Patient call backs

[Jkittycat]

Long time lurker, first time poster.

Today is a new EM low. I work a pretty ok gig. It is a CMG gig, but overall, pretty ok. We were told that we now must do patient call backs for patients seen the previous day by another doctor (we do 24 hour shifts). We are not supposed to give any medical advice, of course, but just "check on them! they will love it! it will improve our patient satisfaction scores!" These patients are already called back by a nurse to check in on them. This is a new extra "service."

It is awful. I could only bear to do a single call.

"Hello! Is this Mr Patient X? Great! This is Dr JKittycat. I am calling to check in to see how you are doing today"

"My rib still F-ing hurts."

"Ah, yes. Rib fractures are so painful! Have you been taking the Norco that was prescribed for you?"

"Yes, it doesn't f-ing work. I see my REAL doctor tomorrow. Why are you calling me" (yay! pcp follow up!)

"Well, great. Um. yeah. So, we hope you feel better soon. Bye!"

It was horrible. So awful. Like, I just can't do this job.

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[bravotwozero]

Fortunately the one job that requires me to do this, none of the patients pick up the phone when I call.

 

[southerndoc]

Sounds like a nightmare.

 

[GeneralVeers]

Just don't do it. Wait until they catch you, then claim ignorance. I've heard of some people calling back the homeless patients and documenting "Could not reach".

Either way if they enforced this, it'd be a deal breaker and I'd quit. During COVID at once place they were making the AM doctor call patients back about positive COVID results. What a waste of the doctor's time when a nurse, or NP could do this.

 

[robellis]

I have no words…you’re a doctor not a secretary holy ****

 

[Groove]

Long time lurker, first time poster.

Today is a new EM low. I work a pretty ok gig. It is a CMG gig, but overall, pretty ok. We were told that we now must do patient call backs for patients seen the previous day by another doctor (we do 24 hour shifts). We are not supposed to give any medical advice, of course, but just "check on them! they will love it! it will improve our patient satisfaction scores!" These patients are already called back by a nurse to check in on them. This is a new extra "service."

It is awful. I could only bear to do a single call.

"Hello! Is this Mr Patient X? Great! This is Dr JKittycat. I am calling to check in to see how you are doing today"

"My rib still F-ing hurts."

"Ah, yes. Rib fractures are so painful! Have you been taking the Norco that was prescribed for you?"

"Yes, it doesn't f-ing work. I see my REAL doctor tomorrow. Why are you calling me" (yay! pcp follow up!)

"Well, great. Um. yeah. So, we hope you feel better soon. Bye!"

It was horrible. So awful. Like, I just can't do this job.

I just couldn't do this....and that's in spite of being very conscious of the lack of job security in today's environment. I'd probably just not do it and wait to get confronted about it and then quit. That also seems to be a huge medicolegal risk in calling to check on patients that you never saw since you no doubt will be forced to give additional medical advice over the telephone.

 

[RustedFox]

Every job except for the one where I worked with dchristismi made us do this callback thing at one time or another.
It generally doesn't last very long; a few months - and then admin finds some other shiny toy to bat about.

 

[nikolaite]

I can’t imagine anyone thinking MD cold-calling for follow ups in an ER setting is a good idea. It comes across as extremely ridiculous for so many reasons.

Where my sister works they do this. She says it is an absolute nightmare because they have a tracking system that rolls over all uncalled patients to the next shift. Some MDs at her facility flat out refuse to make the calls. Because she’s trying to play ball with admin during her “office rotation” she says this task can consume about four hours. Then the admin calls everyone to morale boosting meetings to upbraid everyone collectively in a passive aggressive way to get them to make the calls. Sounds like a sure way to make a disgruntled work force...as she says she didn’t go through all the debt and schooling to do call center work.

I do some patient and patient family interviews for my line of work, and find it somewhat stressful...and often comically like the patient history sketch by Doc Schmidt on YouTube. I find his humor very cathartic.

All the best to you, OP.

 

[Tenk]

Eh, I’ve called patients at home if I actually like them and was concerned about them. Overall I would say it’s a good experience. I don’t think it should be forced and I don’t think it should be someone else’s patient. That doesn’t make sense. Sorry your CMG is dumb.

