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Sometimes, life calls for you to be out of the office for a length of time. Whether the absence is planned or not, it’s important to consider the best actions to take given the circumstances to ensure patients are cared for during your absence.
Alexa Meara, MD, clinical instructor and rheumatologist, The Ohio State University Wexner Medical Center, Columbus, Ohio, was a general medicine attending when she went on maternity leave twice. Both times, her children arrived before their due dates.
“I called my boss [from] the hospital and said that I would not be in clinic or on the hospital wards,” she says. For her first pregnancy, her boss planned ahead and had arranged for several others to be available on short notice in case she went into labor early. For her second pregnancy, her boss hadn’t done any pre-planning, but her colleagues covered her work by dividing inpatient and outpatient duties among themselves.
James Udell, MD, FACR, rheumatologist, Arthritis Group, Philadelphia, has also found that cross coverage works well for lengthier absences because his group has five rheumatologists on staff. He also recommends finding a locum tenens physician or training a physician extender in advance, if the length of the absence is known.
Dr. Meara
As a solo private practitioner, Karen S. Kolba, MD, rheumatologist, Pacific Arthritis Center, Santa Maria, Calif., has established a time-off schedule. She always closes the office the weeks of Christmas and the 4th of July. Because no one is in the office, voicemail is forwarded to her cell phone.
When Dr. Kolba is traveling in North America, she doesn’t seek additional physician coverage, because she can easily handle cell phone messages. Any patient who is acutely ill is referred to the emergency department, which is the same protocol as when she is working. For longer or overseas trips, Dr. Kolba asks a rheumatologist from a nearby town to provide emergency rheumatology coverage and relays information about any patients who are acutely ill at that time. Because most of her office notes are automatically sent to patients’ primary care physicians, they know her current plans for each patient and can handle most urgent situations.
Revealing Absences to Patients
Amanda Myers, MD, clinician educator, Pritzker School of Medicine, Division of Rheumatology, NorthShore University HealthSystem, Evanston, Ill., believes that patients should be made aware of their practitioner’s availability. “This helps them make decisions about their healthcare, allows them access to care and alleviates anxiety,” she says. “If you will be away for an extended period, explaining to the patient the plan (e.g., temporary care by a covering practitioner) is appropriate. While I worried about my patients transferring to a new provider during my absence, I felt that they appreciated my honesty and communication and, as a result, were more likely to continue in my care.”