Standing next to her, my nurse fields a phone call. Average, 25/day. The average family doc sees about 25 patients a day of a group of about 1500 under management, handles another 25 refill requests daily and about 100 other documents. Today, there are messages, emails, portal requests. NONE of that work is paid for by insurance, although now some are billing patients for them.
Where was I? Oh, yeah. She gets a call. “What’s the problem? Uh-huh. Sir, if you’re having chest pain you should hang up and call 911. Why not?” She hung up, bothered. “What’s up?” I said. “This man is having chest pain and says he won’t call 911 because he is in our parking lot!” Then, my receptionist comes running back to me saying, “Doctor B, this man is having a heart attack!”
I went to the front desk and found my patient ashen and sweating profusely standing at the check-in. “Call 911, get him a wheelchair!” We took him to an exam room and put on the oxygen, fed him an aspirin, and were getting out the IV equipment when 911 arrived.
Now, I worked in a suburban office in the Seattle area, where 911 was invented by Dr. Michael Copass and his team at Harborview, the level I trauma center and County Hospital. The Seattle area has the highest percentage of population trained in CPR, an excellent 911 system, so it was routine for us that the first responders arrived in 2-4 minutes of being called. And, once they are called, they take over. In about one minute, the man had an IV running in his arm, an ECG, and a fireman telling him, “Sir, you’re having a heart attack, we’re taking you to the hospital!” And off they went.
At the end of the day, I drove out to the hospital to see him. He was very happy, and explained, the cardiologist had taken him to the cath lab, found a clotted off coronary artery, opened up the artery with a balloon angioplasty and inserted a stent, all had gone well, and blood tests and subsequent ECG showed he had NO heart damage.
“That’s great!” said I, “but Roger, there’s just one more thing.”
“What’s that?”
“The next time you have a heart attack, call 911, and DON’T come to my office!”