Chasing the Inefficiencies of the Healthcare System

Not long after my last appointment with my respirologist, also known as Dr. Smartypants, I received my next appointment date in the mail alongside an appointment date for pulmonary function tests (PFTs) for a week prior.
Of course, a less distractible person than myself would have taken the 30 seconds to enter these appointments into her calendar, and then maybe gone and filed the papers away somewhere sensible. I, however, have the lovely combination of asthma and ADHD, of which asthma requires me to be more organized, and ADHD impedes that process frequently.

The problem with the phone

This is not just one of those situations where I simply don’t want to just pick up the phone, though we all know I enjoy avoiding talking to humans. The problem is, in the past, when I missed an appointment because I forgot and went to the zoo instead (clearly also did not enter that into the calendar!), it took several weeks for me to receive a call back rescheduling my appointment. in this case, I sort of wanted the dates so I can continue to plan my life. So waiting 3-6 weeks to hear back about when my already-scheduled appointments are didn’t seem a good option.

Other than, you know, faxing them, which is not beyond me, I figured the other way I could get these dates (and PFT instructions) sooner than 4-6 weeks from my request, like an old-school mail order, was to physically go into the respiratory clinic.

A dual-purpose hospital trek

The area of the hospital is somewhere I never am nearby, ever. Except for in early September, a friend’s one-year-old had surgery, and she was of course spending nights with him sleeping in the foldy hospital chair at the Children’s Hospital. I asked if they wanted a visitor, and my friend said “if you want, I’m going stir crazy”, which is clearly a yes.
So, off I went to visit the smiliest ever after surgery baby and his mama, which meant I’d be across a traffic loop from the respiratory outpatient's clinic. After visiting them for a few hours (and feeding a very happy little guy ice cream!), I slid out to the clinic and had my papers re-printed and in my hands in about 90 seconds.

I’m not sure it would have been worth trekking over there if I didn’t have a dual purpose, but it was definitely worth it since I was over there.

Inefficiencies of the system

This is one of the problems of the inefficiencies of a health care system that functions to a great degree still by way of a fax machine, telephone and voicemail dependence—there is probably no other industry where the consumer allegedly being served cannot connect in efficient ways to the service they are seeking. The problem with healthcare is that because we are dependent on it, there is less a motivation to improve the efficiency of tasks such as this, less a motivation make it suck less. Like with some insurers in the US, in Canada, we have little if any choice in our providers or the centres they are based at, which means there is even less motivation to create a functional system for reason of patient satisfaction: I can’t simply choose a hospital that works better or a doctor that is more “techy” than another when I am sick of chasing paper (or any other issue). I do not believe medical care should be treated as a business, but it is evident that the business model of medicine—or even that of innovation seeming to happen most in large university-based hospital systems (thus needing to attract students and, in a roundabout way, tuition dollars)—is one of few motivators for innovation and change that actually makes the process of care better for patients—even if the care is the same.

Until then, until we have a provincial government that values innovation and progress—or until we have a federal government that legislates a national standard of connected care that decreases disparities between and within provinces—I as the patient will still be taking long bus trips for the purpose of chasing appointment papers, leaving voicemails, and sending my own faxes, not by choice nor desire, but by necessity.


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