Olongapo City – Personal experience has taught me that giving out your personal numbers to patients is really a bit of a nuisance. Patients will try to seek consult for free by texting/emailing you and refusing to be seen at the clinic for further work-up. Other patients will text/email you symptoms that a companion has so that they too can sort of get a free consult. Most of the time, they get angered when I do not give them that priviledge especially when they text me at 3 in the morning. This is not because I want to charge a Professional Fee. Trust me, I usually give out clinic consults for free. I don’t give out consults online or via mobile because it’s dangerous.
Few months ago, an OB-GYNE was enjoying a meal with friends. She got a text from an unregistered number. The sender identified herself as her patient and that she is experiencing abdominal pain. The doctor is nowhere near her clinic and has (of course) no copy of the patient’s medical records nor any way to access it. She texted back instead, “TAKE BUSCOPAN 10mg/tab 3x a day.” She did as the doctor ordered. After 2 months, the OB-GYNE received a subpoena.
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The sender happens to be pregnant at the time and she was experiencing premature labor. Hyoscine (Buscopan) hastened the process and she delivered a premature baby, who died a few minutes later. She consulted another doctor (not me, promise!) who told a lot of things to incriminate the OB-GYNE. The court case is still ongoing.
Mobile consults are not something you will see in the future. It is happening now. For mobile consults to happen, a system must be set in place to prevent incidences like this. Higher charges should be imposed on mobile consults because the risks for malpractice are greater.
For now, I do give out my personal cellphone number but I do not give out consults via text or online methods. I simply request my patients to see me at the clinic or if the case is urgent, be seen at the emergency room. It is important to me that I see the patient personally before I prescribe a medication. The patient may be an old friend but every new symptom must be treated with a fresh eye. Complacency can kill patients.
If you are a patient (whether mine or somebody else’s), please bear in mind that we have every duty to put you first but you must understand that we need to see you, feel you, and hear you. We do not care about financial compensation. We do care about your safety. Please refrain from asking what is the best medicine for a certain ailment. We can answer you, but the answer may not be the best medication for you.
The art of medicine is the art of when to give and when not to give a certain medication.
Zero MD 
The phenomenon of consult texting or email consults is also an indirect sign of how society has lowered its respect for the profession of medicinebbecause of lack of understanding. Many people think that being a physician is like being in a restaueant where a menu is ready for every illness or symptoms mentioned on the phone, e.g.- pain= this medicine. And what is bothersome is they expect you to answer them instantly. That is not the end. They google and see if what you said was correct. Worst they think Dr. Google’s answer is better than yours. Sadly they dont realize that what both of you are doing is wrong. That it is for their own welfare that the physician should see and examine them before presctibing a medicine.
The reason giving of a doctor’s personal number and email is avoiding the dangers of mobile and virtual consultation. Mobile and virtual consulting is a risky process as the clinical eye become distorted in such situation. A physician always has to correlate his/her personal observation and physical examination findings with a laboratory result. As said, doctors are obliged to treat the patient and not the laboratory result. Merely stating one’s subjective complaints and personal observations are not enough. Most of the time, patients overexagerate or underreports complaints rendering the information basically useless for physicians. Trying to teach patients how to check for findings doctors want to see takes a lot of time to master. Despite advances in technologies like online video and search engines, learning to think, examine and develop the said clinical eye takes years to practice. One simply cannot become a doctor just by reading medical books and journals. It requires years of clinical exposure.
Refraining from giving personal contact information is likewise a show of concern by our doctors. It will be a disservice to us if they make an impression or diagnosis based on limited information.
