Impatience

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I get it. We all have somewhere to be.

But waiting a few extra minutes for a clinical appointment isn’t the same thing as a long line at Sbux.

Our appointments are scheduled in tidy 20 minute chunks of time, as if all the work it takes to listen to a patient’s story, perform an exam, come up with a diagnosis, discuss the plan, write the prescriptions and lab orders and referrals and then maybe, MAYBE, write the note couldn’t possibly take more than this randomly assigned amount of time.

In reality, things don’t work that way. Patient care takes the time it takes, and exactly how much time that might be is impossible to predict with 100% accuracy.

Sometimes, a visit is straightforward, and this 20-minute guess isn’t too far off: your colds, your strep throats, your uncomplicated UTIs.

But what about the patient with a constellation of nonspecific and/or seemingly unrelated symptoms over several months? Something that requires a little detective work?

What about the patient with a list of 4-5 separate problems, all of which need to be evaluated here and now, and fine, why not, since by the time you’ve asked enough questions to determine whether some of these list items are non-urgent enough to be rescheduled for another visit you’ve already done most of the work anyhow?

What about the patient presenting for the first time with an eating disorder? Or suicidal ideation? Or a sexual assault? Do you really think it’s appropriate for their clinician to enter that visit with a clock ticking in his or her head, rushing the history and exam, and then at some predetermined time chirping “Welp, time’s up! Good luck with all that!”

This is not an academic question. This stuff happens to clinicians all day, very day. It happens to me all day, every day. It’s the nature of the job. And so when one of these particularly challenging situations presented itself in my office earlier this week, did I rush the patient through her impossibly difficult story? Did I even look at the clock once? OF COURSE NOT.

But did that mean I was crazy behind for the rest of my patients that afternoon? Uh, DUH. Obviously. I can’t make extra time materialize out of thin air. I can’t be in two, or even three, rooms at once. Believe me, I wish I could. Because that would be spectacular. For so many reasons.

I suppose I’m writing this because I’m tired of being asked to do the impossible. I’m tired of being measured by all the wrong benchmarks. I’m tired of getting heaps of attitude when I’m running late because you know what, I was providing care for another human being in need of care, dammit, and spending that time with them was the right thing to do. Sorry, but one person’s suffering means more to me than another’s inconvenience.

Wait, no. Not sorry.

Shouldn’t the quality of the care I provide mean more than how long someone waits to see me? Isn’t the part of the visit that really matters the part that happens AFTER the visit begins, rather than before?

Can’t everyone just be a little more patient?

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