Two of my patients recently described contrasting experiences arranging for care while I was away from the office.
The first, an older man whom I have known for many years, was upset that he was unable to see me right away for a preoperative consultation. He was offered appointments with my covering clinicians, but insisted on seeing only me for his care. As a result, he had to reschedule his surgery.
The second, a woman of similar age with many chronic conditions, presented a much different story. While I was away, she developed abdominal pain and agreed to see one of my colleagues. Now fully recovered and satisfied with her care, she was excited to tell me about it.
“I know you are not always going to be available on short notice,” she said with a warm smile, “so I’ve gotten to know one of your partners over the last year. She is my backup.”
Each day, I feel grateful for the confidence my patients place in me. I worry, though, that when some patients are inflexible and unwilling to see other clinicians in our practice, it may cause unnecessary stress or delays in receiving care. Some may go to urgent care or an emergency room rather than receiving treatment within the practice, which can disrupt continuity of care.
Our primary care practice, like many, is a group that functions as a team. We each care for our own patients, and cover for each other for emergencies and absences. I have utmost confidence in my colleagues to deliver excellent care. Although we are a collaborative team, and all of us maintain the highest standards, our patients may see each of us as “my doctor.”
There may be matters for which there is no substitute for the clinician with whom you have established a comfortable, long-standing connection. There is a certain ease and mutual understanding that takes time to develop, and is foundational to thorough, compassionate medical care. My long-standing patients and I can bypass the initial process of learning how to listen to and understand each other, as we already have an established comfort level. Long-term, trusting relationships are medicine’s greatest reward, for both doctors and patients.
But lately, I have been encouraging my patients to get to know other clinicians in the practice. My endorsements and expressions of confidence in my colleagues help, but actually establishing some rapport with another clinician is better yet. These relationships may not run as deep as ours, but may help mitigate the stress of an initial visit if a clinical problem arises while I am away.
If your primary care clinician is part of a group practice, I encourage you to become comfortable with at least one other clinician in the practice — your backup. Medical conditions can be unpredictable, and having options which you are comfortable with can help you get the care you need when you need it.
Jeffrey Millstein is a primary-care physician and medical director for patient experience-regional practices at Penn Medicine.