The desire to make a connection with patients, along with concern about keeping contact with them manageable, creates a certain tension over a staple of modern life: the ubiquitous cell phone. Should physicians call patients with it, and should patients be allowed to call it?
With many rheumatologists and other physicians using cell phones as a matter of course throughout the day, physicians sometimes give out their cell phone numbers to patients, despite concerns about privacy.
Others are not as inclined to do so.
Protecting Private Digits
Christopher Collins, MD, assistant professor of medicine at Georgetown University and a rheumatologist at MedStar Washington Hospital Center, both in Washington, D.C., says rheumatologists in academic settings are probably less likely to use their cell phones as much as those in a private practice setting. He has fellows who do most of the first-line interaction with patients, he says.
He usually does not use his cell phone to call patients, much less give them the number.
“I, personally, very rarely will phone a patient with my cell phone because, outside of work, my cell phone is my personal device,” Dr. Collins says. “When I can, especially if it’s during working hours, I will try to do most talking to patients on a land line.”
Should physicians want to make a call to a patient on a cell phone but want to keep the number private, it’s as simple as hitting *67 before dialing, or, under the phone’s settings, turning “Show Caller ID” to off, or something similar.
A 2011 study out of Israel, in which 120 primary care physicians were surveyed, found that they preferred to answer their cell phones only during the daytime and at predetermined times of day. With e-mail, though, they would respond to messages during most hours of the day, even holidays and weekends, the survey found. Researchers also found that older physicians were more prepared to provide cell phone numbers than younger ones.1
Do Patients Want to Call?
The same group, in a separate study in 2012, interviewed 200 patients, and found that they preferred having their physician’s cell phone number more than their e-mail address.2 Slightly more than 46% of patients says they would be “very interested” in obtaining the cell phone number, while only about 15% of those with e-mail addresses says they would be very interested in getting their physician’s e-mail address.
“With new technologies such as cell phones and e-mail in common use, it is important to determine how they can be best used and how they should be integrated into the flow of clinical practice,” the researchers concluded.
Another study, in 2005, assessed the way patients use physicians’ cell phone numbers once they have them.3 Calls to a secretary, surgical scheduler, and a surgeon’s cell phone number were recorded. Researchers found that 20 of 32 consecutive patients made 65 calls over two months. Only 12 of the calls, or 18%, were to the surgeon. And half of those 12 calls were considered “urgent” in nature, as opposed to 14% of the calls to the secretary and 15% of the calls to the scheduler.
A subsequent survey found that 85% would call the surgeon, and 30% would prefer the surgeon as the first line of communication, with e-mail and home phone communication less desirable. Seventy-two percent said they thought having cell-phone access suggested their surgeon was more caring.
“Patients desired to communicate directly with surgeons, but act with restraint and call as a last resort for mostly urgent issues if given the physician’s cellular telephone number,” researchers wrote. “The cellular telephone has promising benefits for the patient–physician relationship.”
Your Experience May Vary
Anecdotally, the experiences vary for physicians who’ve given out their cell phone numbers.
In a published essay, Winthrop Dillaway, MD, who was then assistant professor of family medicine at the University of Medicine and Dentistry in New Jersey, said he grew comfortable with giving out his cell number because of positive experiences, and gave out the number to patients three or four times a day.4
“Intuitively, physicians do not want to give out their personal phone numbers to patients,” he wrote. “We expect that too many patients would be intrusive and inappropriate. I find the opposite; only once or twice a month do I get after-hours phone calls on my cell phone. Only one patient, one time, blatantly abused this privilege. Otherwise, these calls have always been appropriate.
“I have found that it decreases my stress to know that my sick and worried patients can easily reach me if needed,” he continued. For physicians who would like to try it, he suggested trying it with one or two patients, then gradually increasing that number or abandoning it if it doesn’t work.
In a letter responding to that essay, Mary Chinn, MD, a family medicine physician in Illinois, said she started giving out her cell number to her obstetrics patients, and “can count on one hand” the number of times a cell call could have waited until the morning.
“There are just a handful of patients I am not sure I would want to share my number with,” she wrote. “Overall, I would recommend cell phone contact.”
Another letter of response had a different experience. Jonathan Dreazen, MD, a family medicine doctor in Pennsylvania, said he has “devoted and loyal patients,” but that they would still call after hours for things that weren’t critical. His wife, he says, “found after-hours calls an unpleasant intrusion into our lives,” especially on nonurgent matters.
“After 25 years of solo practice, I finally had enough,” he wrote. “I am now in an occupational medicine practice in which I work 8 a.m. to 5 p.m., Monday through Friday, with no evening or weekend call. I feared the pager enough. I cannot imagine having the same relationship with my cell phone.”
Thomas Geppert, MD, a rheumatologist at Rheumatology Associates in Dallas, says he uses the cell phone to call patients and does not use a blocking feature.
“It has rarely been a major problem,” he says. “Most people are fairly respectful of physician time. I think I’ve probably had two or three inappropriate phone calls in the last six or seven years of using the cell phone. Some of my partners do use blocking features.”
Another rheumatologist, who was attending the recent European Congress of Rheumatology in Madrid and practices outside Boston, says he doesn’t give out his cell phone.
“If they have free access to you they can call you anytime,” he says. “Maybe you might even be away. Like right now, I’m away. They’ll call me on my cell phone, they’re not going to get anybody. They might think that I’m not answering them on purpose. Or if it’s urgent, they just wasted their time when they should be going to the E.R. So I don’t feel comfortable with that.”
He does call patients with his cell phone, but uses the *67 feature to block his number.
“One time I screwed up and didn’t use it,” he says. “And you know what? I got a call.”
Thomas Collins is a freelance medical writer based in Florida.
References
- Peleg R, Avdalimov A, Freud T. Providing cell phone numbers and email addresses to patients: The physician’s perspective. BMC Res Notes. 2011;4:76.
- Peleg R, Nazarenko E. Providing cell phone numbers and e-mail addresses to patients: The patient’s perspective, a cross sectional study. Isr J Health Policy Res. 2012;1:32.
- Chin KR, Adams SB Jr, Khoury L, Zurakowski D. Patient behavior if given their surgeon’s cellular telephone number. Clin Orthop Relat Res. 2005;439:260-268.
- Dillaway WC. Why I give my cell phone number to my patients. Fam Pract Manag. 2009;16:24-25.
