Kevin, M.D. - Medical Weblog

I recently had a patient with acute renal failure requiring dialysis leave the hospital AMA to attend his daughter's birthday party.

Everyone has their priorities. As an adult, your health care (and that of your family) is supposed to be one your priorities.

How many dentists do you know that are open on weekends or at night for non-emergency dental care? What about optometrists or gynecologists?

I understand how hard it is to take a day (or more) off to go to the doctor for routine care - we've all done it. However, this sort of schedule will only chase more good people out of primary care.

The medical profession cannot force people to take their health care seriously and cannot fix the fact that some people have jobs that only pay them if they produce a produce that day. Are we supposed to ask our collegues to offer mammograms, colonoscopies, allergy testing or total hip replacements at 9PM because that's when the patient can be there? Try that at a bank or a dry cleaners and see what happens.
 

You can do this, you know. Lots of ER docs see patients in private "urgent care" centers after hours.
The rules are simple: if you want to be a patient, you have to be able to pay. Not surprisingly, they seem to do well.

Convenience should cost. The problem is educating those who have now come to expect that calling in after hours with the same sorts of non-emergent complaints that are seen during working hours that things will not be the same for them when they come in at 11 p.m. Charging nothing more than regular fees just reinforces the false notion of entitlement to what should be seen as extraordinary.

Let the enterprising night owl have a night practice that opens at 6 p.m. Make payment in cash, offer courtesy statements for services on a HCFA 1500 to be filed by the patient later. Pay your staff well and sleep soundly in the morning.
 

No problem with after hours schedule, as long as you pay for it.
 

I disagree with the contention that hours are expanding. I see doctors cutting back hours. I guess it is an effort to cut their losses and lower their overhead.