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Overnight phone call

Home Practice Management Overnight phone call

  • Lordosis Lordosis 
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    There are about 20 providers who split the overnight call in my group.  So basically we get one week day a month and 3 weekends a year.  It is mostly nonsense.

    “Doc would not give me pain meds/antibiotics”  Neither will I

    “I was reviewing this persons chart and discovered they missed a vit D 3 days ago”  You are calling me at midnight because…

    “Mr Jones fell and has no injury.  He is sleeping now”  Thanks for waking me up for that.

    “Mr Smith had chest pain and went to the ER”  Fantastic, I will get the note tomorrow.

     

    Every once in a while you get a call where what we do actually matters like  reassuring a parent that they do not need to bring a child to the ER for something minor.

     

    Does anyone use a nurse triage system?  I figure that can handle 95% of this junk.

    How can I convince my hospital system to go this route?

    “It will cost money and the only benefit is making the providers happy”  This does not sound like a winning argument.

    Maybe spin it that it would help recruitment of new docs?  Sounds like a long shot…

     

    Comments and opinions welcome.

    “Never let your sense of morals prevent you from doing what is right.”

    #227254 Reply
    Liked by RocDoc, Peds
    CordMcNally CordMcNally 
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    Our hospital system has an “Ask A Nurse” line. It’s pointless because they can’t give actual advice over the phone and any advice they do give typically isn’t the greatest. It’s basically what patients do right before they come to the ED.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #227256 Reply
    Liked by RocDoc, MPMD, wonka31
    Lordosis Lordosis 
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    Our hospital system has an “Ask A Nurse” line. It’s pointless because they can’t give actual advice over the phone and any advice they do give typically isn’t the greatest. It’s basically what patients do right before they come to the ED.

    Click to expand…

    That is basically what we are.  I sometimes refer to it as the Go to the ER Call

    I would rather they ask a nurse rather then ask the sleeping doctor.  Especially if that doctor is me.

    “Never let your sense of morals prevent you from doing what is right.”

    #227260 Reply
    Liked by pulmdoc, RocDoc, Tim
    Avatar SValleyMD 
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    Our hospital went to this for us but we were also taking q4 real call with admits, procedures, cross cover and this was 15th on the list and only given to us to act like they (admin) cared 2 cents.

    I imagine they might scoff if it’s such infrequent home based call but doesn’t hurt to ask

    Throw out the burnout term, sleep deprivation etc and u might get some traction. Imo..

    #227266 Reply
    Liked by Lordosis
    Avatar Panscan 
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    I think you’re “ask a nurse” line is going to send way more patients to the ed than you ever would. Something to consider. Much easier to put your foot down and say youre fine when you’re the doc. Midlevels and nurses don’t really do that, they either escalate, order more imaging or give meds.

    #227268 Reply
    Liked by wonka31
    Avatar Panscan 
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    Your ask a nurse * mobile edit

    #227277 Reply
    Liked by Tim
    Lordosis Lordosis 
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    I would agree if we only covered our own patients. But most of the docs could give two craps and recommend the ER for everything because it is safer and faster. They have sent some of my patients to the ER for some silly stuff. A nurse could not do much worse.

    “Never let your sense of morals prevent you from doing what is right.”

    #227293 Reply
    CordMcNally CordMcNally 
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    A nursing triage system with almost assuredly not keep your patients out of the ED but it will allow your group to get better sleep. You can always sell the concept to your hospital administrators as a form of advertising which will increase their business.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #227296 Reply
    MPMD MPMD 
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    A nursing triage system with almost assuredly not keep your patients out of the ED but it will allow your group to get better sleep. You can always sell the concept to your hospital administrators as a form of advertising which will increase their business.

    Click to expand…

    Man I try not to gripe too much about our job, but the sheer # of patients I see who call their primary doc, never get through to them, and are told by a nurse to “just go to the ER” is really out of control.

    #227308 Reply
    Liked by Tim, CordMcNally
    Lordosis Lordosis 
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    Maybe the overnight ER doc would field the phone calls :p

    “Never let your sense of morals prevent you from doing what is right.”

    #227324 Reply
    Vagabond MD Vagabond MD 
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    In 2019, it is silly for an attending physician to field BS calls in the middle of the night and then work the next day. Either someone else fields the call or the on-call doc gets the next day off to rest.

    #227329 Reply
    Lordosis Lordosis 
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    Heck yeah. You preach it vagabond!

    “Never let your sense of morals prevent you from doing what is right.”

    #227333 Reply
    Liked by Tim, RocDoc, jfoxcpacfp
    Avatar mjohnson 
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    If doctors could get paid like lawyers and actually get paid for the time to do a good job fielding calls at night, then I think more would.  Patients want/deserve concierge level care, but don’t want to pay for it.

    #227336 Reply
    nachos31 nachos31 
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    My employer recently instituted a nurse triage line. It has decreased the calls we get. My clinic’s group is similar size with similar call schedule to OP’s but part of a much larger organization. I can say it’s nice but at the same time we’ve lost RN support in the clinic. I’d much rather have an RN every day at work which helps get me home faster daily than cutting the number of calls down a little for my home call.

    I believe my employer billed it as a provider satisfier as well as patient satisfier as a wider pool of RNs get back to pages or answer a phone faster than we can. Really, I think we were the only large organization without such coverage so we were playing catch-up. I’d take the angle of helping docs, helping pts with less wait time, etc etc.

    #227362 Reply
    Avatar HikingDO 
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    In our large hospital owned group, we have nurses who help with triage call, and their response about 90% of the time seems to be “go to the ER”. Always thought it was a bit of a conflict of interest for a hospital employed nurse to send most of her patient calls to her employer’s ER, but whatever.

    #227365 Reply
    Liked by Tim, Vagabond MD

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