Intended for healthcare professionals

Soundings Soundings

Looking for the man who fell off the roof

BMJ 2000; 320 doi: (Published 29 January 2000) Cite this as: BMJ 2000;320:323
  1. George Dunea, attending physician
  1. Cook County Hospital, Chicago, Illinois, USA

    Dr Mumps, a primary care physician, has a patient who fell off the roof and was taken to the University of Excellence Hospital, the one that advertises every morning on the radio.

    In a capricious mood, Dr Mumps decides to find out how his patient is doing.

    He is greeted by a friendly recording: “If you speak Spanish press one, if you speak Swahili press two, to speak to the laundry press three, for the kitchen four, for billing press five… If you have exhausted all 12 possibilities stay on the line. Your call is very important to us and we will answer you promptly.”

    Half an hour later Dr Mumps at last speaks to a human voice. It directs him to Dr Buggs, the attending physician, an infectious disease specialist

    Dr Buggs answers promptly, but says that he has been “off service” for a week and is back in the laboratory. He suggests calling Dr Chan, offers to transfer the call, but inadvertently disconnects the phone.

    Undaunted, Dr Mumps tries again. Not once, but many times. Each time the same ritual: “If you speak Turkish press seven….” He looks for Dr Chan, but there are 25 Dr Chans working at the University of Excellence.

    On the third attempt he finds the right one, but he has signed off the day to Dr Patel, who says that the patient belongs to Dr Mbawa, who believes that the patient belongs to Dr Rigamortis, who is doing a venepucture and cannot come to the phone. Dr Mumps asks for the patient's room:there is no reply. Perhaps he has gone for an x ray examination.

    The next day Dr Rigamortis does not answer. The nurse is “on her break.” The medical student seems to be in charge, but does not know the patient and suggests calling medical education. Alas, the programme director is in a meeting that will last all day.

    The secretary is “away from her desk,” but calls back later. Dr Rigamortis has gone for a job interview. His patients were to be followed by Dr Mbawa, she adds mournfully, but the good doctor fell off the roof last night and is in intensive care. “You could call the new attending physician, Dr Smith,” she muses, “but he has gone off to a meeting in Patagonia and Dr Buggs is covering for him.”

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