Farns.PA Posted September 29, 2012 Share Posted September 29, 2012 Newly minted PA-C who just joined a private family practice. Will be rotating call with 3 other MD's. Only thing is, I've never taken call via the phone through a call center and just wanted to get any advice/pointers/experience from anybody willing to share! Link to comment Share on other sites More sharing options...
Just Steve Posted September 29, 2012 Share Posted September 29, 2012 repeat after me 1. "oh, that sounds like it could be serious. Go the ER. I will get the report from them and follow up with you during clinic hours." 2. "Ok, take an extra dose of your Xanax, go to bed, and come see me on Monday. We'll get a consult with behavioral health" 3. "Oh hi John, how are the kids? Sick again? Same as last time? Ok, I'll phone in a script for Augmentin to the pharmacy, get them started on it today, then come see me Monday first thing". That should cover most of it. Good luck :-) Link to comment Share on other sites More sharing options...
mdebord Posted September 29, 2012 Share Posted September 29, 2012 Sounds about right! Most of it is sinus infections and UTIs but every now and then it gets sticky. You should have a low threshold for sending them to the ER - It's very hard for you to get all the information to rule out the bad things if you can't see them. And you have to protect yourself! A few weeks ago I had an elderly gentleman that was very angry with me when I told him to go, but I just couldn't comfortably let his "severe diarrhea and stomach pain" go. Also, you may ask the docs - We have a policy where we DO NOT refill pain meds on call. Another idea: keep notes. You never know... Link to comment Share on other sites More sharing options...
rcdavis Posted September 29, 2012 Share Posted September 29, 2012 ^^^^ you absolutely need to keep a record of the conversation, and put a note in the chart. You will be medico legally responsible for your advice, your only defense is the record of the conversation. Find out how your docs handle various calls -- do they want you to call in abx for the woman who calls complaining of a "sinus infection", refill blood pressure / diabetic medications? How quick are they to want X-rays? If someone falls on outstretched arm or twists ankle, do they have the pt come to clinic tomorrow, or do they send to ED. good idea about no pain med refills over phone.. Of course that means that I, who have presumably never seen the patient will see him in the ED and will bristle when they tell me they need pain Meds and you told them to come to see me.. What will be your narc policy? There is an art to phone call, and you will have to develope it as you develope as a PA, and the patients you serve become more familiar to you. Link to comment Share on other sites More sharing options...
Contrarian Posted September 29, 2012 Share Posted September 29, 2012 All great advise above... When I used to have a strictly internal medicine housecalls practice, I would be on call for 2 weeks at a time. Lots of DumbA$$ calls, but also a few a week that could be hairy... As has been said, have a low threshold for "turfing to ED"... and get the call recorder program for your on-call smartphone. Its the program that records both sides of the conversation and saves it as a digital file that can be uploaded, emailed to your work computer. Just be sure to inform the caller that the conversation is being recorded unless you want to be charged with wiretapping. Link to comment Share on other sites More sharing options...
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