In general, the weather in Baltimore tends to be fairly temperate, but we occasionally have snow. Because we don’t have that much snow, the highway department is generally not prepared, especially right after it starts snowing, so the usual pattern is for travel during the beginning of a snowstorm to be pretty hazardous, especially when you add in a bunch of drivers who are not used to driving in the snow to the whole mix.
Last week, I needed to see a patient on an emergency basis, so I made an appointment to see him last Saturday. Unfortunately, it was snowing that day, and my patient had to come quite a distance to see me.
The reason I needed to see the patient was to make enough of an assessment to decide whether or not he could be treated as an outpatient, whether he should go into the hospital when a bed opened up, or just go to the nearest ER and get admitted that way.
Having worked as a resident in the ER in the past, I used to despise all the mental health workers who just dumped their problems on the people in the ER. I became very familiar with certain local psychiatrists, who clearly had no mechanism to handle any kind of minor emergency, so they just sent anyone who called them out of business hours to the ER. I always make some kind of effort to see if the patient’s problem can be settled somehow before telling them to go to the ER.
Anyway, while waiting for my patient to show (delayed because of the weather), I thought about how great this situation would have been for a Skype visit rather than a face-to-face visit. First, the whole thing would have been a lot more convenient for both the patient and me. Second, the visit would have taken place on time, not later. Third, I honestly think my exam was worse because my patient was very stressed by the time he got to my office, and I believe I could have done a better exam if he wasn’t so distressed.
Probably safer to be off the road, too.
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