Do they make this and do I want it?

[Mister Mxyzptlk]

I'm tired of getting crappy messages from the answering service. Had a patient call over the weekend and the service just said she had a procedure done a few days ago (facet injections) and was having severe pain, so I told them to tell her to go to the ER if it couldn't wait. Patient called yesterday, not very happy. I had the service email me the recording and it was much more involved than what I was told on the phone - patient was scared, worried about whether this was a normal reaction, etc.

So I was thinking that perhaps there was a service or software or a magic box where patients could leave a voice mail and I could send them a voice mail back via a private mailbox with a PIN. Then I started thinking this could turn into an endless loop of voicemails back and forth.

Then I started thinking that maybe I should do what some of my colleagues do, which is have the answering machine on after hours telling people to go to the ER if they have an emergency. I'm reluctant to go this route because I don't want to miss someone with e.g. urinary retention after an ESI. The patient doesn't know what's an emergency.

Open to any suggestions that don't involve actually having to talk to a patient.

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[101N]

I'm tired of getting crappy messages from the answering service. Had a patient call over the weekend and the service just said she had a procedure done a few days ago (facet injections) and was having severe pain, so I told them to tell her to go to the ER if it couldn't wait. Patient called yesterday, not very happy. I had the service email me the recording and it was much more involved than what I was told on the phone - patient was scared, worried about whether this was a normal reaction, etc.

So I was thinking that perhaps there was a service or software or a magic box where patients could leave a voice mail and I could send them a voice mail back via a private mailbox with a PIN. Then I started thinking this could turn into an endless loop of voicemails back and forth.

Then I started thinking that maybe I should do what some of my colleagues do, which is have the answering machine on after hours telling people to go to the ER if they have an emergency. I'm reluctant to go this route because I don't want to miss someone with e.g. urinary retention after an ESI. The patient doesn't know what's an emergency.

Open to any suggestions that don't involve actually having to talk to a patient.

We have a call in voice message system that we use. Patient calls in and leaves a message after hours and the system pages which ever one of us is on call. Prior to leaving
their message the patients are instructed not leave emergency messages or opioid refill requests there.

When a patient calls and leaves a message after hours the oncall doc calls the office # and key in a password to listen to their message. Then we call them back. Thus far it's worked well and hasn't been abused.

 

[epidural man]

Open to any suggestions that don't involve actually having to talk to a patient.

Ha!

Here is my suggestion....start a fellowship. They answer the phone for you.

 

[DOctorJay]

some people set up "google voice" to do something like this. it will transcribe your voice message and send you an email of the text, not extremely accurate from what I've heard but probably enough to figure out if you need to listen to the actual message. not sure about the HIPAA compliance of this though.

 

[Aether2000]

Our telephone system purchased 7 years ago came with an emergency box with a message to the patients. If they leave a message, and it is indeed one of my patients, our telephone system calls my cell and tells me I have a message. I retrieve it directly from the cell phone by pressing a code, then use my www.gotomypc.com terminal emulation at home or out of town or on my cell phone to get patient data from the EMR, then can respond to the patient appropriately. Works great!

 

[PMR 4 MSK]

I think any system where the patient can only leave a message and you can only leave one back is going to frsutrate one or both sides. No one likes phoning patients after hours, but sometimes you have to. Our answering service just sends shorthand texts to us.

E.g. "Mike Smith ur pt PCP u, severe pain. 555-5432." I guess typing out "ur" takes so much less time than "your." They also have yet to remember I am no one's PCP. Then I have to call the pt.

When I was solo, my office voice mail said to leave a message and it would be answered the next business day. For emergencies they should go to the ER. For non-emergencies that cannot wait until am, my cell number was listed. very few people called me. Most that did call me were just told to call in the morning for an appt or told to go to the ER.

 

[Mister Mxyzptlk]

I could do this thru Google voice or through Comcast, which will answer the phone and send the message (transcribed and recording) to email, but returning calls personally turns into a telephone office visit too often. I want automated patient callback but I guess it's not ready for prime time yet.

