"Our options have changed. .. we will not call you back". Communicating with my primary care physician.

With the rise in managed care and the changes in the organization and delivery of health care, the medical literature is rife with expressions of doctors' discontent. Less is known about how these changes have affected patients in the course of everyday interactions with their doctors. As an efficiency measure, many physician practices rely on voice mail to screen and direct calls to the appropriate party. This simple, low-tech alteration in communication between patient and doctor has the potential to interfere with the development and maintenance of a constructive doctor-patient relationship. This paper describes the author's experience communicating with her physicians. It focuses on making an appointment via voice mail and offers a perspective on how the process of appointment making through an electronic third party can have a negative impact on the doctor-patient relationship.