Monday, May 7, 2012

But, It's an Emergency!

How was your weekend? Did you hear about the Super Moon? It meant a busy emergency weekend for me. What do you do for after hour weekend emergencies? What is a dental emergency? I have my own thoughts on this; often, they seem different than patients’.

I am on a two-week rotation with Dr. Jackson, so we take turns. How do you handle emergencies? We have a phone system that allows a patient to leave a message that will be returned the next business day (usually prior to 9 a.m.) and get the patient scheduled. The patient has the option to have the phone system call the doctor’s cell phone, and they can leave a message. We usually get back to them within the hour. I rarely answer the phone so that I can hear the message, verify they are actually a patient, and go ahead and try to figure out what I want to do. Most of the calls sound something like this: “Hi. This is Mr. Jones. My filling just broke and is rough to my tongue. I would like to come in and get it fixed this weekend!” Sometimes they have an appointment scheduled for next week and want a call back to reschedule. My favorite always comes from the patient that I have been recommending treatment to for years: “My front tooth/veneer just came off, and I am going to die if I do not get it back on today!”

What do you constitute as a dental emergency? For a real emergency, I tell them to call 911 and get to the E.R. But to some patients, bleeding gums from gingivitis is a weekend emergency. We really try to offer complete patient care with exceptional service, but at times, it drives me nuts how demanding patients can be with truly minor issues that could wait until Monday morning.

I need a mental break from the office. At times, that is almost impossible. I know some doctors who cannot be found anywhere on the planet once Thursday afternoon hits. It is almost like they enter the witness protection program! We call every patient of record back and assess their situation, but rarely do we come in. To help curb abuse, we do have a standard after-hours fee. The time, gas and stress of having to come in and open the office, especially if I need an assistant, can be expensive. We do not always use the after-hours fee; it just at our discretion. If Mr. Smith is a great, long-term patient, I do not usually charge it. But if it is one of those patients that only shows up once in a while for limited care, they are getting the charge.

I have had patients demand that I extract a tooth on the weekend. They always go into elaborate, dramatic stories. I have even busted one lying to me, saying they had spoken to my partner and he told them to tell me to go in!

The main reason I do not want to go in is that I really need an assistant to help because I have the hardest time finding where everything is. I guess I really could treat a patient if I had to. But can you imagine trying to extract a tooth and having the root tip break, and trying to get that out without an assistant? That sounds like a great weekend to me! It is not easy trying to find an assistant to come in on the weekend, so it is typically pain medicine and an antibiotic, if needed.

Other dentists might subscribe to the philosophy that if the patient’s mandible is not in their hand with blood dripping down their face, there is no need to go in or even call them back. I think that is a bit drastic. Sometimes all the patient needs is a reassuring voice to tell them it will be okay and the problem is solved until Monday morning. Others are screaming and yelling, wanting treatment now for the chipped incisal edge of #9.

I think that I have had to come in three times in the last several years, which is not too bad. I guess if I want to make it on to Angie’s list with the plumbers and auto mechanics, I will need to start seeing emergencies in my kitchen like the commercial.

Have a good week.



Anonymous said...

They tell us in school to never ever go into an office alone without an assistant because someone could always claim something "happened"...

Anonymous said...

Used to do the after hours emergency thing but often only got strangers who were off their faces, not wanting to pay, and saying things at 1 am in the morning like "I want to tell you, I don't (expletive)want to be here!" In the end, it got too dangerous. No tooth is worth my death. A pharmacist I know always insists on a police escort.
My own patients, on whom I've done complex work or an extraction, are always given my after hours number. They rarely call


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