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Fam Pract Manag. 2016;23(6):32

Handle out-of-area patient calls with care

When patients call from out of the state, province, or country seeking medical advice, it can be difficult for providers and staff to know how best to respond. Many jurisdictions consider telephone consultations with patients to be telemedicine and require the physician to be licensed where the care is being received. Also, staff and providers may be unfamiliar with certain illnesses patients contract while traveling in remote parts of the world.

It is valuable to have a policy for handling these calls. In my practice, if the number on the call display looks odd, staff ask the patient their location. They encourage patients calling from another jurisdiction to seek care from a local provider, if possible. If a call is transferred to a member of the patient's care team, staff alert the provider to the fact that the patient is calling from another jurisdiction. The provider clearly explains the limited assistance he or she can provide and encourages the patient to seek care locally. Finally, the provider encourages the patient to keep all records of the care received and to follow up with our office after returning home.

We try to be proactive when possible, encouraging all patients before traveling that they should obtain sufficient medical insurance and find out if their insurer offers an international help line to link them with qualified providers in the region.

Set aside your ego as a leader

Modern leaders, including physician leaders, are increasingly recognizing the importance of quieting their egos when making decisions and managing their organizations. It turns out that humility can aid critical thinking, innovation, and engagement with other people.

Here are some tips to help you keep your ego in check and become more team-oriented:

  • Seek out information that contradicts your opinions, and learn from those who disagree with you.

  • Ask those close to you to give honest feedback about your ability to be open-minded, empathetic, humble, and willing to listen. You can't fix what you don't know is broken.

  • Focus more on asking the right questions and evaluating answers rather than relying strictly on your personal knowledge.

  • Consider the experiences of others before formulating your response.

  • Focus on the moment, and do not dwell on things that happened in the past or worry about the future.

  • Accept the reality that you will be wrong sometimes and make mistakes.

  • Evaluate yourself after meetings or at the end of the day to consider whether you are becoming more empathetic and less ego-driven.

Achieve more goals by picking fewer of them

Accomplishing big things doesn't require a long list of goals. Instead, it requires focus on a few. Attempting to complete too many goals, especially ones that are not vitally important to you or your organization, decreases your likelihood of completing any of them. In general, if a team has two or three key goals, they will accomplish those. If they have four to 10 goals, they may accomplish one or two. Groups trying to tackle 11 or more goals often fail to achieve any of them. It's the law of diminishing returns.

Goals should not focus on “lag measures,” which are based on a desired outcome such as “lose 20 pounds.” Instead, goals should focus on the “lead measures” that will produce that desired outcome, such as “walk 30 minutes three times a week.”


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Submit a pearl (250 words or less) to FPM at

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