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Showing posts with label antbiotic. Show all posts
Showing posts with label antbiotic. Show all posts

Thursday, December 14, 2017

Stressful and Nonstressful Visits


Driving to a hotel can be stressful. I talk to guests by phone beforehand, eliminating obvious emergencies and unreasonable requests, but plenty of worrisome possibilities remain.

Sick babies make some hotel doctors nervous. I see them but some don’t. If, over the phone, the doctor tells you to take your baby to an emergency room, ask politely if he prefers not to see infants. If he admits this is so, try to find another hotel doctor before going off.

Elderly patients can be challenging. They seem fragile, so a doctor may lean over backwards to treat illnesses that don’t require treatment or refer to a hospital more quickly than he would a younger person. I consider eighty the beginning of fragility; other doctors begin at seventy, but this is clearly wrong because I am over seventy and not fragile at all.

If a patient has a bellyache, I worry. Without tests or x-rays I have to decide if it’s safe to wait. When I decide it’s safe, I’m almost always right, but I send guests to emergency rooms if uncertainty remains. Many endure a long, tedious, expensive experience only to learn that nothing abnormal has turned up. Some consider this good news, but others wonder why, having summoned me and paid my fee, I didn’t save them the trouble.

I’m always uneasy before seeing guests suffering an ordinary respiratory infection because a large percentage – perhaps a quarter – are obviously disappointed if I don’t prescribe an antibiotic. We feel bad when a patient believes we haven’t helped.

On the bright side, I often drive off knowing the diagnosis, knowing I’ll help, and certain the guest will deliver a satisfying dose of gratitude. Relaxing drives include those for simple urine infections, eye infections, ear infections, and rashes. I generally diagnose chicken pox, shingles, hives, and the common cold over the phone. Isolated abdominal pain is tricky, but I feel better if vomiting or diarrhea accompany it because they usually indicate a short-lived stomach virus. Guests who want their blood pressure checked rarely worry me. High blood pressure doesn’t cause symptoms, so those who make this request have other problems, generally anxiety-related.