REFLECTIONS
HELLO! I NEED A DOCTOR NOW
Teresita Bacani-Oropilla, MD
I
n a modern country like ours, when we need
a physician, we call for one on the phone.
A couple, all dressed up to attend the 25 th
wedding anniversary of their colleagues, was
on the way out when the call of nature came
upon the man. Finished with his business,
he mentioned to his wife that his stools were
remarkably black. A quick phone call to their
family physician resulted in an order for immediate admission to a
hospital. A plea for a few hours’ reprieve to honor their hosts was
flatly denied. Workup revealed a duodenal vessel actively spurting
red blood from a newly discovered duodenal ulcer. Cauterization of
the offending blood vessel and an ulcer regimen solved the problem.
An elderly gentleman with diabetes and one functioning kidney
was unable to keep his food and fluids down for two days. When
he called his primary physician’s office, he was told that the first
available appointment would be the next day and that he should
go to an emergency room. Compliant with the recommendation,
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LOUISVILLE MEDICINE
they found that the wait to be seen by the doctor at the emergency
room, however, would be more than two hours. His wife, noting
how bad her husband looked, loaded him back in the car and head-
ed for the nearest urgent care center. The staff there noted that he
needed more care than they could provide and mercifully called
and referred him to another hospital miles away. There, the patient
was immediately admitted, rehydrated and stabilized before being
discharged two days later.
What is a patient supposed to do in a crisis?
Physicians, with their vast knowledge and experience are able to
judge, usually even from a phone call, what a patient needs. Despite
the fact that not all phone calls from patients are crucial to the
preservation of life, and besides, would certainly tax a physician's
precious time if he/she answered them all, to the callers they are
indeed emergencies and need to be attended to ASAP. In the days
when doctors knew their patients and vice versa, many so called
emergencies were satisfactorily handled by phone. In these days of
fragmented care however, patients float in limbo, not owning one