When Doctors Don't Return Calls

[mkoven]

Hi everyone,

As I posted last week, I ended up in the hospital last Friday-Saturday with exertion-related chest pain. They were able to rule out heart attack, but no one knows what to do with me locally. ANS stuff not in their repertoire. I continue to have chest pain whenever I'm up, worse when I walk, worst when I walk up any sort of incline.

I've left THREE messages with my ans doc (who is in Chicago) asking for advice about what to do or how to advise my local doctors. No reply. Her secretary says she's relayed all the messages. I imagine the doctor is just very busy, but I really need to hear from her. Being busy doesn't strike me as a good excuse. The ten minutes is would take for her to speak to me could have saved me a two-days hospital stay and all accompanying financial, energy, and mental costs. I don't think it's too much to ask. She is definitely understaffed, but come on. The burden on her has got to be much smaller here than the toll on me.

I really like her face-to-face, but it seems she is not someone I can ever communicate with outside of an office visit. (this is not the first time I tried to communicate with her outside of face-to face). And as she's three hours away, and booked weeks in advance, that means she's just not helpful in any sort of acute problem.

What is reasonable for me to expect? I don't really want to fire her, but am really disappointed that she doesn't respond, for whatever reason, and my local doctors and I are left hanging without a plan, while I continue to have exertion-related chest pain. I need her to respond. My pcp is coming up with some strange treatment ideas, in the absence of any expert input. His office has said though that they will defer to her--IF SHE"D RESPOND! And I'm cautious enough to want to hold off on those odd suggestions, till I hear from her.

If any of you have any "from the doctor's point of view" suggestions...I would really appreciate it.

There was an ep cardiologist recommended to me 4 hours away who treats ncs in ehlers-danlos patients. I've had email exchanges with him, and he, sight unseen, answered them promptly. So he has the merit of being responsive, though he might be otherwise less of an ans specialist. I don't want to doctor-hop, and I like her personally, and respect her expertise, but accessibility matters to me. And it just ain't there.

What would you guys do?

Michele

[Ernie]

Hi,

I had that problem happened to me quite a few times and now I just take an appointment with the specialist and wait to see him.

[dezyrae2]

I just had the same thing happen to me. I was in the hospital for four days for dizzy and passing out, crazy blood pressure and heart rates so my family doc told me to call the ep doctor. I called two weeks ago and again last week. The receptionist told me sorry they will call you today but here it is 3 weeks later and still no call. I get so mad. If they dont know how to help or want to be my doctor just tell me. Ahhh!!! so frustrating.

[iheartcats]

I sent you a PM. I had a similar experience (but fortunately stayed out of the hospital...but missed 2.5 days of work I can't afford to miss which has led to further stress...)...

But no response. After calls/emails/etc. I only got an email from her secretary.

At this point, I think I am going in for my final lab results, paperwork, and going back to my EP who called me back the next MORNING. He's so much more responsive and is familiar with POTS. I'd rather have someone on my side/willing to try treatments then someone I see for 20 minutes once a month and can't contact in a severe emergency. (I was having very abnormal symptoms and rates above 160 just standing which is not usual for me).

Firing a doctor is hard, and no fun, but you MUST put yourself first.

[Maxine]

That just seems so irresponsible for a Doctor to NOT return your calls, especially if it's following an ER visit/hospital admission-----------

You would think that they would feel obligated to get in touch with a patient who has had an kind of hospital visit.

If the doctor is out of town for some reason, then it's his or her responsibility to forward that information to their secretary or nurse, so your not left hanging with no explanation on WHY your calls have not been retrned.

I've e-mailed doctors and had more timely responses. Just a thought.

It's hard to find anything on the proper etiquette on doctors returning phone calls. Let me know if any of you can find something on the net.

Good luck to you, and I'm sorry you have to deal with such rudeness.

Maxine :0)

[pat57]

Would your PCP call the ANS Dr. directly?

[flop]

Pat, you posted exactly what I was thinking. In the UK it is customary for one doctor to contact a specialist to ask for advice, not for the patient to do the phoning (usually it is letter / fax between doctors). I think this is because the doctor can often use a few medical terms to succinctly describe the issue that they want advice on and recent findings.

