After Hours

How to obtain assistance when the office is closed
In the event of a critical medical emergency after hours, call 911.

After Hours

Most complications of cancer treatment can be handled during normal office hours by your regular oncologist or oncology nurse, but occasionally problems arise after hours. This section of our web site explains how to obtain assistance for a cancer-related problem when the office is closed. Problems not related to cancer or its treatment should be directed to your primary care physician or the physician on call.

The Answering Service

Calls to Redwood Regional Medical Group before 9:00 a.m. or after 5:00 p.m. weekdays or on weekends and holidays are routed through an answering service. You should call the office where you see your doctor if you need non-emergency assistance after hours. If you don't have your doctor's office number, please go to the Contact page on this web site.

When you call after hours the operator will take your phone number and page the on-call physician who will generally call back within 15 minutes. If there is no response within 30 minutes you should call the answering service back.

The On-Call Physician

Whenever the office is closed there is a designated physician on call for emergencies. During the 60-hour weekend shift (Friday evening until Monday morning), in addition to taking phone calls, this physician performs hospital rounds on all our hospitalized oncology patients in Sonoma County and oversees the weekend injection clinic in Santa Rosa. Thus, the physician may be taking your call from a hospital, on a cellular phone, from a car, or from home. Your office chart will generally not be accessible to the physician when you call, so you should have certain information at hand when you call.

Preparing For The Call

If a physician other than your regular oncologist is on call you are likely to be asked questions regarding your medical history. This will allow the physician to assess your problem more accurately. You should be able to briefly describe your cancer diagnosis (what kind of cancer and if it has spread), current treatment and the symptoms that prompted your call.

Particularly important are the names of the medicines you currently take and the date of your last chemotherapy. It may help to have prescription bottles and treatment calendar by the phone when you call.

You should also know the name of your primary care physician and whether your insurance specifies the hospital to which you are to be admitted should that be necessary.

You may find it helpful to have a family member or close friend make the call for you if you are feeling poorly or are in pain.

When to Call

Routine matters such as scheduling, obtaining lab results or refills on prescriptions, and minor acute problems such as constipation and mild nausea are best handled during normal working hours when nursing personnel are available and your chart is easily accessible. Patient education materials distributed in our offices in the form of booklets and handouts often contain useful information that may answer your questions and these should be consulted first.

More serious problems such as uncontrolled pain, shortness of breath, profuse diarrhea or fever are examples of reasons to call the on-call physician, who is available 24 hours/day, 7 days/week for urgent needs. A fever of 100.5 that persists for an hour or a fever of 101 for any duration is a reason to call if it occurs midway between chemotherapy cycles or is accompanied by shaking chills (shivering) or profuse sweating. You should have a reliable thermometer at home if you are receiving chemotherapy.

Depending on the nature of your problem and its urgency, it may be handled over the phone, you may be asked to contact your primary care physician, or you may be instructed to go to an emergency room or hospital for admission.

The Emergency Room

You should go to an emergency room directly or call 911 in case of a critical medical emergency or if directed to do so by the on-call physician. In some cases the emergency room physician will perform the evaluation and treatment with direction from the oncologist. In other cases (especially when hospital admission is required) the oncologist or a hospital physician will meet you and initiate treatment. It is most efficient to use the emergency room of the hospital to which your insurance requires admission. If this is a restriction of your insurance plan you should communicate this information to the on-call physician. You should always bring a list of your current medications (or the bottles themselves) when you go to the emergency room.

Prescription Refills

Routine prescription refills should never be put off until after hours for a variety of reasons. Refills are best handled by the pharmacy directly through the nurse in your usual office who can note in your record when the request is called in. Such requests are time-consuming and disrupt the other duties of the on-call physician.

Narcotic prescriptions in particular should never be allowed to run out. For legal reasons, most pharmacists refuse to take such orders over the phone. Physicians may be reluctant to fill such prescriptions for patients they don't know or may limit the prescription to a few pills.

If absolutely necessary to get a refill after hours, it is your responsibility to find a pharmacy that is open and to supply the pharmacy's phone number to the physician when you call..