Telephone Medicine

If you are ill, I would like to see you in person.

Telephone medicine is bad medicine. Some reasons for this are:

• The doctor cannot examine you.

  It's difficult for the doctor to be sure he has made the correct diagnosis if he can't do a physical exam.

• Your medical record may not be available.

  If the patient calls the doctor during off-hours, the patient's medical record is not available to the doctor. You get the best medical care when the doctor reviews your medical record while evaluating you.

• Body language is important.

  The subtleties of social interaction are sometimes critical in making the correct diagnosis. Many of these subtleties are not available over the telephone. For example, a patient might say he isn't depressed but look sad; or the patient might say he just has a cough but be obviously short of breath.

• More mistakes are made over the telephone.

  If a doctor makes a mistake, somebody might die. For this reason, we doctors do everything we possibly can to avoid making mistakes. One of the most important things we can do to avoid making mistakes is to only treat patients in person. It's difficult to be sure you're doing the right thing when you can't see the patient.

There are 2 types of telephone medicine:

1. During office hours: If you call during office hours with an illness, I will insist on seeing you in the office. If necessary, I will fit you into the schedule. However, sometimes I may need to send you to the emergency room or urgent care center. An example of this is when someone calls in the late afternoon but has an illness requiring same-day attention.
2. After office hours: I do not call in medications to the pharmacy during off-hours. If you have an emergency at night or on the weekend, please don't hesitate to call me. But the resolution to the problem will most likely not involve the prescribing of a medication over the telephone.