[aladoc99]

Any patient who tells me they've got to have my private number will be told that they've got to get a different doctor. It is vitally important for me to be able to disconnect from patients and their potentially bottomless well of need in order to maintain sanity.

[shakna]

Looking over the article, and guessing, here.

This isn't likely to be a what a phone appointment is.

A phone appointment is what it sounds like. A set time, generally within normal office hours, pre-arranged, for the doctor and patient to speak.

It's simply a way of not taxing the patient with travel, especially if they need to travel any significant distance like to the next town.

[_dark_matter_]

The parent comment was reading from a different line: `I made lists of questions for my doctors and insisted they give me their personal phone numbers.`

[naner]

That is a pretty big leap from just a single statement.

I've noticed the same problem and I'm not in the medical profession. Many people don't have good judgement when given direct 24/7 phone access.

[Bartweiss]

I'm curious how this varies by speciality.

It's pretty obvious why you'd want this space. Constant on-call status is rough enough for technical roles, I can't imagine how much higher the burden would be when people's health is at stake and 'false alarms' are human fears instead of automated notices. Long hours and high emotional burdens scream for boundaries. But... I've also seen doctors who seem to consider this standard practice. Not that they're obliged to respond immediately, but they even offer phone numbers unprompted. (I hope for their sake they have a different number for those calls.)

What stands out to me is that this article is about Crohn's, a probably lifelong condition for which a doctor might see a huge number of patients. The doctors I've seen giving out personal phone numbers are oncologists and similar, who see people for long but finite stretches and have relatively low patient counts. (And, of course, are dealing with a disease where "is this serious?" is not-uncommonly met with "go to the ER immediately".)

I'm not sure what your specialty is, but I'd be really interested to know whether this is just a per-doctor preference or has broad patterns between fields.

[homero]

I try not to bother my doctors for this reason. I'm the opposite.

[trapezoidion]

I think everyone should avoid interacting with doctors unless it's absolutely necessary (in the US). They have to diagnose hundreds or thousands of patients, and it's unreasonable to expect them to care or deliberate about your specific needs. They are running or working under a business, and are incentivized to minimize patient time and maximize billing. Even a phone call to their office can be converted into an insurance claims if you're asking them to correct a mistake, which I found out when I looked at my health insurance online. This also means that you should always be skeptical if doctor recommends a certain procedure, especially if he's involved. You have to assume he's acting in his or his employer's best interest under our current model of health care.

[UnpossibleJim]

Service to others doesn't mean lackey to all. Boundaries have to be set for sanity's sake, for both patients and doctors. There are emergency lines if the situation is truly dire, and this is coming from someone who is both a brittle diabetic and an epileptic.

[scarmig]

Doctors who don't set boundaries and who perform an unlimited amount of emotional labor are those who burn out.

There's no medical reason for a doctor to be on-call 24/7/365, and it's stupid to expect them to. If an urgent medical issue comes up at 2 AM, the patient can go to the ER, which is what the doctor would tell them to do anyway.

[iguy]

Maybe the patients to whom they offer their private numbers, and the patients who "tell me they've got to have my private number" are non-overlapping sets.

I'm sure that experienced doctors can spot people who are going to ruin every weekend a mile away, and also those responsible enough to call only when it really is appropriate.

[nate_meurer]

> The worst have been preachy, god-complex douchebags.

Is this sideways dig really necessary? I could say the same about programmers (and I am one).

I count half a dozen doctors and nurses among my inlaws. None of them will give their personal phone numbers out to patients. If a patient asks, they're politely told to call the office, who will then curate the calls.

If you've ever been around a doctor, especially a GP, you know how many calls they get. My father-in-law takes dozens of calls a day from his office, several of which come at night when he's asleep. If he were expected to take calls directly from patients, he'd be completely unable to do his job.

So, serious question for you jachee: is it possible that the doctor you're responding to has some insight into the challenges of his job that you don't?

[Nomentatus]

Chronic illness demographics - particularly for diseases of inflammation - have exploded in the last fifty years, outpacing the supply of doctors and then some. The need is now bottomless, and it is in fact a need.

[m_fayer]

My clients, as a whole, are a bottomless well of various IT needs. This is by design.

[homero]

One patient with health anxiety will call daily, multiply that by any number. Then add family members.

[normal_man]

I mean, a "bottomless well of need" is basically exactly what a chronic illness is. Have some compassion; doctors and medical professionals deserve to clock out at some point just like the rest of us. It doesn't mean they are in the wrong profession.

[unclebucknasty]

>patients and their potentially bottomless well of need

That's worded with a tinge of contempt. Not saying it's undeserved--I've never walked in your shoes, and I can imagine the medical profession being exhausting and one of high-burnout.

But, it does make me think of how things have changed in this regard, for both doctors and patients. Time was that doctors made house calls, knew every patient personally, and frequently cared for multiple-generations of a family. There seemed to be a certain intimacy baked into the profession. Of course, that's pretty much impossible today with insurance, medical costs, etc. making medical practices more of a numbers game.

On the other end, patients are consumers like any other. And, after running a consumer-facing business for many years, I can say that there seems to be an unreasonably high-expectation of service and outright deference to the customer--sometimes bordering on a sort of pathological entitlement.

The result is that there seems to be a lot of hostility baked into transactions and other professional interactions. Given the personal nature of one's health, I can only imagine this to be amplified.

[seszett]

> Time was that doctors made house calls, knew every patient personally, and frequently cared for multiple-generations of a family

They (some) still do. But they have to have their patients' numbers, not the other way round, if they want to have a life of their own.

Some people can devote the totality of their life to patients, and it's a good thing if the article author could find some of them I guess, but most doctors also have a family and their own needs, which is extremely difficult if your patients can call you whenever they want.

Doctor or not, you don't want to risk receiving constant calls from a few particularly difficult patients at any time of the day or night while you're trying to lead a life with a husband/wife and kids. And that's not even taking into account the potential for abuse from other (or the same) patients who will find there a method to bypass appointments and to avoid paid consultations.

On the other hand, email works very well for "push requests" from patients, and is a lot less disruptive for the doctor.

[loteck]

Time was that doctors made house calls, knew every patient personally, and frequently cared for multiple-generations of a family.

Time was also that doctors had very few treatment options for a vast array of maladies that afflicted their patients. Now we use high technology to try to win every fight. Bedside manner is nice, but it won't stave off lymphoma.

[coldtea]

That happens when communities and communal links break down into mere sellers and buyers...

[saiya-jin]

Imagine you have 7 minutes for a patient, and off to the next one. Imagine 90-95% of your work time is spent in front of computer, filling in forms for every patient coming in, getting any treatment or leaving hospital. Each one takes 60-90 minutes (no kidding). My fiancee's daily/nightly routine, every single day, in biggest hospital in Switzerland.

Our romantic views on what it is to be a doctor are long gone, unless you go with orgs like MSF to ie Africa. Reality is, most of doctor's work these days is pure bureaucracy (maybe apart from surgeons). Any job that gets into this 'corporate work' state will have any positive energy drained out of it.

Do you know any doctors personally? Most of them end up pretty disappointed bitter with their work right after school - those rosy expectations meet reality. In fact, in our circle of friends where there are many young doctors, there is 0 happy with their work.