Friday, April 21, 2006

Hurry Up And Wait...

I know I promised to blog something hilariously funny yesterday, but...well, I just had a hard time finding anything funny after my Rituxan Study research appointment in the morning. You see, my old neurologist had to tell me my MS was progressing and I had developed new brain lesions. It just wasn't a "funny" kind of day.

But then I got to thinking, "Surely there was SOMETHING about my day that was laughable, wasn't there?", and here's what I came up with: My medical rant called Hurry Up And Wait.

Why is it whenever I go to the doctor's office I have to hurry up and wait? Who started this phenomenon and made it a code of ethics for physicians that they are to make their patients wait for an uncomfortable amount of time (usually at least 10-15 minutes is standard practice) before going in to see them?

These days whenever I make a doctor's appointment, I get some high tech voice recording or a live caller from the scheduling department calling me a day in advance to remind me of my appointment time and requesting I be there EARLY, anywhere from 5 to 15 minutes. This is so I can check in and sit in the lobby to WAIT until my name is called to be escorted back to an exam room.

Now, I'm fully aware no one is going to come hopping out from the back at exactly my appointment time (or earlier just because I'm already there!) to greet me and take me back to an exam room. This just doesn't happen. Instead, I am forced to sit in a lobby full of sick people and/or crying sick children and wait. I call this room Waiting Room Number 1. I believe this part of the appointment time may be to check my immune system...after all, if I don't "catch" anything at my doctor's office from the cesspool of available germs and viruses in Waiting Room Number 1, I must be doing pretty well in the immune system department!

Usually about 5-10 minutes past my appointment time (and after some diseased person has already sneezed or coughed in my direction) a nurse or assistant will come out from behind door number one with a harried lookon his/her face and say, "I'm so sorry. The doctor is running a bit behind today. Come on back and I'll get you in a room." This is where I have found it does no good to ask, "What is a bit behind?" This assistant or nurse is well trained to lie to me and respond with, "Oh, 5-10 minutes Dr. So-And-So should be right in."

So I go back to what I now call Waiting Room Number 2 and take my seat. The magazines and available distractions in WRN2 are usually a pared down version of what's available in Waiting Room Number 1, minus the sick people. These magazines are more "specialized". Things like Golf Digest or other headline topics I know nothing about are neatly tucked in a magazine rack in the wall. I have a theory about magazines in WRN2...they shouldn't be there. Anytime there are magazines in WRN2 it already means a long wait. After all, why would you NEED a magazine in WRN2? Because you are going to wait a little bit longer and would like something to read...

Finally, after what can be anywhere from 5-20 minutes, a doctor will knock politely on the door and enter WRN2. After an exchange of a few niceties, I whip out my list of questions and concerns and begin my bombardment of quickly spewing the writing on my list, in hopes of getting a few answers to these questions. I know the hour glass was turned over just before Dr. So-And-So entered, so I am on a time crunch now to get everything in as quickly as I can...after all, Dr. So-And-So's time is very valuable and he/she has an entire waiting room of sick people left to see.

After about 15 minutes with Dr. So-And-So (and knowing the last grain of sand has probably fallen from the upper portion of the hour glass), the physician will subtly signal my time is up by standing. This is where I receive whatever remedy to my problem we have decided upon. Dr. So-And-So hands me a script or a lab sheet or something in writing and instructs me to come back in so many days/weeks/months. There's always the courteous, "It's good to see you", which I doubt is really true, and Dr. So-And-So disappears into the bowels of the hallway.

If I total up all the time I have waited just to have my private 15 minutes with Dr. So-And-So, it usually comes out to be somewhere around a 1/2 hour to 45 minutes...sometimes longer. This includes the instructed voice recording time asking ME to be there 15 minutes before my appointment time is scheduled.

Now if I'm really sick, this time frame of waiting can nearly kill me...I have crawled out of the comfort and sanctity of my bed where I was warm and cozy just to Hurry Up And Wait to ask a doctor questions I could have easily submitted in writing and just stayed in bed. Or perhaps I could have simply talked with the doctor over the phone and gotten the same answers.

I don't like Hurry Up And annoys me. I think physicians appointments should be more like college class. You remember when your professor was late more than 10 minutes, you could just walk out? I think doctors should be on this same plan...10 minutes late, the patient can walk out, and they are not billed for the appointment. AND, there is a window on your way out where another physician (perhaps one that is being punished for being tardy) is waiting to answer your questions and provide your treatment at no cost to you...sort of like a drive thru type situation.

As a disclaimer, I have to say here not ALL physicians are on the Hurry Up And Wait plan. For instance, my psychiatrist has never been late for an appointment in the past 6 years and my wonderful new neurologist lets me email my questions to her without having to make an appointment. They seem to have missed the lecture in med school about making their patients wait for them.

I have decided the next time I am made to play the Hurry Up And Wait game with a physician, I am going to play dead in their office...I will sprawl myself out on the exam table and appear unresponsive and when Dr. So-And-So begins to panic and slap my checks to wake me up, I will come to mumbling, "Oh wow. I think I had a near death experience waiting to see you. I've been here so long...what day is it?" I'm certain this will not change Dr. So-And-So's habitual behavior of making his/her patients wait, but I'll sure feel better about it!

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