Should You Page Your Doctor When …?

A few months ago I had the strangest page from the hospital operators.
They said, “Doctor, we know you don’t take calls but this patient said she is returning a call from you. Will you accept it?”

“What do you mean I don’t take call?” I asked them. I stopped to think for a minute – I actually hadn’t had a patient page in over a month. And I hadn’t even noticed. “We have you checked out to your group. Permanently,” The operator said.

In typical fashion, my husband happened to be sitting beside me. “Be quiet,” he said, “Don’t tell them to change it. It’s your get-out-of-jail free card.” He knew there was NO way I was going to do that but figured it was worth a try. I guess he doesn’t like 2am pages anymore than I do.

“Of course I take calls,” I told the operator, “I just haven’t had any in awhile.”

I was wrong. As it turned out, I HAD been checked out from pages to my group for over a month. And I truly get so few pages from patients these days that I did not even know. And my partners never said a word. I almost felt bad.

Why So Few Pages?

With the nature of health care these days, primary care Doctor pages from patients are less and less frequent. I am NOT complaining there. As patients can call telemedicine, go to the urgent care, or go to the emergency room after hours, calling your Family Physician for treatment when the clinic if closed is not as vital as it was in the past.

Add to that the fact that treatment through pages has become increasingly rare. With antibiotic resistance on the rise, Doctors nearly always need a physical exam to determine the need for antibiotics prior to treatment. Additionally, many medications are under increasing control and cannot be “called in” any longer.

To put it simply, there is little I can do for TREATMENT when you page me. I can give ADVICE on what to do, though. And that may be equally important.

When you are considering paging your Doctor, I suggest that you start by asking 2 simple questions:

2 Simple Questions to Ask Before You Page Your Doctor:

1. Can my Doctor help me through this page or is this something that requires the clinic to be open? (Ex: scheduling or cancelling appointments, medications that require printing, or questions as to why the nurse didn’t return a call)

2. What can my Doctor do in terms of a solution to my problem through this page? (Ex: Do you know you need to go to the ER? Can they do anything about this problem without seeing me in person?)

Should you page your Doctor when

So, let’s take a look at some real-life examples of pages I have received and ask “Should You Page Your Doctor When..?”:

Page #1:

“My baby is running a fever that is not coming down when I give her Tylenol. She is not eating as much as normal and has not urinated much today. She is still crying tears, though. What should I do?”

Page? YES, I NEVER mind parents paging on their babies. I have been there in the middle of the night scared over a child that literally feels like she is on fire. Some advice may be all that you need. This child with decreased urination is most likely going to need to go to the emergency room, though, for IV hydration.

Page #2:

“My cough has been going on for 3 days and my nose is running. I have not checked for a fever and am not taking anything for it. Can you call me out an antibiotic? That has always worked for me in the past and I know this is not going to clear without one.”

Page? NO I don’t want to get into why viruses are not treated with antibiotics BUT I will say this is definitely not something that requires after hours attention. Please call the clinic in the morning for an appointment.

Page #3:

“Doctor, I know it’s Saturday afternoon but I ran out of my blood pressure medication and I forgot to call in for a refill.”

Page? YES BUT … Don’t become a repeat offender. We want you to stay on your blood pressure medication. And I don’t want you to run out just because the office closed. As you can imagine, though, if everyone did this I would be on the phone all night. Most Doctors request 48 hours notice for refills through the office so that they are filled in a timely manner and this does not occur.

Page #4:

“My chest is killing me and my left arm is numb.”
Page? NO This one baffles me. If you are seriously questioning a heart attack or stroke, DO NOT wait for your Doctor to call back. Just go to the emergency room. You need an evaluation and speed is key. Most Doctors answer their pages through cell phones. That does make us more available than in the past but we do actually shower, put our kids to bed, forget our phone in the other room, etc. We are human and living our lives after clinic hours. If you know you need to go to the ER, you do not need my approval first.

Page #5:

“I am having tons of blood in my stool and I’m starting to get lightheaded.”

Page? NO – Another just head to the emergency room situation. If you are losing that much blood then you need to proceed to medical care. This patient was diagnosed with colon cancer.

Page #6:

“My son just used up all of his inhaler. He has been using it so often and still wheezing even when he uses it. Can you refill the inhaler for him?”

Page? YES BUT please be factual with your symptom descriptions. Refilling an inhaler for a patient with asthma is reasonable. Quite often, though, parents exaggerate symptoms in order to get what they want. When you tell me that your child is working to breathe despite using an inhaler, I am much more likely to tell you take bring him or her in for an evaluation. We all want to be safe first. If that’s true, please don’t hide it. But if you think making it sound worse will get you out of a visit, that may not be the case.

Page #7:

“I’m heading to the ER. Can you call ahead and tell them that I am coming?”

Page? NO – Believe it or not Doctors in the emergency room know how to treat patients. And ER’s have triaging processes in place in order to treat you in a timely manner. When I have called ahead after seeing a patient in clinic, I always get the wrong Doctor and the message get dropped. I appreciate your faith in me as your Doctor but no need to page on your way to get care.

Page #8:

“I’m in the ER right now and I want you to get on the phone with the Doctor and tell him that I am not a druggie. I’m so tired of them treating me like I am.”

Page? NO – Sooo… this patient used to page me repetitively at 3:00 am and she would talk for 15 minutes without allowing me to say a word. I’m fairly certain the ER had a reason to ask this question. After more than a few nights, we sent her a letter to stop abusing the pager system. It is the only patient in 10 years whose paging privileges I reprimanded.

To help you all be ROCK STAR patients, I created a Say What? Paging your Doctor Checklist. There are a few things you will want to have ready should you page after hours to speed the process and help your Doctor out.

Remember, we are here to help. But we are also living our lives. Being prepared will help us all out.

Simple Solution: When paging your Doctor, ask yourself two questions: Can they help with this situation through a page? What can they do in terms of a solution through this page? And be prepared with my checklist to help everyone get the most out of your page.

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