So here’s the dilemma – I was diagnosed with a strep throat at about 6 pm tonight. I have patients scheduled for tomorrow am, and a lunch at the home of the head of the volunteer board I sit on.
I’ve taken one dose of antibiotics so far (at 7 pm tonight). I feel pretty crappy right now, but not so bad that I can’t work tomorrow.
Is my obligation to see my patients or to protect them from infection and cancel their appointments?
God knows if I infected anyone today – I saw about 20 patients, but the truth is that I am extremely obsessive about washing my hands before and after examining every patient.
UPDATE
I stayed home. But only after calling my patients myself to cancel them last night. (One of the advantages of the EMR is that I can access it at home). None were urgent visits, most were patients I’ve known for years, and everyone was happy not to be seen and wished me well. I actually feel worse this morning than last night, so I think it was the right decision.
Thanks, everyone, for your input.
Hmmm…tough one.
I’d say it depends on how busy you are and if you have partners that could see your acutes.
If they won’t be able to see you for months if they reschedule, I bet most would rather risk the strep.
If you end up going in tomorrow, take and informal poll so you’ll know for next time.
You’ve already seen patients while infected. If you feel like seeing them, I say do so. You’ll have had antibiotics (I know not quite 24 hrs worth) and with good (more vigilent than normal) hand washing (and as my mother taught me–not coughing on anyone) I would say it would be okay. If a patient feels the need to hug you tomorrow, defer with a small apology.
Sorry you came back from the vacation sick. I know I always feel like I’m putting my patients out if they have to be rescheduled. When I had Shingles 6 yrs ago though I was very careful to avoid pregnant women while I had my rash (easier to do when a plastic surg than family MD). Hope you feel better soon.
I give you permission to ditch tomorrow morning’s schedule. Contageousness is airborne for strep. You should wear a mask if you see patients. If your partners can pick up your slack (they probably do that if you have a morning full of deliveries anyhow), then have them help you out.
What do you do if you are in the hospital all morning? You should end up doing the same thing tomorrow.
You’re off the hook: Two doses of Amox (taken BID; one at 7 pm and tomorrow at 7 am) and you should no longer be contagious. Given what you do (ie, no ophthalmoscopy or other procedures where you’re “in someone’s face”) your patients from yesterday are probably ok. (Hm: then again, is Group A strep as bad an actor at the hoo-ha level as GBS?)
OTOH I too would back up your decision to ditch your schedule just on the basis of feeling crappy. We prescribe a lot more rest for our patients than we’re willing to take for ourselves.
I am with Dino. We need to take care of ourselves. I do rarely get sick, but we fool ourselves if we think we are irreplaceable to our patients. I hope you are now better for having hunkered down.
So I was a good patient and FINALLY went in for my exam and pap (I saw Dr. Greybush–snicker, snicker). We discussed BC options and she wasn’t thrilled with oral because my blood pressure is up (job stress, you know), so she suggested the IUD. Sounds pretty fabulous.
Since you are the master of detailing the pro’s and con’s, how about a piece on the IUD (specifically Merina).
Thanks,
Friend of OBS Housekeeper
Hope you’re feeling better!
I’m sorry you’re feeling unwell. I hope you feel better already!
Thanks, Guys. I’m all better. Been too busy to blog – the kids are back in school, Family events, etc.
Be back soon.
Ciao!