 

[Franzd'Epinay]

How are they policing this? What if the patient doesn't answer?

 

[Apollyon]

How are they policing this? What if the patient doesn't answer?

Haha, you're funny. I would guess that half or more of the pts I saw gave a fake number. Who cares about a call back, when you (the pt) are more concerned about collections?

 

[GeneralVeers]

How are they policing this? What if the patient doesn't answer?

Exactly. Stupid rules are meant to be broken. I would just ignore it, or document that I called people and didn't. How would they know?

 

[emergentmd]

This admin crap has been thrown around for over 10 yrs.

When we were a Private SDG - Screw Them, We are not calling, let the nurses do it
When we were a CMG - Screw them. We are not calling, let the nurses do it
If a CMG makes me do it, and I want to keep this job and they are tracking it - Call pt, miss type a digit, hang up, mark that pt did not answer.

I WOULD NOT talk to pts to ask them how they are doing

Now, at our FSER we do this and although most docs hate it, it does promote pts to come back so from a business standpoint it is high reward for low amount of work. Plus the population is insured, educated, so calls are pretty quick.

 

[KnuxNole]

The question about the mistyping digits and/or "fake" calling....what if it comes to bite back in the rear end? I.E. someone else calls and says we documented we called you X times and the patient says "that's not true! there is fraud!" and someone in admin investigates

 

[robellis]

The question about the mistyping digits and/or "fake" calling....what if it comes to bite back in the rear end? I.E. someone else calls and says we documented we called you X times and the patient says "that's not true! there is fraud!" and someone in admin investigates

How would you investigate that..? There’s literally no way to prove that you didn’t call, also if you miss type a digit then you made an “innocent mistake” so you can’t be faulted for that either..this is so pathetic we are doctors we have to stand up at some point next thing you know we’re gonna be cleaning the bathrooms in order to “boost morale” of the janitorial staff ffs

 

[KnuxNole]

I feel ya, I'm just saying you know admin has an ivory tower look on everything. They can say "we need to monitor metrics and to comply you have to use the hospital phone and we'll pull reports on call logs".

 

[GeneralVeers]

The question about the mistyping digits and/or "fake" calling....what if it comes to bite back in the rear end? I.E. someone else calls and says we documented we called you X times and the patient says "that's not true! there is fraud!" and someone in admin investigates

Correct there's literally no way to investigate this. It would also require someone from administration calling the patient to confirm that we called......so why don't they just call in the first place? Wait.....we could have doctors do a second call, to confirm that the first doctor called about the follow-up. I should be in administration!

 

[EM Junkie]

We did this at the low volume FSED I worked in too. Helpful to sort out pharmacy issues, simple advice, that sort of thing. As someone else alluded to, these were relatively nice, normal people. Now- calling back from a busy ER shift? No thanks!

 

[GeneralVeers]

We did this at the low volume FSED I worked in too. Helpful to sort out pharmacy issues, simple advice, that sort of thing. As someone else alluded to, these were relatively nice, normal people. Now- calling back from a busy ER shift? No thanks!

It's different if you have ownership. If I owned a FSED and had a stake in patient satisfaction and their return visits, absolutely calls would be helpful. Do I give a crap if these people ever come back to my busy ED? Nope.

 

[emergentmd]

The question about the mistyping digits and/or "fake" calling....what if it comes to bite back in the rear end? I.E. someone else calls and says we documented we called you X times and the patient says "that's not true! there is fraud!" and someone in admin investigates

No way anyone can prove that I mistyped a number. There are 10 digits and seems like a common mistake. You can't be dumb to mistype all numbers.

This is a painful process and if you really have to do it to keep your job I would

1. Call everyone with simple complaints - UTI, Cough, Lacerations
2. Complicated pts - Misclicks.

If admin is going to go through the tedious process of vetting all of my calls, then truthfully, it is time for me to find a new place.

 

[emergentmd]

It's different if you have ownership. If I owned a FSED and had a stake in patient satisfaction and their return visits, absolutely calls would be helpful. Do I give a crap if these people ever come back to my busy ED? Nope.

