Dr. Campbell: Timely information critical for patients

In Samuel Beckett's play, two vagrants pass the time
of the day by waiting for another man named Gadot – a person that they have
never met.  The wait becomes intolerable at times and the men argue,
philosophize and even go as far as to contemplate suicide in order to “pass the

It is estimated that Americans spend
roughly 37 billion hours waiting in lines each year. Waiting in lines can have
a negative emotional toll, just as in Beckett's play. As we stand in line, many
of us have a nagging sensation that our life is slipping away. Waiting can
produce irritability, anger, anxiety and boredom.

Unfortunately, healthcare is
ubiquitous with waiting.  We wait for an appointment, we wait to be called
to the exam room, we wait to hear the rattle in the door that signifies the
arrival of the physician.  As patients, we all come to accept waiting as
part of the ritual of medical care – and with the new Affordable Care Act, I
expect waiting will become even more commonplace. 

However, some waits can be
intolerable and can negatively affect our psyche, leading to sleeplessness,
anxiety and even depression.  One of the biggest challenges facing
healthcare providers is the ability to quickly and accurately disseminate tests
results and information to patients.  Even in this era of electronic
medical records, smartphones, Twitter and Facebook we still sometimes have to
wait for an old-fashioned phone call from our doctors.

This week in The New York Times, Dr. Mikkael Sekeres
shares his own experience with waiting for news from a physician. Sekeres, an
oncologist, often must return panicked phone calls from patients and families
with serious diagnoses.  In his essay, he describes his emotions while
waiting on his doctor to call him about an abnormal cardiac stress test.
 As physicians, it is important that we read this piece and are able to
understand the healing power of a simple phone call.  As with most things,
the experience from the “other side” of the white coat is very different from
what we may perceive about the patient experience.  Learning from our own
experiences as patients will inevitably make us better caregivers in the end.

Today, physicians and other
healthcare providers are asked to do more with less time.  With
increasingly grueling inpatient and outpatient schedules, tasks such as
returning phone calls often get delegated to others or pushed to the end of the
day.  What may seem like a “low priority” activity to a busy physician may
very well be a “game-changer” for the patient awaiting the buzz of his or her
smartphone.  However, we must remember what is most important to a patient
who is left waiting and worrying – information.  Information provides
power and gives back control.  When we have information, we can start to
make choices and begin to move forward.  Living in limbo is not a party – for
many, limbo is purgatory.

Given the mandates for electronic
records and e-prescribing, why can't we come up with a HIPAA compliant way to
allow patients immediate access to test results?  This is a very difficult
question to ponder.  There is no easy answer.  

Doctors are not reimbursed for this
type of work and yet physicians must justify every minute of their existence to
the “bean counters” that follow them around electronically.  Assistants
often answer patient calls for healthcare providers and are often ill-equipped to
handle the questions that may arise when providing results or other medical

Many patients and practices have
systems in place that allow a patient to log on to a secure website and look up
results. But how does the average patient interpret these results?  Will
this create even more anxiety and worry?  There is no replacement for the
doctor's call – some situations must be handled by either a face-to-face visit
or a personal phone call.  We must remember to imagine what waiting in
purgatory must be like for our patients and make it a priority to provide
timely results and information in order to ease their pain. Even if Gadot never
shows his face…

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