Your ANS doctor won't have any details of your recent hospital admission or any tests done. Also the doctor will have to review your file before calling to ensure that they don't get something from your medical history mixed up with a different patient (after all they do have lots of patients with similar problems). So rather than it being a quick 10 minute phone call there is often a lot of preparation that the doctor would need to do before calling you.

I suggest asking your PCP to fax your ans doc, hoefully you'll then get some co-ordinated care and making an appt with your ans doc would let you follow up any questions face to face.

If it is any consolation I am still waiting for the discharge letter and test results from my autonomic testing in January - I can't even go on the waiting list for an appointment with my local cardiologist until we have that letter, grrr getting annoyed now as new meds were suggested in January that I can't try yet.

Flop

[persephone]

My ANS Dr did exactly the same to me- and even ignored calls, faxes and letters from my local cardiologists. In the end I gave up on this Dr and sought help elsewhere. I ended up with a great Scottish EP purely by chance. I agree though, it is frustrating and definitely not good enough. Common courtesy would dictate that the ANS Doc says hey, thanks for the letters but I'm very busy and will get around to you as soon as I can.

In actual fact I had something similar with my thesis supervisor where I was just ignored for a whole month and told bluntly "you aren't a priority."

What a croc. I suggest punching a cushion or having a hot bath. I feel your annoyance even just remembering my experiences in the past!

[mkoven]

Thanks, you guys for your support and vicarious annoyance!

It seems really hard to get doctors to talk to each other. In the US, we now have these patient privacy laws, hippa, which makes it REALLY hard to get doctors from different hospitals to talk--rather than actually protecting anything. I believe I've signed the proper releases, but my pcp's nurse said he didn't have the authorization to talk to the ans doc. so I have to call around to get the right forms signed to let them talk-- which I think they'd prefer not to do.

I may still see this ans doc, given her expertise, but will have to come up with a polite way to tell her that I'm concerned about not being able to contact her in an acute situation.

I'd rather not add on new docs, but I may go see this ep guy in Indiana, since he does do email, and comes recommended.

[MightyMouse]

Just an aside here, but I once had a similar problem getting through to my neurologist for a migraine crisis. When I finally had my appt, I told him how many times I called and I was upset at being unable to get help. I found out that he never got my messages, and he was furious with his front office staff who never relayed them to him. He ended up giving me his private pager number! You may want to check into why your calls weren't returned at your next appointment when you're face to face, and then evaluate your situation from there.

Nina

[icthus]

Recently I had a critical situation that needed medical intervention. I called my wonderful PCP, and the nurse told me I had to go to Urgent Care because they couldn't handle "that type of medical need" in the office.

Several hundred dollars later, I was sitting in the PCP's office for a follow-up to the Urgent Care visit. When she found out that I had called the office for an appointment (and even looked up on the computer tracking system to see which nurse I talked with) she was very upset. Not only could she have handled "that type of medical need" in the office, but she could have also attended to the spin-off consequences of that medical need.

To circumvent the phone relay system hosted by computer voice 342 offering numerous multiple choice options, I now simply fax my concerns to the PCP office directly. It is very efficient, they have a paper record, there is no third-part interpretation of "what I said", and the doctor can simply jot a note to the nurse on how to respond to me without great time involvement on her part.

It's been a great solution.

[Megan]

I just wanted to add that I've had this problem also. The route my mom and I have taken is just to call and leave messages until they do respond.

Nina-I will take your advice and ask at my next appointment to be sure messages are actually being passed on!

Meg

[doctorguest]

Agree with Nina. Sometimes office staff does not directly or immediately notify the doctor that a patient called. Or they notify by a method that is not easily accessible by a doctor, like leaving a written message in their mailbox at an office, where, for example, they only work a few times a week. Many doctors work at various locations, including several offices and/or hospitals, and thus, may not be able to receive non-urgent messages in a timely manner. Of course, if your matter is urgent, then a physician should be immediately accessible to the office staff via pager or cell phone. Another problem is the "out-of-town" specialists. It is sometimes difficult to coordinate care with local doctors, but of course, not impossible.

I would not dismiss your specialist because of this incident, though it's understandably frustrating; rather, I'd discuss this with her at your next appointment, emphasizing the need to reach her when urgent matters arise and asking her how to best accomplish this in the future.