By Robert Kotler MD, FACS
The Medical Board of California publishes a newsletter several times a year. Included in the newsletter is a list of disciplinary actions against California-licensed physicians. The disciplinary actions may range from revocation of a license to the lesser punishment of publishing a “Letter of Reprimand” for the public record. In the latter category was a recent action against a surgeon who had been
“Disciplined by (another state) for…failing to have after hours phone support available to patients in the event of complications following cosmetic procedures.”
It amazes me that, often, it is more difficult to get in touch with your doctor than to place a call to the White House, which has a publically listed telephone number. I have always taught my medical students and residents that a surgeon must be available to the patient around the clock, 24/7. There are sound medical reasons for being able to reach your surgeon. One never knows when questions and, even more importantly, complications will arise. For example, if a patient had a rhinoplasty and is suddenly having a major nose bleed, it is important that the surgeon know about it. First, certain actions can be taken via telephone direction. Most importantly, the mere anxiety of having a problem and not being able to reach your surgeon only heightens blood pressure, which makes the bleeding worse.
Before surgery, my patients receive a list of telephone numbers where I can be reached should any problems arise. Even a minor complication can lead to a major issue if not addressed quickly. Major complications could include loss of tissue, which is disastrous.
So, remember to ask about doctor availability after surgery. Your doctor may provide their own contact information, or that of another doctor who is similarly qualified and knowledgeable. Someone must be available, even if it is just a matter of answering questions or adjusting medications — a patient whose pain medicine is not working is an emergency and must be aided immediately.