadu, India
Chapter 10: Qualifications, Certificates & Photos
If a patient by mistake comes to your office, with reference letter addressed to another consultant from his family Doctor, it's ethical to explain this to the patient and advise him to go to the Doctor, to whom he was referred, even though you may also belong to the same specialty.
But inspite of it, if the patient insists in seeing you, then you are justified in entertaining his request. It's in order, after the consultation process, to give the 'usual' reply to his family Doctor, adding an explanation, under what circumstances he saw the patient.
Chapter 11: Patient without appointment
If it's genuine emergency, it's only fair that the Doctor attends (condoning the lack of prior appointment) on him at the earliest and plan for appropriate course of action, depending upon whether the problem is medical or surgical, whether you are the right specialist and whether he requires admission to a hospital or not.
If there is no true emergency problem for the patient, the Doctor has three options, refuse to see him or try to see him at the end of the day's work or the assistant may order necessary investigations and arrange for an earliest appointment with the Doctor. First option is most logical, if the patient is a habitual defaulter in this regard, but the assistant may give him an interim prescription (preferably in consultation with the senior) and some fees is collected from him. If the Doctor chooses second option, additional amount may be collected over the regular fees, as a penalty, to discourage him for repeating the same mistake in future. In all situations, where the consultant hasn't seen the patient, it's advisable that some interim treatment is given (by the assistant), to satisfy the patient, to some extent and also to justify collecting some fees.
Some patient coming with an appointment, at the end makes a request to see another person accompanying him (without an appointment), who may be having some problem. Under such situations, if you feel his (other person) problem requires immediate attention, you may advise him to see the reception, to go through the standard protocol, so that you may see him as early as possible. If you feel the matter is not urgent, you may ask him fix a regular appointment, for a detailed evaluation. Best way to avoid such unwanted intrusions would be by politely telling them 'I don't like to see any patient in a hurry, inviting the possibility of commiting a mistake'. Same procedure may be followed, if the patient reports late, after the reasonable 'grace' time. We have to be lenient to a patient who claims he'd taken an appointment, but it's not recorded in your offce, since it's possible that your secretary failed to note it in the book.
Chapter 12: Availability
This is an important asset for any Doctor, to be credited with ready accessibility and availability. The happiness the patient derives when he's able to talk to his Doctor, whenever required is immeasurable and it over compensates the inconvenience, the Doctor may experience.
If the Doctor is preoccupied at the time he gets a call, the patient may be asked to call back at a convenient time or to send an SMS if it's urgent. If the Doctor needs to verify the records to give a proper reply, the patient may be asked to call his secretary during working hours, to retrieve his records and place them on the Doctor's table for review. If the Doctor feels that the patient has to be seen by a Doctor immediately, the patient may be asked to come to his office, if the Doctor is able to see or asked to go to a hospital of his (or Doctor's) choice, where some Doctor can see and discuss with you about the management, till you're able to see him.
We have to remember that we may have 'consulting hours' according to our convenience, but the diseases have no 'manifestation hours' and our prompt service at critical times, goes a long way in our professional credentials.
A highly duty-conscious, dedicated Doctor was living with his wife and a child. His wife always wanted him to take her out for eating, movie or some entertainment, but he couldn't spare time. Even the day they planned to go to a movie, he got cought in an emergency and had to cancel their program, at the last minute. She was terribly annoyed, depressed and got dejected over these incidents. The 'eye-opener' for her came one day, when the Doctor was out of town and their child was taken seriously ill. She had tough time finding a Doctor to attend on the child, during odd hours on a holiday. Then she realized the importance of availability of Doctors for medical emergencies and never complained about his commitment to profession, later.
Chapter 13: Social engagements
We get invitations to many functions, weddings etc. from friends and relatives, some of them may be so important that we have to attend. Unless we maintain a separate planner for outside engagements, we are likely to forget and miss them, only to regret later.
Another problem is misplacing the invitation card, not able to find when required, to know the venue, time etc. It's very useful to maintain a 'monthly' planner (for the current and next month), displayed in a prominent place and preserve all the invitation cards (which you decided to attend) in seven 'pigeon holes' in a cupboard, one for each day of the week, making it easy to locate.
A Doctor is considered an important person in that area and his attendance for a function would certainly make the organizers very happy and every one appreciates your social outlook, inspite of busy profession. We must realize that man is a social animal and can't live in isolation.
"Testifying against another Doctor would violate my ethics, so I'll have to charge double."
Chapter 14: Consulting hours
Most of the Doctors work late hours in the night. We must remember that it's our life profession and not a hobby. If you have school-going children, it's better you program your activities, so that you can spend some time with them, otherwise they miss you. For example, if you're a surgeon operating early mornings, kids go to school by the time you come home after surgery.
If you start seeing patients in your office early afternoon, you're not home, when your children return from school. Suppose you work late, they may go to sleep by the time you reach home. So they never get to see you at all on week days. There is a possibility the kids may tell their mom, when they see you on a Sunday 'mom, uncle has come to see you'.
Till the kids grow up, it's your responsibility to spare time to interact with them, at least by returning home early in the evening. This will give you an opportunity to assess their intellectual growth and also to attend some important social engagements.
Improper scheduling of working hours is the main reason, why we don't find many Doctors in social gatherings. Doctors working in Govt service, may plan private consultations during late hours. In fact, those in Central Govt service are not allowed private practice.
"Hospital regulations. You gotta wear the strips while I read the bill."
Chapter 15: Patient reporting morning with evening appointment
If the Doctor has visiting hours in two sessions, morning and evening, some out-of-town patients with evening appointments, may report in the morning itself. It's very advantageous, if possible, the Doctor can briefly see them and order for necessary investigations.
They will be ready with those reports by evening, when the Doctor can see and dispose, so that they don't have to stay 'over night', at additional expense. If some lab reports are awaited, if they are very important, there is no choice for the patient, except to stay on, till the next day.
Otherwise, they may be permitted to leave, make a call next day about the reports, any additional instructions required, may be given by the Doctor on phone and the reports mailed to the patient. By this arrangement, the patient will be fully satisfied about the efficiency and expediency of the whole set up, which is the 'bottom line' of all of our efforts.
"Considering the obvious lies on your information form and my tendency to misdiagnose, we should get along just fine."