* * Anonymous Doc: While I have you on the phone... do I need to put my father in a nursing home?

Monday, September 10, 2012

While I have you on the phone... do I need to put my father in a nursing home?

...so the biggest difference so far between residency and fellowship is that I have actual patients, I am their doctor, and I'm seeing for the first time what it means to be accessible to patients and able to be reached whenever they have a question.  I call back a woman who called the answering service and said she had a medication question regarding her father.

"Hi, doctor.  I don't mean to take up your time, but I was just wondering... I got my father's pills confused and I'm not sure which is the pink one and which is the white one.  I was hoping you could tell me."

"Oh.  That's really a better question for the pharmacist who dispensed the medication.  I don't actually know what the pills look like.  But if you call the pharmacist, he should have your records and be able to look at the actual pills and tell you which is which."

"The pink ones are bigger."

"Okay, that's great.  But I don't know what the pills look like.  So you'll need to call the pharmacist.  If the pharmacist needs to get in touch with me, or you have trouble reaching him, you can give me a call back."

"Great.  Oh, just one more quick thing while I have you on the phone."


"Do I need to put my father in a nursing home?"


"Well, I don't imagine his situation is going to get much better, and I'm having a rough time taking care of him."

"This is definitely a discussion you should have with the social worker you and your mother met with in the hospital-- there might be some services your father can qualify for.  Or she may have some other ideas."

"No, but, just generally, is my father the kind of person who should be in a nursing home?"

"This might be a longer discussion than we should have on the phone right now--"

"No, I have time."

"Yes, but I think this should be something we look at over time, and we can talk at your father's next appointment about what services he might need, and what the best situation might be for him, now and in the future."

"Do you have any nursing home recommendations?"

"I don't, but the social worker would be the best person for you to talk to about this.  You have her card, right?"

"Yes, could you transfer me to her?"

"I'm not in the hospital right now-- I'm calling you back from home.  So if you call the number on the card, you should be able to reach her."

"I don't have the card in front of me right now-- it's in my purse downstairs.  Could you give me the number again?"

"I actually don't have the number-- I'm at home.  If you can't find the card, call again tomorrow during business hours and I can get that to you."

"I can't call during business hours.  I'm at work."

"Okay, that's fine.  I will call you tomorrow with that number."

"You can't just tell me now?"
"I don't have the number right now."

"And you can't transfer me?"

"I'm sorry, I'm not in the hospital right now."
"Wait, one more thing-- are you sure you don't know which is the pink pill and which is the white one?  I'd hate to bother the pharmacist."


  1. Why aren't the pills being kept in their original bottles? With the labels explaining what they are and when/how they should be taken?

  2. I'm calling shenanigans on the last sentence right now... no one hates to bother the pharmacist... :-)

    1. Agreed. In fact, I think people go out of their way to bother the pharmacist . . .

  3. Don't ever tell them you are calling from home! Always lie about that! Before long you'll have them calling your home at 10pm at night to ask about your opinions about the nursing homes.

  4. After years in primary care I avoid these discussions over the phone. Tell them to make office visit to discuss. You should be having these conversations during work hours. Say, bring your father and all his pill bottles to appointment. Going over pill bottles with the family member is very good educational tool. Though in this case it seems like she is just looking for reasons to put him in the NH.

  5. Holy hell. Did she take some of said medication she was asking about?

  6. Last few posts have been HI-larious. Definitely going up in the staff bathroom.

  7. Maybe they should both go to the nursing home. Then neither would have to worry about what pill to take because the nursing home would take care of it.