i am like you - unless it's a life/death matter, i don't think it's an emergency. e.g., suicidal thoughts aren't an emergency for me. however, if i started to act on them, i might call my pdoc.

these are the rules i've figured out with my pdoc: like yours, you can either leave a message, or get an operator to page him. he's told me to always leave a message, because he doesn't trust his reception girls anymore (they sometimes won't pass a message on if they don't think it's an emergency). and besides, he never interrupts appts to take calls, but always checks in between appts. so he will get the message/page at the same time anyway, and it is probably better for him to have a brief idea of what is happening.

he has told me he is always happy to receive a phone call from me - emergency/urgency or not. what i do is to leave it up to him whether he calls back. so, e.g., i can say, "i'm having suicidal thoughts, but i don't have a plan" or "i'm having suicidal thoughts and do have a plan, but not going to act on it just yet" etc. once (years back) i actually called him and said "i'm just having a crap day. need a friendly voice". definitely not an emergency!! but he knows me enough to know that if i do make contact, then it's because i really am struggling, so he called me back. he has said some of his other clients call all the time, and he has to base his decisions on whether to call back on a different set of rules, because if they said the same thing, chances are they weren't at the same level of distress i was at.