The Gift of After-Hours Medical Care A new study shows that people who have after-hours access to their doctor use the emergency room less. Published online in the journal Health Affairs, the study found that one in five people who attempted after-hours contact with their primary care doctor reported it was "very difficult" or "somewhat difficult" to do so. But those who reported less difficulty contacting a doctor after hours, say on nights and weekends, had fewer emergency room visits than people who experienced more difficulty. I can relate at least one experience in which our pediatrician's evening hours saved us an emergency room visit, after a mishap known in our family as the Fork Incident. It was one of those times when we really needed to see a doctor, in person, past regular business hours -- not just talk to an on-call advice nurse. We had moved to a new town and into a newly renovated home, complete with polished hardwood floors. One evening, my then 5-year-old daughter was helping me set the table, and she grabbed a handful of forks from the silverware drawer. She didn't run. But somehow, in the few steps to the table, she slipped and fell. On her face. On the forks. When she began howling, I took one look at the blood pouring from her face and felt my knees go weak. Fearing her eyeball was punctured, I yelled for my husband, who calmly removed her to the bathroom to assess the damage. The utensils hadn't, thankfully, hit her eye. But the tines of at least two forks did pierce the skin just above her eyebrow, which was rapidly swelling. We thought it should be looked at by a doctor, just in case. A call to our new pediatrician revealed that the office had extended hours on some evenings, and we were told to bring her in. The doctor looked at the rows of tiny holes above my daughter's eye. "What kind of a fork was it?" he marveled. It was more than one! I blurted, feeling ridiculous. Everyone knows not to let kids get their hands on scissors or knives. But, come on -- forks? She didn't need stitches, and we went home to put ice on her forehead. The after-hours clinic had probably spared us two hours of waiting and a $100 co-payment at the emergency room. The study found that among people with a regular primary care doctor, 40.2 percent reported that the doctor's practice offered extended hours. One obstacle to the wider availability of the service, the study noted, is that doctors are "insufficiently compensated for working evenings and weekends." The study concludes that after-hours access by phone or e-mail, too, offers the potential to reduce rates of emergency room use. I'm glad, though, that our practice offered in-person visits. Does your doctor offer a way for you to get in touch on evenings and weekends, or to receive care after hours?