In Samuel Beckett’s play, two vagrants pass the time of the day by waiting for another man named Godot–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 time.” 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. Dr Sekeres, an oncologist, often must return panicked phone calls from patients and families with serious diagnoses. In his essay, Mikkael 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 information. Many patients and practices have systems in place that allow a patient to log on to a secure website and look up results–however, 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 Godot never shows his face…