Seeing the doctor, old school.

March 5, 2007 6:41 AM

Sickday. (for my NYC mefites) As I sit here in Chicago with a fresh case of bronchitis and unable to leave the office, I'm wishing I was back in NYC. Apparently they have plans to expand soon...
posted by allkindsoftime (40 comments total)

I don't get it. For me, the sickness equation runs like this:

not sick enough to stay at home < sick enough to stay home, but not sick enough to go to the doctor < sick enough to need to go to the doctor

If you need a doctor, you are two levels too sick to be at work in the first place.

And now I am sick of "sick".
posted by DU at 6:51 AM on March 5, 2007

DU, you've never been too sick to be able to get out of bed to get to the doctor? I know I have.
posted by spicynuts at 7:19 AM on March 5, 2007

And I was hoping this was some way to get a doctor to lie for you when you need to take a mental health day...
posted by papercake at 7:24 AM on March 5, 2007

hey awesome. some fucking shithead at work gave me bronchitis a couple MONTHS ago. enjoy the many, many weeks of hell ahead of you.

i'm having a hard time making it from the car to the office without getting winded.
posted by quarter waters and a bag of chips at 7:26 AM on March 5, 2007

I haven't, but that's not my question. I'm rarely in bed at the office.

My feeling is that if you are sick enough to require medical attention, then "unable to leave the office" is moot. You are even more unable to remain at the office. This sounds more like a ego-boosting "I need to be here to berate the secretaries and I'm too important to sit in a waiting room with commoners" thing to me.

Not that a return to housecalls wouldn't be cool. It's just that having the first place they do it be Manhattan offices kind of betrays a non-medical, ego-stroking reasoning.
posted by DU at 7:27 AM on March 5, 2007

The first think I am thinking is that some poor admin is going to be stuck on the phone all day begging this service to change an appoinment from 2:30 to 3:30, then to 3:45, then to 4:30, then to 5:30. This is the same admin who, if she needs medical attention, will have to take a personal day, and will still get snarked at for "not being a team player" when she returns to the office.

I agree: if you can stagger in to the office, you can damn well stagger your way to the doctor's office.

Not so sure how eager insurance companies are going to be to pay the inflated fees these "house calls" will cost, too.
posted by La Cieca at 7:43 AM on March 5, 2007

DU:

Sickday Medical House Calls arranges prompt medical attention throughout Manhattan in the comfort of your home, office, or hotel.

If you're so sick that you need a doctor and you go to work, you are a douchebag..agreed, however, on the very first page of the link, it says they make house calls.
posted by spicynuts at 7:44 AM on March 5, 2007

I agree: if you can stagger in to the office, you can damn well stagger your way to the doctor's office.

Jesus people, read the link! The OPP says he's at the office, nowhere does the service linked to say they ONLY come to the office. I guess the big ole graphic on the home page that says MEDICAL HOUSE CALLS is confusing, since I guess 'house' has now come be synonymous with OFFICE?
posted by spicynuts at 7:46 AM on March 5, 2007

It's always sad when you have to waste a sick day actually being sick. And it's even worse you're in a doctors office rather than on the couch watching movies.
posted by Slack-a-gogo at 7:47 AM on March 5, 2007

What's that work right after "home"--I can't quite make it out.

I guess I focused on the office aspect because the poster put it in that context. That said...Manhattan. What's the home/office ratio there? Like .0001?
posted by DU at 7:47 AM on March 5, 2007

DU: Manhattan does have 1.5 million people living on it. However, living in Queens, this dosen't do me or my neighbors a fat lot of good, since these angels of mercy apparently aren't big on crossing bridges.
posted by jonmc at 7:56 AM on March 5, 2007

Having tried to get a clinic whilst living in manhattan, I can tell you it's a trying experience. I had strep so bad and could not find a doc-in-the-box clinic to save my life. All the hospitals said to come to the emergency room and wait. Ugh. Finally found a clinic (after many tears) on 23rd and 7th that didn't believe i had strep. Until the culture came back a week later. Love this idea, but have a feeling the cost is prohibitive.
posted by gingembre at 8:19 AM on March 5, 2007

I don't see this business surviving beyond its first malpractice suit.

