I am known by my patients and friends for my calm, imperturbable manner. Yes, I am equipped with the full range of human emotions, but few folks have ever seen me raise my voice or demonstrate bulging next veins. I am not suggesting this is a virtue or a character flaw, but is just the way I am wired.
Sure, I get irritated and frustrated with the absurdities of life, as we all do. For those who cannot relate here, may I suggest calling any airline carrier to discuss changing your ticket reservation. If that fails, then have a go at reaching out for tech support when your home internet goes ‘poof’!
Last week, I did become irritated when I was notified one evening about a patient’s abnormal blood test result. I was on-call for our gastroenterology group, so I would be the designated physician to notify with concerning test results. Why, then, was I miffed?
Our community hospital uses a ‘new and improved’ system for notifying physicians after hours of significantly abnormal test results. The hospital loves it. I hate it. Here’s how it works.
First, I receive a text message notifying me that a patient has a CRITICAL TEST RESULT. I am then directed to call a 10 digit phone number, when I will be greeted by a robotic menu system. After enduring this labyrinth, I will be directed to insert a long series of numbers, a code which will lead to either a non-human voice announcing an abnormal lab value, or to a radiologist’s dictation of a CAT scan report or some other x-ray study. The hospital is happy as once I complete the process, their system indicates that the physician has heard the message and now bears full responsibility. They are in the clear. Here’s some of my objections.
- The initial text message often arrives when I am driving. Attempting this process while driving would be suicidal.
- The messages announcing the abnormalities are not given with any patient contact information or medical details. While the hospital is happy, I then have the fun and excitement of trying to find the patient’s phone number, not easy to do at 9 pm. When I can’t reach the individual, it guarantees a night of insomnia for me.
- Try listening to any radiologist’s dictation. I’ve done this many times and often cannot ascertain which language is being spoken.
I called the lab director and begged to be removed from this automated system. I argued that, while it satisfied the hospital’s documentation police, it was not serving patients or doctors well. If a test result is CRITICAL, then I want to be called by a living and breathing human being. The two of us will have what is called a conversation, providing me with sufficient knowledge so that I will be reasonably equipped when I reach out for the patient. I may want, for example, to hear results of prior tests, so that I will understand the current results in context. Get the point here?
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The lab director couldn’t promise to release me from electronic bondage. Throughout the medical profession, I witness the duel between documentation and doctoring. Guess who’s winning?
Photo: Bigstock
