Learning to behave like an American …
I’m learning a little to be an American within the healthcare system. Today, I asked for a supervisor.
You see, I had an appointment. The online system showed my appointment as 9:15. I was told to arrive 30-minutes prior to my appointment (which is a bit excessive). I arrive 25-minute prior to my appointment (8:50). So, when I was still waiting at 9:30, I went to talk to the receptionist. Anytime I’m asked to wait more than 15-minutes, I want to know why I’m waiting (that is a lesson I learned being here – in Canada I would just wait in silence – it is interesting how this goes so against my ingrained behaviour). I found out that my actual appointment was at 9:45! So, the online system had already added 30-minutes, and the person who made the appointment for me added another 30-minutes. And this is in part, why people spend excessive amounts of time waiting at Stanford!
The problem is, that it is not consistent. The folks at Mammograms, Ultrasound, and Interventional Radiology add the 30-minutes wait time to the online system – so your appointment is actually schedule 30-minutes later than it says on the system. The folks who do MRI do not. So, as a patient, I have no idea whether I should be showing up at the appointed time or 30-minutes before the appointed time … and if 30-minutes accounts for parking, tell me that .. cause it doesn’t take me 30-minutes to park … Scott drops me off, and he parks .. so there is 15-minutes I don’t need added to my pre-appointment time.
So today, I asked for a supervisor. Why not, I was waiting anyways, might as well make use of my time. The supervisor came and spoke to me. She had no idea about this problem. She said this was the first time anyone had bothered to complain – so they didn’t realize there was an issue. She promised me to look into it, and to inform various people. I felt like she was taking my feedback seriously – like they were craving to better appreciate the patient experience, and learn about ways in which to improve their process. So, I also complained that when I checked in at 8:50 – almost an HOUR before my appointment, that the receptionist did not tell me how early I was. Had the receptionist told me, I would have gone for a walk – gotten myself a second coffee – made use of the 55 minutes that I’d be waiting – rather than sitting in the poorly lit waiting room. My general rule is, if you think I’ll be waiting more than 15-minutes then TELL ME!
So, the Canadian in me feels guilty for making a stink about it, but the other part of me feels good for having asked for the supervisor (my mental state isn’t exactly great right now so I don’t always think to ask). You cannot help fix a broken system if you don’t speak up and tell people it is broken.
One of my biggest pet peeves in this whole cancer treatment process is the amount of time I spend in waiting rooms – and how that time is completely wasted. I think it is a huge lost opportunity – we need to figure out what to do with that time – how we can do something to make that time more useful – so it isn’t just about waiting. I’m open to suggestions.
What can we do about the time wasted in waiting rooms?
How can that be used to improve the healthcare system?
Is there some way this wasted time can be harness / used to improve patient engagement?
I always take a book to the waiting room but don’t remember what I read so I do leg lifts in the chair or flirt with the receptionists. Maybe an exercise bike would help?
What amazes me is keeping people on chemo with compromised immune systems waiting in open areas full of sick people. Here at the hospital I get stat service for blood tests prior to chemo and yesterday someone who’d been waiting pushed me out of the way when I was called before him. Crude, but this is Alberta after all.
The Cardiac Clinic waiting area is way bigger than the Cancer Clinic. My first major heart failure was caused by a bacterial infection so distance between people matters. Also, the cardio people always get me there a half hour early for an ECG and normally to Doc comes to the lab to walk me back to her office. Cardiology does run tight schedules and sometimes it seems too short to justify the 3 hour each way trip to Edmonton. I’ve learned to take notes along with me and unlike my oncologist, my Cardiologist does accept emails through her assistant, which makes seeing her way more productive.
In order to save time at the Cancer Clinic I was told right away that I asked too many questions so now I fill out the 14 day side-effect log with the “happy” numbers they want and avoid extra comments in the short consultation. It’s a bad system and the whole idea is to push people through as fast as possible. Oddly, this is supposed to be a world-class facility but the money they spend on hot-shot / high cost staff is wasted on their being too busy to think, let alone provide care.
I get a sense from your experiences that Stanford regards the whole cancer care system as important and they do want to learn. Here, patient input is discouraged or ignored and engagement is restricted to following orders and being agreeable. Under those conditions the idea of “better care” is to aviod the system entirely.