Furthermore, these aren't going to be great doctors doing these house calls. Good doctors in New York have crammed schedules and see many patients per hour. Here, a doctor is going to spend 4 times longer to get to the patient than to actually see the patient.
posted by Pastabagel at 8:21 AM on March 5, 2007

I can easily see how this could make sense. You live in a big city, you have no car, you don't want to attempt to cram yourself onto public transit with the bacteria-spewing masses, and then plop yourself into a waiting room for 4 more hours with more sick people. I'd just stay home, that's for sure.
posted by ninjew at 8:24 AM on March 5, 2007

Why are house calls going to cause more malpractice suites?

papercake: Yeah, I was also hoping for that as well.
posted by zazerr at 8:33 AM on March 5, 2007

Furthermore, these aren't going to be great doctors doing these house calls.-Pastabagel

I'll bet a lot (or even most) of these doctors are moonlighting; they may be quite good, but they will almost certainly not be your doctor.
posted by Mister_A at 8:37 AM on March 5, 2007

Unless something other than mucus is physically ejecting itself from any of my orifices I go into work. Maybe this isn't ideal, but my mom would make my dad (a UPS guy) feel guilty if he stayed home for anything less.
posted by drezdn at 8:38 AM on March 5, 2007

Why are house calls going to cause more malpractice suites?
posted by zazerr at 11:33 AM EST on March 5

If they result in the same number of suits as hospital visits, they are screwed. In a hospital, you have witnesses, charts, multiple eyes seeing everything etc. On a housecalll, you have no witnesses, uncontrolled environment, etc. and it's the patient's word against the doctor's.
posted by Pastabagel at 8:41 AM on March 5, 2007

Yeah, I'm a douchebag for coming into work sick. I'm sorry I used my pitiful small number of sickdays and then some vacation time as well actually being sick already. I did work from home while I was sick so that should count for something, right? But I still get your point: I'm a total douchebag for actually wanting to not lose my job.

I wish we all had as lovely fucking employers as you.

Jonmc - the source I found the link at claimed they were planning to expand to the 5 boroughs and on after that, but who knows when - I wasn't able to find reliable evidence of that anywhere, sorry.
posted by allkindsoftime at 8:49 AM on March 5, 2007 [1 favorite]

Even though we have free house calls in my country and my father in law is a doctor it still sucked to have to stay in bed all of last week with the flu (H1N1). Anyone suggesting i go to work because i wasnt ejecting stuff would be in a world of hurt after i had coughed a little virus their way.

I really recommend staying home and getting the doctor to come round.
posted by FidelDonson at 8:58 AM on March 5, 2007

these aren't going to be great doctors doing these house calls.

The best vet I've had was a house-calls-only vet whose schedule was always full. Why should doctors be any different?
posted by mediareport at 9:00 AM on March 5, 2007

The best vet I've had was a house-calls-only vet whose schedule was always full. Why should doctors be any different?
posted by mediareport at 12:00 PM EST on March 5

Because animals can't hire lawyers. Seriously, I don't know why doctors are different. But doctors get sued far more often for malpractice than vets, even when they worked in their own controlled environment. I don't know why this is, but it is. After one suit, the malpractice insurance on this is going to be astronomical.
posted by Pastabagel at 9:07 AM on March 5, 2007

Any remotely problematic illness requires testing to more adequately establish a diagnosis. How that hurdle is accomplished is difficult to imagine. Does the doc take blood and urine? Where the hell do you get imaging studies? I can imagine seeing someone in their office and telling them that their abdominal pain could be a pulled muscle...as long as it isn't a UTI, appendicitis, or a malignancy.

This is concierge medicine at it's worst.
posted by docpops at 9:17 AM on March 5, 2007

docpops, these docs will immediately refer anyone with anything more serious than a head cold. That, in itself, can be valuable if your healthcare plan requires a referral to see a specialist.
posted by Mister_A at 9:33 AM on March 5, 2007

There are at least three practices here that do house calls. They're mainly marketed to elderly or disabled patients who are (regularly) housebound, though.

I have been too sick to go sit in the waiting room or to get myself to the doctor's office - even if I could have gotten an appointment with a good doctor - and the emergency room would have been worse. I guess piling all the sick people in the waiting room together to cough and sneeze at one another ensures repeat business.
posted by dilettante at 9:35 AM on March 5, 2007

I don't think they even send a doctor, but a PA. Link. Not that a PA can't do a good job, but this would explain a few things.
posted by exogenous at 9:45 AM on March 5, 2007

“Yeah, I'm a douchebag for coming into work sick. I'm sorry I used my pitiful small number of sickdays and then some vacation time as well actually being sick already. I did work from home while I was sick so that should count for something, right? But I still get your point: I'm a total douchebag for actually wanting to not lose my job.”

Welcome to Chicago.
I got shot six times on the way to work and I still waited until lunch to sit in an emergency trauma center. Got three bullet wounds tended to, but had to leave to get back to work. Some thugs who noticed I had a nice set of kidneys in the trauma center chased me through lower wacker at 105 mph trying to remove them and send them overseas to powerful Zaibatsu.
Finished out the day fighting off rats trying to gnaw at my open bullet wounds. My boss was kind enough to give me a .22 pistol to back them off and a squeegee to sluce the blood off my screen.
We take work seriously here pal. That’s why we have so many local taverns and da beautey-full bean to enjoy on yer time off.
posted by Smedleyman at 10:13 AM on March 5, 2007

It makes sense. Everything else is already delivered in Manhattan.
posted by TheOnlyCoolTim at 10:45 AM on March 5, 2007

“Yeah, I'm a douchebag for coming into work sick.

