It is distressing to us that contemporary medicine seems to have little or no concept about what “direct care” means. Several times, we’ve had hospitals call us to schedule a follow-up appointment for patients who will be discharged. We try to explain to these well-meaning people that our patients know that they can call and be seen at a time and day that will suit them. In short, “direct care” means speaking to and communicating directly with the patient.
We also know our patients, individually. There’s no “MRN” or even DOB needed. We know which ones of our patients need transportation to be arranged ahead of time and which ones have special challenges with scheduling appointments.
We ask the hospital coordinators who are calling to make an appointment on behalf of the patient: “do you know the patient’s schedule?” When they answer “no,” we ask “then how can you know what time is convenient?”
The coordinators seem confused by our question as they are used to dealing with corporate medicine that schedules weeks or even months in advance. They simply cannot conceive of our model of medical care. And that latter point is what distresses us.