“My mom is coughing. What can I give her?”
“I am having pain in my stomach. What can I take?”
“My wife vomited an hour ago. Can she take this medicine?
These are examples of text messages that doctors often receive from patients.
Cellular phones have altered the way we practice medicine. Many patients now expect to get their doctor’s cell phone number and often carry out consultations by calling or texting their doctors.
I have nothing against texting or calling doctors to ask a couple of questions. I give my number to patients and also ask for theirs so that I can follow them up when necessary. This allows me to be one step ahead of potential problems especially for my patients who are undergoing chemotherapy.
I have observed that when patients are treated with respect and made to feel well taken cared of, they rarely, if at all, abuse the use of the cell phone. I sometimes even have to encourage them, to let me know what is happening and allow me to decide whether or not there is a need to address those situations. This has allowed me to sleep peacefully every night knowing that patients are all doing well. This also obviates the need to go back to the hospital in the middle of the night or to have major emergencies that put the patient in severely life-threatening situations.
However, there are also disadvantages to giving patients the doctor’s cell phone number. Some patients text even minor and unimportant things such as whether they can take a bath or not. Some patients think that we are still on call 24/7 and send messages or ask questions anytime they want. Others would just use the cell phone instead of coming to see us in the clinic so as to save on consultation fees. There were also times when patients kept on waiting for the doctor to reply instead of proceeding immediately to the emergency room where proper care can be given right away.
I think cell phones and the practice of medicine will always be intertwined. However, we have to be very judicious with regards to how best and when or when not to use the cell phone for consultations. Here are some guidelines:
- Be more specific about the problem you are asking about.
Getting an answer from your doctor is not as simple as asking “If I have a cough, what should I do?”. There are so many possible diagnoses for a patient experiencing cough. The patient’s age, duration of cough, underlying disease and other information will matter in arriving at a diagnosis. We need a lot of information to be able to help patients. These information include:
- When did the problem start?
- Description of the problem
- Presence or absence of aggravating or relieving factors
- Whether or not medication has already been given
- What has happened to the problem since it started?
2. Don’t always expect us to be able to prescribe medicines just by exchanging a few text messages.
Managing a patient is extremely complicated. We need a lot of information which may be impossible to get just by texting. We also need to review your previous records which may not be accessible right away. “One size fits all” does not apply to patient management. Prescribing medicines without having all these information and without thoroughly examining the patient may do more harm than good.
3. If you haven’t seen your doctor for a very long time, better go see him in his clinic or go directly to the emergency room for pressing problems.
A lot of changes may have happened to you that your doctor does not know. These can affect how he should decide in treating you.
4. Please don’t wait for us to reply if there are pressing problems.
Some patients get paralyzed if their doctors do not reply and sit around waiting. They let precious time slip by without doing anything. Let us not forget that there is such a thing as the emergency room. It has been there even before cellular phones were in fashion. If you cannot reach your doctor, go to the ER as soon as possible.
5. Avoid the temptation of asking your doctor about his clinic schedule.
Being asked about my schedule through text really irritates me especially for patients whom I have been seeing for several times already. Patients have a tendency to ask this question in the morning when I am rushing to the hospital. Schedules should be the turf of the secretaries. They know our schedules better than we do. Also, you can find our schedules on the prescription pad and business card.