This past spring my father underwent a lot of diagnostic testing over several weeks. First, as a man who never interfaced with the health care delivery system, the interaction for him personally was challenging. It was also challenging for my mom and I. To see my dad, who has always been strong, healthy go into the hospital was nothing less than shocking, while concurrently interfacing between how the system operates and the emotions and expectations of my parents was difficult.
Both my parents have expressed multiple complaints about the health care delivery system. I, having played the roles of both provider and patient in my life, see both sides. I believe we are not alone in our observations.
- First the lack of (perceived) caring as demonstrated by the delay (perceived) in return of phone calls, return of results and appointment scheduling. Although daily medical care in an office setting may be perceived differently than an emergency room setting, there is none-the-less a hierarchal list of issues depending on medical urgency that are being addressed at every moment. For example, a person with a heart monitoring exam (EKG) result showing a likely infarct takes precedence over someone who has a mild abnormal finding on a CT scan and the three patients who are in exam rooms. You may understand this now, but if you are the one with the mild abnormal finding on CT scan and your result is available to you on your electronic health record, you may be wondering why the hell your doctor has not already called you about the result.
- Second, there is a deficit in immediacy, coordination and execution in the medical delivery system. It is like getting a brontosaur to move at light speed…it just doesn’t happen. Although, I have been told Mayo Clinic at Rochester has really great service and coordination. The systems I have worked for and interacted in are not operating at such a level. Yes, things get done, but if you are not the trauma victim or your life is not imminently danger, you may find yourself subject to long waits. This is true for seeing your provider to getting your meal in the hospital.
- Third, it seems as if your provider is more interested in the computer than in you. Well, there is a lot to be said about this. Most providers would love to never look at a computer again…while the electronic medical record has its benefits, providers really went into health care to interact with people. However, here we are. So in order to make sure your visit is documented appropriately, and the provider can recall enough info about your visit so next time you are seen progress can be made, it is necessary to tend the electronic medical record (EMR). The other necessity involving the EMR is to order labs before you leaving the exam room.. This is what happens if you leave the exam room without labs being ordered…the moment a provider leaves the exam room, there is anywhere from 1 to 6 people that are waiting to ask him/her questions about other patients, specifics about a diagnostic test, etc, then your labs do not get ordered. Behold you arrive at lab without orders and you are frustrated and lab personal are frustrated, etc.
Please know your provider does care. Please know he/she is doing the best he/she can. Please know if he/she is not freaked out, you can relax some, while also knowing the verbalization of your concerns is welcomed. Please know your provider is human, and if he/she doesn’t call you immediately with a result, sometimes it is so he/she can be in a more compassionate state when he/she does call you. Please know your provider is mandated to work with the constraints of the system, and concurrently wants the best for you delivered in an honorable way with efficiency.