The beauty of going the extra mile when you own something vs increasing profit for the master.

This is basically why Physician owned sites do well and the Neighbors/FCER folded. Docs & Staff at Neighbors/FCER always try to push pts away

 

[GeneralVeers]

The beauty of going the extra mile when you own something vs increasing profit for the master.

This is basically why Physician owned sites do well and the Neighbors/FCER folded. Docs & Staff at Neighbors/FCER always try to push pts away

Right. The CMG-run FSEDs I am forced to work at are all hourly. I want less patients not more. I don't want to encourage people coming back because there's nothing in it for me except more annoyance and work. It's how human nature works.

 

[gamerEMdoc]

Right. The CMG-run FSEDs I am forced to work at are all hourly. I want less patients not more. I don't want to encourage people coming back because there's nothing in it for me except more annoyance and work. It's how human nature works.

Guess it depends. If you are paying me my hourly rate just to call people, I'll call people. Now if you expect me to call people while at the same time seeing patients and maintaining my productivity (which I suspect is the case), that's bs.

I do think its kind of BS that you can't answer questions or give them basic advice over the phone though, whats the point then; I'd be annoyed as a patient if a doc called me to discuss my visit and if I had a question and they said, sorry, I cant answer. So why did you waste my time calling then?

Though this perspective comes from never really having to do this, it is one thing in my entire career in multiple settings I've never been asked to do, other than culture/xray followups, which mainly was when I was a resident.

 

[nikolaite]

Guess it depends. If you are paying me my hourly rate just to call people, I'll call people. Now if you expect me to call people while at the same time seeing patients and maintaining my productivity (which I suspect is the case), that's bs.

I do think its kind of BS that you can't answer questions or give them basic advice over the phone though, whats the point then; I'd be annoyed as a patient if a doc called me to discuss my visit and if I had a question and they said, sorry, I cant answer. So why did you waste my time calling then?

Though this perspective comes from never really having to do this, it is one thing in my entire career in multiple settings I've never been asked to do, other than culture/xray followups, which mainly was when I was a resident.

According to my sister, and she’s no authority just saying, there are two main issues with the call backs she is required to do: the double-booking, so to speak, where “office rotation” does NOT excuse from seeing patients or telemed consults; and the fact that she is prohibited from allowing the patient to consult with her on anything whilst on the line. I can tell each time I ask her about work that she is getting burnt out. I tried to get her to come work for me, but no such luck yet!

 

[Rendar5]

It’s a great idea. Yes I call back every patient every day. Magically I’ve yet to reach a patient in the last four years. (If your metrics are in the middle or ahead of the pack no one cares about anything)

 

[Dred Pirate]

How would you investigate that..? There’s literally no way to prove that you didn’t call, also if you miss type a digit then you made an “innocent mistake” so you can’t be faulted for that either..this is so pathetic we are doctors we have to stand up at some point next thing you know we’re gonna be cleaning the bathrooms in order to “boost morale” of the janitorial staff ffs

not that this is relevant - but I know CVS makes the rph's call and it does it through the computer system somehow and then the systems tracks the calls. Not that I think this is gonna happen to y'all, but there is technology that can track this if someone wants to go through the hassle.

 

[KnuxNole]

It happens with EPIC too, there are ways to track your keystrokes, how often you copy/paste and how fast you sign a note, etc. I'm sure there are some directors/admins who run reports on how many missed call backs. If there are too many you may have someone sit next to you on a clipboard to monitor your calling methods. We have people in our hospital who's main job is to run reports on so many aspects haha

 

[Dred Pirate]

It happens with EPIC too, there are ways to track your keystrokes, how often you copy/paste and how fast you sign a note, etc. I'm sure there are some directors/admins who run reports on how many missed call backs. If there are too many you may have someone sit next to you on a clipboard to monitor your calling methods. We have people in our hospital who's main job is to run reports on so many aspects haha

Yes. There people whose only job is to track what others do If we actually fired them and used their money to hire more worker bees, we would all be better off.

 

[GeneralVeers]

Yes. There people whose only job is to track what others do If we actually fired them and used their money to hire more worker bees, we would all be better off.

But who's watching the watchers?