Paul Goldfinger, MD, FACC. Editor; Blogfinger.net. 2023 re-post
Have you noticed that your mobile phone has become an indispensable part of your life? In the past you could take it or leave it. We had “land lines” at home and we generally had no need for a mobile phone. If someone wanted to leave a message you had an answering machine. And there were always phone booths.
Here’s a Blogfinger link you might enjoy:
At first our mobile phones were novelties, and we didn’t consider a text message or an email to require immediate attention.
For me I would look for voice mails or emails or texts when it was convenient for me, and I often didn’t carry my phone with me.
I was the master of my electronic fate.
But all that has changed. People contact you by texts or emails and they expect your immediate attention. They don’t like to phone you because that requires an actual conversation, and they want immediate access without dialogue.
And some get annoyed if you do not treat their texts as emergencies.
In healthcare, I now find myself receiving texts and emails from doctors’ offices, and information and messages from corporate communicators such as RobertWoodJohnson/Barnabus “MyChart.”
These sources badger you with their endless emails and texts. All of a sudden we are compelled to respond to our mobile phones, often several times per day, and their messages often give us jobs such as to read the latest note from “My Chart.”
These people send you links to their sites every time anything occurs in your record. For example if you have a phone conversation with a nurse in a doctor’s office, a written record of the call appears in your on-line “chart,” and you are notified by text or email and ordered to read it. The RWJ conglomerate is particularly annoying that way.
Or if you have an office visit, a link is sent to you within an hour to read what the doctor had to say at your visit. This deluge of information generated by corporate healthcare and sent to your device interfere with your life on a daily basis and makes your iPhone a primary focus.
Why is this happening? Beware of mind control by these providers. Their main interest seems to be to document services that they bill for such as a phone conversation with a medical assistant.
The biggest problem that I see is in the area of outpatient communication: There is a confusion of ways to communicate with doctors’ offices using mobile phones. The issue becomes apparent when you try to call your doctor. A patient will often find this to be challenging and frustrating. Providers do not want to converse with you. Corporate management wants you to do it all on line.
The industry hasn’t figured out exactly how to deal with medical office inquiries by phone. Whereas you may be trying to reach your doctor with important medical questions, in the doctor’s office their priority seems to be to block you from making contact with your physician.
Calling on the phone you are often confronted by robotic devices and robotic people who pick up your calls. And medical offices have a variety of ways to handle patient inquiries. So you are not sure what to expect.
Doctors will often not call you back, and often their assistants (nurses or medical assistants) may not return calls either.
This is my biggest gripe because the phone dopes who pick up calls at the front desks are often clueless, and no one seems to be doing critical triaging; so you may find yourself frustrated and angry as you keep checking your phone for a response to your call. It seems that office personnel have been trained to avoid allowing patients to speak to their doctors. And the are often not medically trained.
Doctors do not call you back because they don’t get paid for phone calls and they are too busy and understaffed. We expect to find expert information by calling our doctors, but that is often impossible, and the idea of putting the patient’s best interest first is being abandoned. If you read drug information, they always say, “If you are having a problem with medication, call your doctor.” Really? Not!
Consider some of the variations I have experienced in trying to get to speak to my doctor:
Type A: You call your doctor’s office, and today my call was picked up by a machine which said, “Can you please hold on a moment, thank you.” I hung up after about five minutes of silence, which I think was the desired outcome. There was no opportunity to leave a message and no human to pick up the phone.
Type B: You call the office and get a machine which lets you leave a message. You have no idea who will handle your message. And you may or may not get a call back. The latest meme in this situation is that you are expected to wait 24-48 hours before receiving a call back.
Type C: You call and someone answers the phone. You ask if you can leave a message for your doctor. She resists and says, “The doctor is not in this office today.” She tells you he will be there in 2 days.
You ask her to send your message to him, not to wait till he catches up to your message in two days. She takes the information. But you have been speaking to someone who has no inkling of what you are talking about. No one calls back after two days.
Type D. A person picks up your call. You begin to speak when you are interrupted with something like, “What’s your birthday?” You respond and try to continue your explanation, but they cut you off again, “The doctor’s nurse is with patients. She will call you back.” Maybe! You hope to talk to the nurse since you have given up hoping to speak to the doctor. But the nurse doesn’t call you back. You are left with an empty feeling—-what happened to American quality healthcare where the patient comes first?
Type E . A machine answers your call and says, “We are very busy. Call us back later.” There is a small chance that anyone will answer your call when you call back.
Type F. “We are at lunch from 12-1. Call back later.” No one will talk to you during that hour. There is no way to signal that you are in bad shape. Better call 911 or go to urgent care.
And there are other variations on the theme. I could go on and on, but you had better carry your phone everywhere. We-the- people are forced to respond to this electronic deluge or miss important information. I welcome the information, but I want control over how I process it all.
Corporate healthcare is taking over traditional care, and the results suggest a decline in quality, an increase in patient frustration, and a financial priority. The nurse strike at RWJ has been going for two months. A disgrace!
Some large practices offer text access and responses from “general practitioners,” and some offer tele-visits which are also useful and rewarding.
Such communication concerns should, I hope, be fixed by improved electronic methods and industry wide procedures.
But putting barriers between patient and doctors is wrong and unfortunately becoming routine.
I have not seen statistics, but I wonder if the frequency of malpractice cases has risen dramatically.
As for my iPhone, it has become too heavy, and I am always putting it down and losing it. Now I have an over the shoulder holster with a special disc on the phone to help me locate it. I really dislike my phone.
I’m glad I am not practicing medicine any more. Doctors no longer control their professional lives, and burn-outs and early retirements are rampant.
And all of us folks must carry a mobile phone—I hate that.
Calm down and hear some music:
Caetano Veloso (vocal) and David Byrne (guitar) at Carnegie Hall. “Linda.”