If you are so sick that you can barely get out of bed to see a doctor, and you still drag yourself to work, and by so doing you get me sick and I have to use my sick days for being sick instead of for going golfing , you are a douchebag. Is that better?
posted by spicynuts at 10:46 AM on March 5, 2007

"I've got this pain..."

"I can't stop coughing..."

Sounds like the front page of AskMe.
posted by mkultra at 10:54 AM on March 5, 2007

It makes sense. Everything else is already delivered in Manhattan.

What they need to do is offer more delivery options. I want the doctor to swing by Blockbuster and pick up a movie, hit Hearty Soups and get some Chicken Noodle, and then stop by Amy's Breads for a cookie, in case I feel better later — and THEN come over.
posted by papercake at 10:59 AM on March 5, 2007

Untrue, mkultra.

If it were real, it'd read:

"I've got this pain...in my penis [more inside]"

or

"I can't stop coughing while I think of a song song, so I'm coughing the song for you to listen to. Listen to my mp3 and see if you can tell me what it is."
posted by owenkun at 11:02 AM on March 5, 2007

You don't need a doctor for a head cold, and that is a fabulous waste of the expensive time of trained medical professionals who could be helping people who really need it. A head cold is a virus. It gets better by itself, and no doctor can do more for you than a trip to the drugstore by yourself will accomplish for appropriate symptomatic relief.

Docpops has it right. This is a waste of someone's money -- presumably the patients who use this service. I tend to doubt insurance will be covering it.

Besides, if you're really, really sick with something awful, you can just post a question to AskMe and a dozen people will tell you to go to the doctor, another will suggest some useless and disproven naturopathic placebo like echinacea or AirBorne, and someone else will tell you you have a horrible disease because they had the *exact* same symptoms and it turned out to be leprosy of the skull.
posted by fourcheesemac at 12:53 PM on March 5, 2007

Oh, and one person will post to MeTa demanding that the admins remove the question.
posted by fourcheesemac at 12:54 PM on March 5, 2007

Oh, and please tell me that this is really a very sophisticated drug-dealing operation, pharmaceutical grade. That I would believe.
posted by fourcheesemac at 12:55 PM on March 5, 2007

< --, a, b, -->, A, A,
thanks XQUZYPHYR
*rockets off*
posted by Smedleyman at 1:50 PM on March 5, 2007

UMMM.....IT'S NOT EVEN A REAL DOCTOR THAT IS GOING TO TREAT YOU!

The service uses "physician's associates" not M.D.'s or D.O.'s!

If such care providers are who I think they are, they're the same as "physician's assistants" and they've given themselves some type of euphemisitic promotion to associates (which seems to imply they are more like doctors).

From what I know of PA's -- they usually can't work without a doctor near them or signing off on something they prescribe or write, so where is the actual M.D.? (In the car, waiting to the feed the meter or something?!)

Their training is far, far less than a doctors and it's not as tough to get into PA school as it is medical school (in this country at least). So, it does not guarantee that their diagnosis won't be as good, it could be more likely however.

It's a shame, when I first read it, I thought it was a service model for doctors who were fed up with having their own practice or hospital bureacracy. I figured if they paid the M.D.s enough, they would be onto something. So, obviously, they are not paying enough to get M.D.s to do the housecalls, and remember, most times in this world, you get what you pay for......

Curiously, I would like to read the NYT analysis of this service as being some type of godsend......strikes me as ood from the "paper of record."
posted by skepticallypleased at 2:49 PM on March 5, 2007

If you are so sick that you can barely get out of bed to see a doctor, and you still drag yourself to work, and by so doing you get me sick and I have to use my sick days for being sick instead of for going golfing , you are a douchebag. Is that better?

Where the hell do you think I got sick from in the first place?
posted by allkindsoftime at 3:13 PM on March 5, 2007

Oh, and please tell me that this is really a very sophisticated drug-dealing operation, pharmaceutical grade. That I would believe.

Illegal drug delivery services already exist in Manhattan.
posted by TheOnlyCoolTim at 5:47 PM on March 5, 2007

Does the doc take blood and urine? Where the hell do you get imaging studies?

The vet I used had an ongoing relationship with a local animal hospital, where she could go to take care of lab work or quickly get the animals into surgery if needed. I don't know about the service in this particular link (and think this was kind of a lame post, to be honest), but come on, do you really think they haven't thought of where they'd take blood and urine samples for testing? Yeesh. You may not like it, but this kind of service is one of the waves of our medical future, for sure.
posted by mediareport at 7:29 PM on March 5, 2007