3 Things “The System” Can Do Better

On a recent visit to a doctor’s office, I approached the front desk to check in, and with me I had my new insurance card. For various reasons – and I’m sure this is true for many folks today – my health insurance provider had changed a few times over the last several years, so I should be used to going through the motions by now. So I was surprised when the person at Reception informed me that I was a “new patient,” and proceeded to treat me as a stranger, even though I’d been there several times before.

A couple years earlier, when calling to make an appointment at another facility (which I’d also been to several times before), I was told I most certainly had never seen any doctors there before and would need to get a new referral. After a curt exchange it was determined that my name had been misspelled (one letter was off) the last time it was entered in “the system,” so my records couldn’t be brought up, and the practical result was that I didn’t exist.

In a final example of system strife, a doctor I had been seeing changed affiliations. However, this was never announced, so when I arrived at Facility I at the appointed time, the staff told me that the doctor now worked at Facility II and was not taking patients at Facility I anymore. Staff members assured me that I could not have been scheduled for an appointment as I claimed, and the look of puzzlement on their faces screamed “user error” in my direction. But I pressed them, more staff were called in to examine “the system,” and they determined that I had in fact been scheduled for an appointment at Facility I, even though that was impossible.

It’s true – we have a long way to go toward making medical records and scheduling simpler and create a more user-friendly experience. So what could be the takeaways from my experiences and so many others like them? I’d like to offer three –

  • More isn’t always better. In my experiences, there was a whole host of staff and software acting on my records, and the result was only more complexity, not better delivery of service and care. We need to rethink the wisdom of specialization and the multitude of moving parts in achieving our health goals.
  • Incentives are lacking. There were no carrots or sticks evident in my system scenarios. We talk so much about the impending shift of doctors being scored on the quality of care rather than the quantity. We need to start making similar considerations for the administrative and systems sides of the house.
  • Advocacy is needed. Dealing with “the system” is challenging, and most of us don’t know where to start with records collection, scheduling, or fixing glitches. Foremost, we have to learn to speak up and advocate for ourselves, and also know when to enlist the help of a trusted friend or resource.
  • BONUS Takeaway #4 – Empathy goes a long way! Many of us don’t see medical visits as a pleasant experience. There are forms, wait times, sick or otherwise unhappy people surrounding us, and it’s time we’d rather not be taking out of our day. But when the staff person entrusted with your case treats you like a name and not a number and injects a dose of comity into the visit, what a tremendous difference that can make.

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