Thursday, March 04, 2004

My 1st patient!

I saw my 1st patient on Monday evening. But he was almost my 2nd patient.

I had received a message on my answering machine Sunday night from an older gentleman who was looking for a new doctor. I called him back the next morning, but it was clear from talking with him that there was some serious Axis I issues going on with him. I briefly considered whether it would be worth it for me to try and help him, but after 15 minutes of listening to him ramble from one delusion to another, I decided that it would be a lost cause. So I told him that I was very sorry but I didn't think I could help him.

After I hung up, it occurred to me that this was one of the benefits of no longer working at Kaiser. If I saw someone like him at Kaiser, I'd be stuck with him as a patient unless he voluntarily switched to another physician, or he acted in a manner that would justify my discharging him as a patient. That only happened once that I could recall (me discharging a patient, that is).

It was an elderly woman with chronic complaints who somehow had gotten a hold of my private phone line, and would call throughout the day to complain about this or that. At that time, I guarded my private phone number like it was gold, and never gave it out for fear of getting inundated with messages from patients. We had a system whereby messages from patients would get filtered by a nurse, who could sometimes handle the call, or route it to the appropriate doctor. My reasoning was that, if patients called me on my line directly, I could easily spend hours handling phone calls, and not have enough time to see the patients in for office visits. But it was inefficient, too, because the messages would get to us 2 hours after the original call, and when we'd call back, the patient would no longer be at the callback number, and the game of phone tag would begin.

So when this patient first called, I was very surprised and asked her not to call my direct number, explaining that I didn't have her chart or information in front of me, and to please call the message line instead. But she refused, saying she would call me whenever she wanted to. Well, I got angry and asked the clinic administrator to transfer her to a different primary doctor, which she did. Strange how now, I'm giving out my cellphone number to patients on my business cards. In retrospect, I'd have to say that that lady probably had it right, that she should be able to contact her doctor whenever she needed to. But she should've respected my request to follow my policy for its use, too. It's a two way street.

Anyways, later on Monday, I got another call and the caller ID read "**** RESEARCH INC". Having received a LOT of telemarketing calls, this sounded suspicious to me so I elected not to answer it. However, after the beep, a voice started explaining how he wanted to see a doctor...

I quickly grabbed the phone and started talking. He wanted to be seen but worked until 7:30 PM. No problem, I said. How about 8 PM? Flexible appointment times is another benefit of having my own practice. And even though it was raining, he did show up at 7:45 PM. I had explained on the phone that I wasn't able to accept insurance yet, and he said that was okay since he didn't have any insurance. I had explained that I charged $50 per 15 minutes, but would reduce it to $40 if he paid at the time of service. I asked him how he heard about me, and he explained that his secretary had read an article in the newspaper about me (the one I wrote the press release for).

We spent probably 30 minutes talking but I charged him $40 because, well, it didn't seem worth $80 to me (my problem with valuing my own time). But he only had a $100 bill; did I have any change? Of course, I didn't, but I didn't want to send him a bill. We finally decided he would go down the street to the local grocery store and get change. He offered to leave something to show that he would return, but I told him that I trusted him, and I did. He returned with the $40 and I gave him a receipt. I still have the two twenties in my office. I'm wondering if I should frame them as my first earned income as a solo practitioner?
It turns out he owns his own company, and so I'm hoping he may steer some of his employees my way.

This business of finding patients seems to be a slow process. But as long as it grows, that's okay. This morning I spoke to another person who scheduled an appointment for his son next week. A patient a week. Good thing I'm still working part-time at Kaiser.