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Nov. 12, 2009

ART OF MEDICINE CAN REQUIRE LONG HOURS AND LONG WAITS

DEAR ABBY: May I respond to your column regarding excessive
waits in doctors' offices (Sept. 1)?

I am a board-certified interventional cardiologist who has
been practicing for 30 years. I work 85 to 90 hours each
week. As hard as we try, our office schedule often falls be-
hind. Despite recommendations that acute problems go to the
emergency room, unscheduled patients come to the office with
chest pains, and they must be attended to. Even scheduled
patients can develop complex medical issues that require ex-
tra, unplanned time to evaluate and treat.

Our patients with a history of heart disease do not mind
waiting when the office runs behind because they receive the
same specialized extra-care treatment when they need it.
Delays that result from spending extra time evaluating and
treating sick patients with complicated problems is not
"unprofessional" behavior as "Larry W." implied. On the con-
trary, it relates to the art of medicine and caring for the
well-being of each patient above all else.

And for the architect, I wonder when he last worked a 90-hour
week, took seven or eight phone calls from his clients after
midnight, and got up at 3 a.m. to do an emergency two-hour
procedure before returning to his office at 8 in the morning
bright-eyed, bushy-tailed and running on schedule the rest
of the day?
-- DR. RON IN LAS VEGAS

DEAR DR. RON: I felt it was only fair to print your response
to my follow-up column on "Sick of Waiting in Denver." That
column elicited a mountain of letters, all of them offering
reasonable explanations for the delays in medical offices.
Read on:

DEAR ABBY: Many factors cause doctors to run behind. Routine
physicals can reveal life-threatening conditions that must
be dealt with immediately.

Also, people do not reveal the true reason for their visit
when they call, so they are not given the appropriate amount
of time for the appointment. A teenager brought in for vom-
iting could have the stomach flu, onset diabetes or even be
pregnant.

A colleague once had a woman complaining of abdominal pain
who gave birth in the exam room. That definitely took more
than 15 minutes!
-- M.D. IN WOODSTOCK, ILL.


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DEAR ABBY: My husband is a thoracic surgeon who spends four
days a week in the O.R. and one action-packed day seeing
patients in his office in addition to his on-call schedules.
When I ask my husband what held him up when he gets home
late for dinner, his response is always the same: "I give
each patient my undivided attention. I would never cut them
off or hurry to see the next one until I know every concern
was addressed." If these readers who complained about waiting
have a doctor as kind and caring as my husband, their wait
is worth every second.
-- MARRIED TO A WONDERFUL MAN

DEAR ABBY: Every single day, multiple patients wait until
their appointment time is up to say, "There's just one more
thing I was afraid to bring up ..." Then they tell me about
their chest pain, depression or possible abuse. These are
things I cannot and will not ignore. But it does mean the
next patient will have to wait.

Some people behave as if they're going to a fast food drive-
thru. And if things don't change, that is exactly the kind
of care they'll end up getting.
-- DELMAR, N.Y., DOCTOR

DEAR ABBY: When your doctor has to deliver devastating news
about your health and you have lots of questions, lots of
tears and your mind is filled with terror, you'll appreciate
the time being spent with you -- which means someone else
will have to wait.
-- MEDICAL OFFICE MANAGER IN KINGSPORT, TENN.



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