Industry Update
Opinion Article 3 March 2021

Hotel Visits I don’t Make

By Mike Oppenheim, MD

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Oppenheim

I try not to make housecalls for shortness of breath, chest pain, loss of consciousness, and severe abdominal pain.

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Treating asthma, the leading cause of breathlessness in the young, takes hours. Giving a shot and then leaving before the guest improves is risky.

Breathless in older people usually means heart or lung disease. No doctor in his right mind treats this with a prescription, although possessing a mind is not a legal requirement for practicing medicine.

No one ignores an elderly person who faints, but this doesn't happen often. The young seem to faint regularly. They collapse, wake up, and call me, frightened. I'm happy to make a housecall, check blood pressure, do an exam, and ask questions. By this time he or she has recovered, and I've never discovered something alarming in otherwise healthy young people. "Everyone is entitled to one faint," a wise old doctor told me. If it keeps happening, a doctor should investigate.

Chest pain is a serious sign, but serious chest pain is not subtle. Niggling discomfort does not qualify. Textbooks warn that heart attacks can occur with no symptoms although these are usually in people with other problems, especially diabetes. Since a doctor cannot diagnose a heart attack by listening with a stethoscope, a housecall isn't helpful. If you phone because you're worried, it's unlikely, for the obvious reason, that the doctor will tell you not to worry.

As I've written before, when a guest suffers abdominal pain, I feel reassured when there's diarrhea or vomiting. That usually indicates a stomach virus, miserable but short-lived, and I get the credit when the guest recovers. Pain alone can also be a stomach virus but plenty of serious conditions (gallstones, kidney stones, blood clots) come to mind.

Medical science has no cure for drunkenness, but hope springs eternal, so my phone continues to ring.

Mike Oppenheim

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