 

[Jcm800]

I could do this thru Google voice or through Comcast, which will answer the phone and send the message (transcribed and recording) to email, but returning calls personally turns into a telephone office visit too often. I want automated patient callback but I guess it's not ready for prime time yet.

we have an answering service, that is instructed to tell patients, if it is not an emergency or serious concern, to call back.

so if they tell the answering service they need to talk to me, they page me, and i call the answering service, and get connected. Most of the time it is NOT an emergency, but not unreasonable of a question or issue. This happens once a week, at most.

this way i dont miss anything important, and if it is unimportant, its rare anyway...

 

[sblau001]

Call me crazy, but I have my cell phone number printed on the back of my business card which tells patients to call me directly if they have an emergency. Of course, my patient demographic is not typical, as I practice in a heavily populated elderly retiree region. Once in a blue moon, I'll have someone call me with a completely inappropriate, non-emergency question, but the benefits of having my patients able to reach me any time far outweighs the minor nuisance of these occurrences. Plus, one of my biggest peeves is miscommunication causing angry patients.

 

[PMR2008]

Call me crazy, but I have my cell phone number printed on the back of my business card which tells patients to call me directly if they have an emergency. .

Wow!! I would never even consider doing that.

 

[bedrock]

Wow!! I would never even consider doing that.

+ 1

I call you crazy for that. That's ridiculous. Patients don't need that kind of access.

 

[Jcm800]

+ 1

I call you crazy for that. That's ridiculous. Patients don't need that kind of access.

I will also call you crazy.
No if I had two cell phones maybe, one just for patients, but who wants that headache....

 

[Tenesma]

My patients get a list of symptoms that are a reason to present to ER... We have a voice mail system that advises them to go to ER or call pcp... I haven't had any issues

 

[PMPMD]

Anyone charging for returning calls? I've heard of this in a few fields, pain was one of them? It was a nominal fee (~$25) but was said to cut down on frivolous calls. Still cheaper than calling a lawyer.

 

[PMR 4 MSK]

I will also call you crazy.
No if I had two cell phones maybe, one just for patients, but who wants that headache....

I would not call that crazy, but a cheap alternative to an answering service. If yours is like mine, they don't do call backs for us. We have to call the patients ourselves. So why pay them?

Any patient who abuses the privilege gets a warning. Repeated offenses will get you fired.

Anyone charging for returning calls? I've heard of this in a few fields, pain was one of them? It was a nominal fee (~$25) but was said to cut down on frivolous calls. Still cheaper than calling a lawyer.

Most insurances will not only not pay the charge, they will not let you pass the charge on to the patient. If you are not in-network with that insurance, though, feel free to charge.

 

[specepic]

Call me crazy, but I have my cell phone number printed on the back of my business card which tells patients to call me directly if they have an emergency. Of course, my patient demographic is not typical, as I practice in a heavily populated elderly retiree region. Once in a blue moon, I'll have someone call me with a completely inappropriate, non-emergency question, but the benefits of having my patients able to reach me any time far outweighs the minor nuisance of these occurrences. Plus, one of my biggest peeves is miscommunication causing angry patients.

As you say, in the right area/ pt population this can work. I would rather have them call than email me, I do not have my email on my cards b/c otherwise you get these really long emails that require detailed responses. No emails with pts, period.

I use the hosp operator and have had a RN on call service offered to me by the hosp but it has not been an issue. The operator asks "did you have a procedure"n if the answer is yes they call me, if no, wait till office hours or in doubt ER/PCP. If they had a procedure and think they have an issue, I want to s/w them personally.

The other issue to consider is all communication that runs through the office will usually get charted for you, the more you take on yourself, then you have to spend time charting the call

I bill phone consults for all calls I return (I believe there is a rule that this has to be 72 hours after their last appt to charge). I'm on an RVU system so it does not matter if the ins denies. If my MA handles it no charge of course.