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Medical care is a team effort that depends on our patients knowing when and how to contact us.

Dear Patient,


We know it's stressful to wait for our office to answer your calls or respond to your online messages. To help us address your medical needs as quickly as possible, this handout reviews the best ways to contact us between office visits.


In a medical emergency, call 911 (not our office). Examples include chest pain lasting more than a couple of minutes; sudden shortness of breath; symptoms of a stroke; vomiting blood; or a seizure.


Who will talk to you when you call our office?

Trained office staff answer all patient calls. Based on your symptoms or concerns, they arrange for you to receive a call from a nurse, nurse practitioner, physician assistant, or your physician. If your issue requires an in-person visit, they help you schedule an appointment.


For questions or requests that can easily wait a few days for a response, it's best to use the patient portal if you have a computer. Otherwise, call our office.


Why do we insist you talk to our staff first about your medical concerns?

We know and understand that people like to talk directly to their doctors. To enable all our patients to receive timely care, calls are managed by nurses, nurse practitioners, physicians assistants, and other qualified staff. They serve as our eyes and ears while we are busy examining patients, consulting with professionals about patients' care, or attending conferences to stay up to date in cancer care.


Rest assured, the professionals responding to your calls are experienced in addressing common medical problems. Often, they provide immediate answers and inform your doctors later about the details of the call. Other times, they consult with your doctors and then call you with answers. Still other times, they inform you that your symptoms require in-person evaluation to make a proper diagnosis and start treatment.


If your call is picked up by an answering machine, that means all our staff are caring for other patients. Please leave a detailed message, which they will listen to as soon as possible.


What if your call is not answered quickly enough?

Please call again if you've waited hours or if your problem worsens. Some days we receive a flood of calls. Despite our best efforts, an occasional call may fall through the cracks. Note: If your problem has worsened into an emergency, call 911. Do not keep waiting for us to call you.


What if you aren't sure whether to call the office or 911?

It depends on the specifics. If you call the office and don't get through right away to someone who can guide you, err on the side of safety: Call 911 or go to the ER.


If you have an upcoming appointment, should you wait until that visit to report new or worsening symptoms?

No. Follow-up appointments are scheduled with the understanding that patients will notify us of any new or worsening symptoms.


When you call the office to report symptoms or concerns, let them know of your upcoming appointment. If our trained office staff says it can wait for your appointment, that's great. Please remind yourself that you did the right thing to get their expert advice. We are grateful you did not wait with a problem that might have needed immediate attention for the best outcome.


What if after talking with the staff you still want to talk with the doctors?

That's fine. Let the staff know. Ask when to expect your doctor's call. Your doctor may instruct the staff to tell you that further discussion requires an in-person evaluation-a decision based on what your doctor knows is best for you. In that case, the staff will help you schedule an appointment.


What if you miss our callback?

We appreciate the stress and frustration of missing a callback. You help us by...


* Giving us the best callback numbers and the biggest time window you can (e.g., "I'll be reachable all afternoon").


* Asking us when to expect the callback. (Note: Some days, even an estimate is impossible; we don't want to set unrealistic expectations.)


* Checking your answering machine periodically. If you somehow missed our callback, please call to request another.



When should you use-or not use-the online patient portal?

The patient portal is our preferred method for reporting concerns or asking questions that can wait a few days for our response. When thinking of using the portal, remember: NEVER USE THE PORTAL TO REPORT URGENT PROBLEMS.


Trained staff read all the portal messages as quickly as possible. When we receive a large volume of messages, it may take a few days before you receive a response. That happens more often when your doctor's input is needed before responding or when your doctor wants to respond directly.


If our staff informs you that your symptoms or concerns require an in-person visit, that determination reflects your doctor's commitment to providing high-quality care. Call the office to schedule.


Please call the office if you don't get a response to a message or your situation changes while waiting.


[If you have never used the portal, we encourage you to become familiar with it. Messages and medication refills might get speedier responses. A bonus for both you and us: Portal communications automatically become part of your medical record.]


How can you prepare for calling the office or sending a portal message?

Before calling or using the portal, jot down a few notes to yourself that help you to...


* Explain in one sentence why you are calling. (e.g., "My pain is getting medicine upsets my stomach...I'm worried about redness around my port...I'm not sure when to take my medications).


* State whether you... have fever, are getting worse, have had this problem before, have done anything to treat it.


* Provide callback numbers and the best times to call.



What now?

Your calls and messages are important to us. Knowing how to contact us helps us provide timely and compassionate care to all our patients.


WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include Healing Hope-Through and Beyond Cancer, as well as Diagnosis Cancer, After Cancer, When a Parent Has Cancer, and Only 10 Seconds to Care: help and hope for Busy Clinicians. She lectures on "Healthy Survivorship" and "healing hope." As she notes on her website ( and her blog (, her mission is to help others through the synergy of science and caring.

Wendy S. Harpham, MD... - Click to enlarge in new windowWendy S. Harpham, MD, FACP. Wendy S. Harpham, MD, FACP