Md. doctors cope with flood of calls about H1N1 flu

Phone is best weapon to deal with concerns, they say

  • Dr. Sarah F. Whiteford at GBMC looks at Ken Kurz of Homeland, above, who had been staying home with the flu but turned out to have a secondary infection that required antibiotics.
Dr. Sarah F. Whiteford at GBMC looks at Ken Kurz of Homeland,… (Baltimore Sun photo by Karl…)
November 12, 2009|By Meredith Cohn | meredith.cohn@baltsun.com

Nearly 5,500 calls came in to the Towson office of Dr. Sarah F. Whiteford in the month of October - more than twice the usual number. And even with extra staff manning the phones, about 1,000 patients grew tired of waiting and hung up.

It's a flu season like the office has never experienced. And despite the nearly overwhelming volume, Whitefordand other primary doctors saythe phone has become their most essential tool in not only managing the first pandemic in decades but tamping down the widespread anxiety about the swine flu virus that has killed 13 people in the state.

For the sick, the doctors have used the phones to weed out the truly needy cases and to convince everyone else that they will get better with rest, Tylenol and fluids at home. For the healthy, they have used the phones to schedule appointments for vaccination, and to spread news when they have no more doses.

"Everyone has been helping answer the phones," said Whiteford, a family doctor from the Greater Baltimore Medical Center's Family Care Associates, which has several thousand patients. "October was really busy and November isn't shaping up to be any slower."

The phone system is set up to funnel swine, and seasonal, flu calls to receptionists. They can make vaccination appointments or take messages for the doctors. Other calls, such as for referrals or prescription refills, go to specific voice mail boxes.

Even with their system, Whiteford's waiting room one day last week was full within minutes of the door opening.

Some of the patients have been in rough shape, like Ken Kurz, who had been trying to weather the flu at home. He spent most nights in his Homeland bed staring at the clock, waiting for the next four-hour block to pass so he could take more medicine.

Still, he was getting worse. The pain of his congestion was so bad his teeth hurt. And he was worried about infecting his wife and 6-month-old son, who had not yet been vaccinated against the H1N1 virus. As he suspected, he had a secondary infection that required antibiotics.

But doctors say most patients do not need such prescriptions. And they don't need Tamiflu, the antiviral medication administered mainly to young children or patients with underlying conditions in the first couple of days of the flu to lesson the severity.

Most patients with the flu don't need to come to the office at all, and they don't need to go to the emergency room. Whiteford said those with no complications such as trouble breathing or severe dehydration and no chronic health problems such as asthma or respiratory disorders should stay home so they don't spread the disease.

Dr. Michael Randolph, a private physician who shares a 5,000-patient practice with another doctor at Union Memorial Hospital, said that while his call volume is up, people seem to have gotten the message about who is first for a vaccination and who needs to see the doctor. He said he has many patients with other health issues, and he does want to see them because they are more vulnerable to troublesome secondary infections such as pneumonia.

"That's who I'm really concerned about, but many people seem to be educated about when to call," he said. "Others who are calling and it's only Day 1 and they don't have a complication or an underlying conditions, I give them my Grandmother Rule: If you're not better in four or five days, call me back."

That, however, can be a tough sell for adults. It's an even harder sell for some parents, who have read about the high toll the virus has taken on kids, Whiteford said. Million of people have gotten the flu, and the vast majority recover at home with no problems. But two Maryland kids and more than 100 children across the country have died, though the U.S. Centers for Disease Control and Prevention reports two-thirds have had another health condition.

"A lot of people want to be listened to and examined," Whiteford said. "Sometimes it makes them feel better to be seen."

And doctors do want those with other health conditions to come in for an examination if they are sick or get a vaccination if they are healthy. Many doctors, though, don't have vaccine doses. Out of a stock of 400 doses, Whiteford had just a small number left of the nasal spray version of the swine flu vaccine, which can't be used on those with chronic health problems or young kids. She also had some injectable pediatric doses of the seasonal flu.

Other doctors have no H1N1 vaccine at all, including Randolph. He already blew through his doses, about 200, of seasonal flu vaccine even though that flu strain has not yet surfaced and isn't expected until December.

He's been telling people about public clinics offering swine flu vaccine for priority groups, which include pregnant women, infant caregivers, kids six months to 24 years, adults with underlying health conditions and health care workers.

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