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Telephone Care

Treating patients by Telephone, Email or MyChart:

It is impossible for us to do a good job treating medical problems by phone or email:

  • No matter how long we talk, only you can guess if you need to be seen;
  • If you are worried about a problem, we need you standing in front of us;
  • It is irresponsible to call in prescriptions, including antibiotics, without seeing you;
  • Trying to treat you by phone leads to miscommunication, back-and-forth messages, and usually delays your treatment.

Our staff has been given this simple rule-of-thumb:

“For more than a ‘yes-or-no’ answer, the patient needs to be seen”.

You need an appointment if :

  • You have a new medical problem;
  • You are having significant changes to an existing problem;
  • You need a note for work or school;
  • You want labs or testing for an illness.

Go to the ER or call 911 if you are having:

  • Seizures;
  • Change of Consciousness;
  • Severe Headache;
  • Neck Pain with Fever;
  • Chest Pain;
  • Significant Shortness of Breath;
  • Severe Abdominal Pain;
  • Current Bright Red Blood in your Vomit or Stool.

MyChart:

It is equally impossible to take care of new or serious medical problems by MyChart. 
We have a webpage section dedicated to MyChart usage and questions: “http://www.nortonhighlands.com/faq/mychart”. 

General advice:

This webpage has a lot of good medical infomation under “http://www.nortonhighlands.com/staying-healthy/health-resources”. 

Other great sites to help you think through medical issues:

  • For Kids: www.kidshealth.org
  • For Kids and Adults: www.familydoctor.org (American Academy of Family Practice) FamilyDoctor.org has really nice “triage” pages to help decide if you need to be seen.

Common Reasons for Calls:

UTIs

Adult women who clearly recognize their symptoms from past UTIs, and who have no nausea or fever, can sometimes be treated by calling in antibiotics without an office visit.

Without a visit, we will not be able to culture your urine to identify the actual bug you have in your urine, or to determine what antibiotics it is sensitive to.

You will need an appointment for any of the following:

  • This is your second UTI in 6 months:
  • If you are pregnant
  • If you are having nausea or vomiting, back pain, or fever or chills
  • If you are having vaginal discharge 

We should see you in a week if you’re not better.

 

Colds, or Upper Respiratory infections:

The good (or bad) news is that you probably don’t need to be seen, because there is nothing we can do to help:

Colds, Sinus infections (sinus pressure), Bronchitis (productive cough from chest), and Sore Throats are caused by Viruses 99% of the time.  Since viruses are not living things, you can’t kill them with an antibiotic.  The only thing the antibiotic will kill is the important bacteria in your guts and vagina. 

So whether you call, or come in, or go to the immediate care, we’ll probably give you Information On Viral Infections, and hope you feel better soon.

The only reason to be seen for an upper respiratory infection is:

  • If you are having severe problems breathing, in which case you may need to go to the emergency room,
  • Or if you can point to the infection with one finger, which is suspicious for a bacterial infection that would benefit from an antibiotic. 

Patients who are breathing comfortably, with fevers less than 103, and who can’t point with one finger to the site of their infection, generally don’t need to be seen. 

We should see you in a week if you’re not better.

 

“Pink Eye” or Conjunctivitis:

“Pink eye” usually is viral, and is caused by the same virus that causes your cold.  If there is no fever or eye pain, and only small amounts of yellow-green crust, “Pink Eye” likely does not need to be treated. 

We should see you in a week if you’re not better, or if you need a note for school.

 

Flu:

Influenza is another viral illness, and like all viruses, flu can only be cured by your body’s immune system. 

If you are healthy, not pregnant and breathing well, you likely do not need to be seen for Flu.  In fact, coming in the office will just share your flu with other patients. 

Patients with Flu generally are going to be treated with acetaminophen and ibuprofen.  The CDC asks that we use Tamiflu and anti-flu medicines only if you are at risk of going to the hospital: pregnancy, extremes of age, real respiratory distress.  And since we will treat you based on how sick you are, rather on whether a flu test is positive, there is little value in testing. 

There is a lot of good Flu info on our web page, or at www.flu.gov

If you are having real trouble breathing, you need to go promptly to the Emergency Room
You will have to be seen if you want flu testing, or if you are not better in a week.

 

Diarrhea:

If you are not having bleeding, significant pain, signs of dehydration (such as decreased urination) or a high fever, patients generally do not need to be seen for diarrhea. 

Diarrhea is treated with lots of fluids.  There is a good Viral Gastroenteritis handout on our webpage under “Antibiotics & Viral Infections”. 

We should see you if you’re not better in a week.

 

Lice                                        

There are 2 great Lice handouts in the Health Resources section of our webpage. 

Lice are treated with over-the-counter permethrin (Nix).  But the most important lice treatment CAREFUL daily nit-picking. 

We should see you if you’re not better in a week.

 

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