David Altshuler, M.S.
(305) 978-8917 | [email protected]

Barriers to Service

Hoping to consult about a mutual client, I called the office manager of the psychiatrist. “Thank you for taking my call,” I began. “My name is David Altshuler. Dr. Schmeckleferritz and I have a patient in common. When might it be convenient for the doctor and me to consult?”

“Dr. Schmeckleferritz is out of the office today and won’t be back until tomorrow at noon. Then he has patients all day on the hour.”

“Undrerstood. Thank you. Is there a good time for me to call back?”

“I just told you. The doctor has patients all day tomorrow.”

“I understand,” I blundered on. “I’d be happy to call on Saturday. The patient is an active crystal meth user and the family is concerned that…”

“The doctor does not return calls on the weekend,” the receptionist interrupted. “Is there anything else I can help you with?”

Admittedly, I was stumped. Indeed there did not seem to be anything at all that the receptionist could help me with. She did seem willing to write down my name and phone number. Perhaps she perceived that the only way to get me off the phone was to acquiesce. But I felt strongly about consulting with the doctor. A young person’s life was at stake after all. So I called back twice the next day. On Monday, I left four messages. On Tuesday, I was prepared to call eight times. The receptionist let my calls go to voice mail–caller ID is a thing–but I kept calling.

On Wednesday morning, my phone buzzed at 7:43 am. It was the psychiatrist. Finally. We had a good chat. His insights into the patient were, in my judgment, right on the money. I was able to make treatment recommendations as a result. The patient is making progress at the facility that the doctor and I discussed.

Of course, when the phone buzzed at 7:43 in the morning, my first thought was to say, “Who the heck do you think you are calling me so early, hoping I won’t pick up the call, after you didn’t condescend to return my call until I had left six messages and undergone endless attitude from your nasty office manager winner of the 2019 Rudeness Award and who I’m pretty sure works part time at the Help Desk in hell and you are too darn busy to help with this desperately needy child?”

It would have been easy to allow myself to be a victim of a churlish, incompetent, boorish, slug of an office manager. About the third or fourth unreturned call, I could certainly have said, “I’M TRYING TO HELP SAVE THE LIFE OF A YOUNG ADULT WITH SEVERE SUBSTANCE USE DISORDER, YOU OBFUSCATING BOOR!” And when the doctor finally returned my call before 8:00 am I was tempted to being the conversation, “YOU WERE HOPING THAT I WOULDN’T PICK UP WEREN’T YOU, YOU INEFFECTUAL QUACK!”

But I was able to sublimate my need to be treated like a human. I focused on helping my client rather than expressing my outraged point of view. Indeed, I still have little regard for the office manager. But I made it a point to get the doctor’s cell phone number. The next time we have a patient in common, I won’t have to go through his dim bulb of an office manager. The point is, I got the job done.

I’m writing about my successful interaction last week not to break my arm patting myself on the back, but to make a point about communicating with our children. Invariably, there are “barriers to service.” A low-income single mom certainly SHOULD bring her child back to the pediatrician for a follow up visit. But if she has to miss work, risk losing her job, and take two buses across town to make the appointment, she may have to reconsider. Even when economic restraints are not so cogent, parents have to consider keeping their eyes on the prize.

Yes, our kids should bathe prior to cuddling up for books before bed. But if I believe that a few chapters of Winnie the Pooh is the most important thing I’m going to do with my child today, I may be willing to occasionally put a dirty kid between clean sheets. Yes, school attendance is important. But if I can sneak away from work for a day, I can snatch my kid and head out to the Everglades to maybe see a wood stork. Sleep is certainly important for growing children. But the Perseid meteor shower comes one night in August each year. I’m going to bundle up the sleepy heads and drive out into the darkness.

If I wait for the office manager to acquit herself as a member of my species, I will never have the chance to fulfill my commitment to a kid in pain. If I wait until the kids behave until I reward them with a day away from school or an excursion to see meteors detonate the heavens, they may be grown and gone. Long term goals take precedence. And your memory of watching the Perseids with your kids will stay with you longer than any memory of the impertinence of a receptionist.

Picture of David


4 thoughts on “Barriers to Service

  1. Barbara Benway

    Dr. Altshuler:

    I hope you and all you care about are just wet and not immersed in the horror of a hurricane.

    Once again, thank you for your thoughtful post. I look forward to your name in my inbox.

    Barbara Benway

  2. Brenda M Moreira

    Love this as usual. You never bore me.
    Thanks for confirming what is my new philosophy… DIP. Do. It. Period. Because tomorrow is not promised….
    I’m DIPPING away…

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