Whether you're looking for a primary care doctor, a specialist, a surgeon or a pediatrician, there's one question most people forget to ask, and it can be a lifesaver: "By the way, who's on call for you? Where will you send me if you're not available?"
Just this morning, I got a call from a friend whose husband has had a feeding tube in his stomach for some time. He had it routinely replaced a week or so ago. When he was having some major problems with the tube working properly, my friend called the gastroenterologist's office. She learned he was on vacation in Hawaii. When she asked who would be handling the doctor's patients while he was away, they just told her to " take him to the ER."
Telling people to visit the emergency room in a situation like that just isn't sufficient. The emergency room is not designed to provide the kind of care you get from physicians who know you and have been following your situation. It's not a good substitute for the level of assessment and follow-up you need. It's designed for genuine emergencies.
An increasing number of physicians are no longer ever really "on call." When they're off duty or on a trip, they don't secure back-up docs in their specialty to cover for them. Instead, they rely on the emergency room to provide complete back-up for anything that comes up: small, medium or large.
You'll learn a lot about how a prospective physician views his or her role and their commitment to their patients by how they answer a question about back-up. You'll get a clear sense of what your situation would be if a significant -- but not emergency -- problem happens after hours, or even during the weekday, when they happen to be gone.
When some physicians are technically on call, they almost always will still just send you to the emergency room. Know that before you choose a doctor.
Beyond the main question or two about back-up, find out a little more if you can:
"If I have a procedure or surgery (or whatever that doctor does) on a Friday and I have issues on Saturday or Sunday, how will my needs be met?"
"If you're not available, to whom would you send me?" If the physician mentions another doctor by name, ask about that individual's qualifications, accessibility and approach.
"If you're on call and you think I need to be seen, would you most likely meet me at your office, meet me in the emergency room or just send me to the emergency room?"
"If you're away for more than a day or two, and if your office tells me to just go to the emergency room, is there another doctor in your specialty in this town that you would suggest I call?"
And if you don't like what you hear, discuss your concerns. If you're still not pleased, check out your other options in your community and in the region.
You'll be glad you did.
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Barbara Bronson Gray is an award-winning writer and a nationally recognized health expert. She writes a blog, www.bodboss.com, and is a regular contributor to HealthDay.com, preparedpatientforum.com and thirdage.com. Barbara has worked in hospitals, as a nurse and as an administrator, led a major healthcare magazine, created a website for WebMD, and served as a leader of global communications for Amgen, the world's largest biotech company. She continues to write and speak about healthcare and has a communications consultancy. Follow her on Twitter: @bbgrayrn.