Housecalls anyone?

I wonder how other doctors handle requests for housecalls.

When you give your personal contact number to patients, it's inevitable that they might call you during the weekends on when you are on leave and ask for advice. Now that's fine with me, I'm happy to assist as far as I can over the phone.

But when they imply that they want YOU to come over to see them and give the advice in person. That's a different matter to me altogether. For one, it's my off day and I have a life, I don't want to be working. But yes I have a duty to the patients since I am a doctor.

But then, most patients who ask for you to come and give advice aren't expecting that they should be paying for your services as a housecall. It's like a social visit to them.

Well I'm sorry, but it isn't a social visit to me. It's work. It's basically an unwelcome disruption to my personal life which I accept because of the nature of my work. I want to be professional as a doctor and serve my patients well. But I also expect that the standard charges be applied to me as a professional.

How much does a housecall cost? http://www.sma.org.sg/guidelines/fees.html In short about $150.

Patients don't want to pay. You tell them go to the hospital then, they say it's too far, too long a wait at the A&E blah blah. (By the way it costs about $70-80 flat for all investigations and medications at the A&E)

In a few cases, I know there is little I can do even if I did the housecall, but they insist I come, I end up going and writing referral letters to the A&E and asking them to go there. Should I be charging patients like that? I think I have the right to. But look at their faces when you tell them it costs $150! Man you've never seen black faces man!

I think this is an Asian cultural problem. My experience doing housecalls for hotel guests showed me that. The caucasians have no problems thanking you profusely even AFTER they have paid the fees with a big smile of gratitude. They would usually go "Thanks for coming at this godforsaken hour! In my country it would be impossible to get a doctor come for a housecall even if I lived next to the clinic or hospital!"

For Asians, they would baulk at the "high fees" and some refuse to pay totally even after the service is rendered. This includes relatively affluent indonesian businessmen staying in the deluxe rooms calling for a doctor for their mistress!

Frankly, I have no problems being a professional. But the problem is that patients in Singapore don't treat the professional as one when it comes to remunerating him/her.

You can't have your cake and eat it.

Having said that, I look at my boss, and find that he is the one going around doing all these free housecalls (he charges only for the medicine usually about $30) for his patients. As such he gets like 4-5 housecalls EVERYDAY!

Man I don't want to end up like him. The best way may be to actually refuse to give my personal contact number to any patient.

Incidentally I had a call yesterday and I told the patient that if her condition worsened to go to A&E (amid lots of complains). Strangely even though my wife told me not to bother about the patient I couldn't get it out of my mind. I called the patient back an hour later to check on the status and it was improving after taking the medicine I advised her to consume. And by the evening the patient was normal. It just worries me and I can't continue in peace.

Sigh.