I should get sick outside of office hours more often. Or maybe I shouldn't.

[rivka]

Telephone conversation at 8:45 this morning:

Tired Female Voice: Hi, this is Dr. Taylor.
Rivka: Hi, my name is Rivka and I'm a patient of Dr. Rifino's. Since yesterday I've been having symptoms of a urinary tract infection, and I'm really hoping for some Bactrim.
Tired Female Voice: Okay, how do you spell your last name? What's the number for your pharmacy?

She didn't ask what my symptoms were. There was no nonsense about actually testing my urine for bacteria. There's just a Bactrim prescription for me down at the CVS.

On the one hand, this is really cool. A visit to an urgent care facility to get tested would have been (a) inconvenient, and (b) expensive. There aren't a lot of other things that mimic a urinary tract infection, so it's not like there's a complicated differential diagnosis tree. I like being trusted to know what I have.

On the other hand, damn it, now I'm second-guessing myself. My lower abdomen doesn't hurt as much as it did forty-five minutes ago - maybe I'm overreacting. Isn't it irresponsible to go on antibiotics without concrete evidence of a bacterial infection? Shouldn't I just make do with lots of cranberry juice until Monday, when I can be tested cheaply in my doctor's office?

No, this is silly. I was up every two hours all night. Just because it's not as bad as the worst UTI I've ever had - when I was up every fifteen minutes - that doesn't mean it's not worth treating. Time to shower and go to the drugstore.

Comments

Primary vs emergency care

[dedoc.livejournal.com]

You're right on the money about trust, Rivka. A primary care practice can get to know their patients, know which ones are trustworthy, which ones aren't, and their practice patterns can be adjusted accordingly.

And if the Bactrim doesn't work, you can always go in and get seen.

I think it's OK--and hope you're feeling better soon...