Doctors always on call. It's a full-time job that goes unnoticed

When a doctor closes the office door, it's not uncommon for his invisible post to begin. A text message from a patient asking for a consultation. An email with test results. A Facebook message asking for a prescription... The nationwide survey of doctors conducted last fall, "Patient on the Phone," aimed to help understand the scale of this phenomenon and its impact on doctors and their patients.

For the sake of the patient

76 percent of the 385 doctors surveyed keep in touch with their patients outside of appointments, and 50 percent of doctors provide patients with their private phone number. Medics who choose to stay in touch with their patients say they do so most often to be able to respond appropriately to a patient's ongoing problems or questions in the treatment process, and to provide the patient with a greater sense of security. One in three physicians declare that constant contact with the patient is needed to increase their influence over the patient's course of treatment.

- With advances in technology, but also changes in lifestyle, a transformation of the health care system is taking place before our eyes and with our participation. The doctor-patient relationship based for years on the subservient role of the medic, who expects in return absolute submission of the patient in the process of diagnosis and treatment, is transforming into a partner, participatory model. The doctor's role is no longer just to diagnose and treat, but to take care of the patient's broad well-being, including psychological and social well-being," explains Dr. Malgorzata Galazka-Sobotka, director of the Institute of Healthcare Management at Lazarski University.

Contact without borders

Such personal support of patients fighting the disease, but also in navigating the health care system, doctors take it upon themselves, often paying a personal price. The main problem is the lack of control over patient contact hours. They often call or text their doctors during their free time (which is aggravating for more than 60 percent of doctors surveyed) or during appointments with other patients (which 30.5 percent of doctors complain about).

- We have been talking loudly about the overwork of doctors for years. According to the Supreme Chamber of Physicians, some of them work as many as 80 hours a week. As the report "Patient on the phone" shows, this is not the end of duties for them. However, the "quiet full-time job" on the phone takes away much more than just their free time. It affects their relationships with loved ones, breeds frustration and a sense of loss of control," says, commenting on the results of the report, Urszula Szybowicz, president of the "You can't see past me" Foundation and chief operating officer of the Polish Federation of Hospitals.

Communication without safeguards

As the lawyers note, informal patient support, while so highly valued, cannot be done in disregard of the security rules for the exchange of medical data.

- Many doctors contact their patients via commercial messengers (such as WhatsApp, Messenger, for example) or email and SMS messages, as these tools are easily accessible. However, they do not provide an adequate level of message privacy - content in emails or on Messenger can be used for advertising profiling of patients, and can be transferred outside the European Economic Area. Using them can also violate doctors' obligations of professional secrecy and confidentiality of patient information, as well as the patient's related right to privacy, emphasizes attorney Olga Dabrowska of the dotlaw law firm.

A problem not only in Poland

The fact that medical care is moving beyond the confines of doctors' offices is becoming a challenge around the world. A recently released survey by The Harriss Poll agency showed that 93 percent of some 1,000 GPs surveyed admitted to professional burnout. 77 percent admitted feeling overwhelmed by the excessive demands of communicating with patients, such as responding to emails, phone calls and text messages, and 60 percent of those surveyed said they were expected to respond to patient messages at all hours of the day, every day of the week. According to the report, they spend an average of 15 hours a week on such "after-work" tasks.

- Telemedicine care has become so widespread that it has become one of the aspects of medical work. Usually, when something is not clear to patients, they seek help on the Internet. Instead, I would prefer the patient to consult a specialist. Of course, I would wish every doctor and physician enough time for a visit, or the ability to tailor messages to the patient, and every patient and patient the ability to ask questions and actively listen. That's why I see the need for constant improvement in patient-doctor communication, including that which takes advantage of technological developments and accompanies social changes in the 21st century," concludes Artur Drobniak, MD, Director of the NIL's Central Research and Education Center, which co-organized the survey.

- I am convinced that we are only a few steps away from the dissemination of effective tools that facilitate the work of doctors, so that they are not forced to work after hours, and build a sense of care in patients. These must be technologies that support systemic solutions, taking into account the needs of patients and health care professionals," he quips.

compiled based on press material