The Best We Can Do?

Added on Feb 27, 2014

For months, I have been anxious about booking elbow surgery for an old injury that’s become pretty debilitating. I have packed weeks, as we all do, and I’ve been working with my colleagues and my family to find the right time to have the outpatient surgery, give myself a day of recuperation and get back to the races. 

After finding “the” day, Friday, March 7, I apprise my colleagues, resolve my meeting conflicts and convince my son to drive me. Then I email my doctor’s office to determine the scheduled time for the surgery. Here’s the response I receive (names changed to protect the innocent): 

Subject: Re: Surgery
Hi Mr. Ryan, 
Unfortunately, I am the last to know (the schedule). They call Dr. X the day before surgery with his time. He starts at 7 am and goes until he is done. 

So, is this the best we can do? Imagine what Jane’s job must be like, with no idea what’s happening until the last minute fire drill on Thursday. Is the OR disorganized? Do they know what procedure I am going to have? Are they clear on which arm I am having it? Do they know which patient I am?

And beyond the medical concerns I now have, what do I say to my work? What do I say to my ride? What do I say to my family? I will let you know the plan Thursday some time? Is it really that hard or is it that “someone doesn’t care”? I called Doctor X and he started to explain and rationalize the behavior, then he paused and agreed there is no good excuse. 

After sharing this story with a friend who recently had open heart surgery, he revealed, “I had more follow up from my dog’s veterinarian than from my own cardiac surgeon.” 

When the system creates complexity, uncertainty and anxiety, trust is eroded! This experience is completely avoidable. And if we all agree it’s unacceptable, the system can be changed within 24 hours. We just all have to agree as health care professionals that the status quo is unacceptable. When we walk in the shoes of a patient, it’s alarming and scary. 

Change can be hard. Health care delivery and the challenges that we face are more complex than my most recent experience, but there is no doubt that we have a care coordination crisis in our system. It is time we start breaking down the old paradigms that got us where we are today. 

While reforming health care will take many years, reforming the patient experience can and must happen much faster. Sometimes we have to simply take the advice from Nike and “Just Do it!”