No one(Doctors) is at the mercy of a stranger (patient who the don’t know) who retrief their number from unknown source
ALL DOCTORS INCLUDING SO CALLED ‘SPECIALISTS’ SHOULD PROVIDE THE EMAIL ADDRESSES OF THEIR CLINICS & NOT NECESSARILY THEIR PERSONAL EMAIL IDs. IN FACT IT SHOULD BE COMPULSORY & OBLIGATORY FOR ALL DOCTORS TO GIVE EMAIL IDs OF THEIR BUSINESS OR PRACTICE SO THAT PATIENTS CAN AT LEAST MAKE OR CANCEL APPOINTMENTS VIA EMAIL [WHICH CAN PROHIBIT ANY MEDICAL CONSULTATION TRHOUGH EMAIL. THIS MUST BE OBLIGATORY FOR ALL DOCTORS. IT IS A MATTER OF MUTUAL SIMPLE MUTUAL COURTESY & CONVENIENCE TO CURRENT OR WOULD BE PAITENTS.
OTHER HIGHLY SKILLED PROFESSIONAL ALSO PROVIDE THE EMAIL ADDRESSES OF THEIR PRACTICE OR BUSINESS, IF NOT PERSONAL EMAIL IDs TO CLIENTS. DOCTORS MUST NOT BE ANY EXCEPTION. PLEASE NOTE THAT EVEN MLAs. MPs & MINISTERS [WHO HAVE MUCH HIGHER PULIC PROFILES & RESPONSIBILITIES TO THE PUBLIC THAN ANY DOCOR] PROVIDE THEIR OFFICE EMAIL IDs. SO WHY SHOULD ANY DOCTOR DECLINE TO GIVE EMAIL IDs OF THEIR BUSINESS OR PRACTICE ?
DOCTORS MUST ACCEPT THAT IT IS THEIR PROFESSIONAL RESPONSIBILITY TO GIVE THEIR OFFICE OR BUSINESS EMAIL IDs AS EQUALLY AS THEY GIVE THEIR WORK TELEPHONE & FACIMILE NUMBERS. DOCTORS MUST NOT BE ANY EXCEPTION IN THIS REGARD.
With all due respect, the Physician’s responsibility is higher than any other because it directly affects the life or death of the patient. Our profession entitles us to examine exhaustively the whole body of a patient, the body and person that God created in his own likeness. So please di not belittle our profession. All other professions can give their numbers because nobody will die by talking to other professionals.
Medicine is a vocation and Physicians treat the person and his body as sacred, blessed by God.
” No other profession has the higher responsibility to human life that that of a Physician”.
You can ask for diagnostics if area is too remote but personal appearance of any MD is mandatory.
I am an OB-Gyne and I give my number to my patients but I always emphasize that I don’t allow consultations over the phone. They can call me in the wee hours of the morning as long as it is an emergency.
THis is not about the doctors giving out their cellphone numbers but the doctor who prescribed medicine without knowing the patient’s condition.
Exactly. Giving out your personal number invites consult via text/ SMS messages. The danger is in the assumption that it’s alright to have a virtual patient-physician relationship rather than a physical one. In today’s world of automation, we think that someday doctors will be replaced by programs where you just text your symptoms and expect an answer. What is important is the intuition that is presented to you brought about by a real visit to your doctor (Hence, the moral of my story)
And the problem is that, like you said, you know what to give under the assumption of what they are telling, but we don’t know the whole diagnosis. This can happen even as simply giving Paracetamol or some basic medication as it can illicit allergic reactions.
Yes, I agree 100%. Until today all my patients and others have my mobile & WA (WhatsApp) number and I have no regrets. I have just saved one twin from immidate death thretening condition (abruption of placenta) since patient WA me 1.38 am and I asked her to go immediately to hospital and emergency cesarean was performed within short time. Prescribing medicine without knowing actual condition of patient is not recommended. Dr should have asked patient to call him and after detailed anamnesis would prescribed oral tocolitics and asked patient to come to hospital for further check (CTG if necessary). I had no problem consulting my patients via WA/mobile and the patient satisfaction should be priority.
Exactly my thoughts, you need not and should not prescribe over the phone but your expert opinion of when to go to the ER for medical evaluation may already alleviate the anxiety of a patient.
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