A Country Doctor Writes:

Many doctors’ offices have little signs discouraging the use of cell phones. Personally, I find them useful more often than annoying or disruptive.

The other day I saw Mrs. Jonah for a sinus infection. She had lost her private insurance and ended up on Medicaid, the insurance for low-income Americans. When her insurance changed, we had to change several of her medications, because Medicaid didn’t cover what she used to take. Mrs. Jonah told me that one of her new medications wasn’t working for her and the step care on the Medicaid website was confusing. I pulled out my cell phone – not a smart phone for this country doctor, but a waterproof one suitable for working around our little farm.

I know our state’s Medicaid office doesn’t keep you on hold forever, and the people who answer the phone actually have the answers to your questions. Within a couple of minutes I had e-prescribed a new medication to her pharmacy along with an antibiotic for her sinusitis and Mrs. Jonah left the office with a smile and the words “you make things happen”.

I also pulled out my cell phone when Mrs. Gordon’s blood pressure was higher than I had ever seen it and she seemed confused about how many blood pressure medications she was actually taking. The pharmacy told me she hadn’t picked up her lisinopril since February.

Bud Swensen told me his little red pills made him itch, so he stopped taking them. I couldn’t figure out which medication he was referring to. He called his wife on his cell phone and we settled the issue right then and there.

Frank Garr always gives me a hard time if I happen to be running late. That is what happened when I last saw him. He said he was running out of his sleeping pills. According to my records, he should have had a refill left. I called his pharmacy to verify this. He looked demonstratively at his watch and said “I’m deducting this from our fifteen minutes”.

“I’m making this call for you”, I replied.

“Fair enough”, he said.

Norm Parsons was having a terrible time with his rapid atrial fibrillation. His cardiologist in the state capital had really wanted him on a beta blocker because of his mild heart failure. Norm had tried them before and had to stop because of side effects. He was beet red, huffing and puffing, and said “this is exactly what happened last time I tried metoprolol”.

A quick cell phone call to his cardiologist gave me permission to switch Norm to diltiazem, even though it theoretically is less ideal for rapid atrial fibrillation with heart failure. Norm’s e-prescrition for the new medication, my office note and the cardiologist’s documentation of the medication change happened quickly and in real-time.

One thing I don’t do with my cell phone is take incoming calls. I have my phone on “vibrate” and check for missed calls or messages between patient visits. But for straightening things out with pharmacists and colleagues, I wouldn’t want to be without my cell phone.