Sunday, September 26, 2010

I'll Take That Call Now.


Jill of All Trades, MD
is a family physician blogger who has a post on KevinMD titled Why answering a cell phone during an office visit is a problem. She writes from the perspective of a primary care doc, and talks about the awkwardness of patients talking on the phone during their office visits. She talks about it with a detective/spy metaphor:

Me: “Your recent lab test shows that your diabetes is currently not sufficiently controlled with the current regimen. Your hemoglobin A1C, which is a lab test that tells me what your sugar level has been at home for the past three months, is 8.1. We need to add a medication at this point because…”

Riiinnnggg!!,” a quite startling sound lifts me off my seat, as if signaling a new secret-agent assignment.

Patient: “Oh, Doctor, hold on one minute please.”

Is this a conspiracy? Before I can even respond, she picks up the cell phone and starts talking to this rather shady intruder.

Patient: “Hi, honey. I’m at the doctor’s office. What do you need? …”

I wait about thirty seconds, with what seems like an eternity in the secret agent world, and she is still on the phone with this suspicious invader. At this point, I decide to exit the premises.
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For some people, answering the phone immediately seems to be a bit of a compulsion. And for someone who's waited a long time to see an over-booked doctor, I can see why they might want to take a call. Maybe it's a call that was prearranged for a time long after the patient thought they'd be free...but the patient was surprised to find the doctor was running late, and so why should they put someone on hold for a doctor who's kept them waiting? Why is it a one-way street? Oh, because it is.

In psychotherapy it's a different story: people pay for time by the chunk and there aren't patients backed up waiting to fit into the same time slot. I feel like it's the patient's time, and I don't feel like I should say to an anxious mother, "Don't take that call." Still, I'm always a bit surprised when people feel the need to take non-urgent calls during an appointment, and to talk for a bit. I feel a little uncomfortable listening. And even for those who quickly say, "I'm with the doctor, I'll call you back," I'm not sure what that gains over having the phone off.

Does my phone ring during sessions? Yes, because sometimes I forget to turn it off--and if it rings, I reach over and silence it . Do I answer it during a session? Never. Whatever it is waits until the session is over. The only exception I make is if I'm trying to get in touch with another physician regarding the care of the patient I'm seeing during that block of time.

I let people talk on the phone or text or deal with their families or clients. No one has done it repeatedly or in a way that notably distracts from therapy. I'm a bit surprised when anyone wants to pay my fee to talk on the phone, or even when anyone runs late, but hey. If I weren't "rented out" in blocks of time, so to speak, I'd be exiting with Dr. Jill-of-all-trades whenever the phone rang.
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And on a completely different note, I noticed that Jill of All Trades has a link on her sidebar to "Shrink Rapping"....I clicked on it thinking it would be us. But, no....There's another Shrink Rapping doc out there-- Dr. Gregory Smith from Georgia and he's been at it a while. How'd we miss that?