On occasion, complex systems crumble because of a single defective part, a part no one anticipated.
The space shuttle Challenger is a case in point.
What happened? O-rings failed at 31 degrees, the temperature at Cape Canaveral at launch. That led to a cascade of badness which resulted in the Challenger exploding. Some at NASA were concerned but they were overruled. So, one of the main problems which caused the disaster was organizational, and not merely technical.
Which brings me to marketing campaigns on healthcare websites.
Yes, that was quite a leap for man and mankind.
This past weekend, I was at a conference where the conversation turned to virtual phone numbers that are used to measure the success of marketing campaigns. One web page will have a certain offer tied to a specific phone number. Another web page will have a different offer tied to a different phone number. All of these phone numbers ring at the same office. But, calls can be tracked. By identifying which phone number the patient used, the practice can make conclusions about which web page (and which offer) is delivering the best results.
One practice said a patient put a marketing campaign phone number in their smart phone. Months later she had surgery. She had a problem post-op. She kept calling the number she had inserted in her smart phone; a number that no longer worked. The marketing campaign had long since been abandoned. The patient was irritated she could not get in touch with the doctor. Instead of going to the primary web site (after doing a generic search), she stewed. All ended well from a clinical perspective. Still, the story highlights how an innocent variable in one part of the healthcare system can cause untoward events downstream.
There’s still value in tracking marketing campaigns. Doctors want to know the money they are spending is being put to good use.
To remedy this potential snafu, it is probably a good idea to revisit which number the patient should use post-op if there’s a problem. This can be done in the pre-op process and confirmed again post-op. Some physicians give patients their mobile number. I think this is generally a good idea. The vast majority of patients do not abuse this privilege. Also, one can purchase virtual numbers that ring on your cell phone. This way you know it is coming from a patient and not a telemarketer.
Patients need access to doctors in the post-op period. Double checking how they can connect to the doctor to answer questions will prevent greater headaches if the patient later complains the doctor “abandoned” them.
What do you think?
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ABOUT THE AUTHOR
Jeffrey Segal, MD, JD
Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
If you have a medico-legal question, write to Medical Justice at infonews@medicaljustice-staging.shfpvdx8-liquidwebsites.com.
In my experience, I do not agree with your statement that the “vast majority of patients do not abuse this privilege.” Many patients do indeed abuse this privilege, storing the private cell phone number, mistaking it for the main office number, calling for less-than-emergent questions/concerns sometimes months later, etc.
It may be worthwhile from a risk-mitigation perspective to give out the cell number, but there is indeed a price associated. I do still carry a pager for two reasons: first, it works better in areas with compromised cellular signal; second, it provides at least a theoretical additional-step barrier to frivolous (or less-than-emergent) calls on the cell phone. I leave the pager number on the outgoing after-hours message associated with my main office number.
“Some physicians give patients their mobile number.”
I’ve been doing that since around 1980. Exactly no one has e er abused it. Patients are thrilled at knowing they can reach me if they need to do so. That seems to do the trick for them. Sooner or later someone would probably have abused it, but in something like 40 years, no one has. I’ve had a patent call because they didn’t know whether symptoms they were having were related to endovascular surgery (they had the flu), but I always thought it was better to call and not need to than the opposite.
My uncle was a pediatrician in New Orleans. He lived in the golden age–made house calls daily, often AM and PM. Answering service was the “doctor’s exchange,” but it didn’t matter: patients got to him and he went to them. Admittedly, that was pretty much over the top, but at the time, it was de rigeur. Now that might be abuse; not then.
Times, as Cole Porter has said, have changed.
I do like the idea of a virtual phone number that then goes to the cell, especially today with so many spam calls and a malfunctioning “Do-Not-Call” list. However, I routinely give my patients my cell phone number. It’s very comforting to patients after surgery to know that if they have a problem, or simply a question, they can reach me. And if they have an out-right emergency and they can’t reach me, I have a backup office that’s open, even Sunday. (Thank you, LI Oral Surgery!). Most patients apologize for calling, and only one has called for a concern that wasn’t emergent in the least. BTW, I’ve been making house calls for my senior patients who shouldn’t drive after dark for the past several years.
I used to give patients my cell routinely. The privilege was abused by a few patients but I thought the benefits outweighed this. I no longer do this for the following reason. A patient who was having a problem called me at 2am. Normally, this would wake me up but this time it didn’t. I answered when I woke up at 530am but this was not acceptable. I was callous and uncaring (from the resulting filed complaint). The point being that when you give out your cell, you are accepting responsibility for that call. An answering service picks up the phone. In a true emergency will call repeatedly, will contact a backup physician and will tell the patient to go to the ER.