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HolidayBuyer's Guide

Health care user experience: If it ain't broke, don't fix it?

About 4 weeks ago, I went for an annual physical and had standard blood work done. I was told to call back in a week, and of course I forgot. Today I had a message that said: "Hello, this is Dr. XX's office, please call us back at xxx-xxx-xxxx."

About four weeks ago, I went for an annual physical and had standard blood work done. I was told to call back in a week, and of course I forgot. Today I had a message that said: "Hello, this is Dr. XX's office, please call us back at xxx-xxx-xxxx." That was it--the person didn't identify herself and also didn't say what the call was for. When I dialed the number, I was expecting to be told that I owed them money. But actually, the woman on the phone had no idea why she had called me. So I sat on hold, and finally she came back with my blood test results and rattled off a bunch of acronyms and numbers. I'm happy to report the results were good (at least that's what she said), except my cholesterol was at 201 and it should be less than 200. Then the call ended.

That was it.

That was my follow-up "examination." I can’t help but think that it could have gone so much better! On the one hand, I think maybe I should find another doctor. On the other hand, maybe they're all like this? I suspect most are.

First problem: Lack of efficient communication.
I had no real motivation to call them after my physical, so I didn't, and I potentially might have missed my results. I think this is perpetuated by the idea that most people think their doctor will call them if there's something serious. No news is good news. But we need to fix that sentiment because there's always room for improvement in our health. Eventually they did call me, but it took a month. We need better systems that make it easy for people to stay proactive and on top of their own health care. I could have had this information via e-mail (maybe even with links to help me understand it), or they could have had a system that automatically reminded me to call. At any rate, timeliness and convenience of information delivery is a big problem.

Second problem: Lack of personal touch. The woman should have given me her name in the message and should have said why she was calling. If I really feared a billing problem, then I would never have called back, and they would likely have forgotten to ever give me the blood test results. Suppose there was something serious? Would it get lost in the cracks? Being hasty and vague in the message made me suspicious. Transparency and a friendly human tone are critical to interactions that are not face-to-face (insurance companies, are you listening?). Also, I find it strange that an office admin called me rather than my doctor. I'd like to know my doctor is thinking about me when I am sick as well as when I'm healthy.

Third problem: Bad office systems and technology. I’ve previously discussed in another post some issues with health IT and EHRs. When I called my doctor, the woman on the phone had no idea why she had called me. She asked for my date of birth and name, but that didn't help. Then, she put me on hold for a long time while she tracked down my chart. One would think she would be able to take my information, enter it into a computer, get a clear picture of why I was on the phone, and also see my chart to read me the results. Of course none of this happened, and she had to track down my actual paper file. Why is it that the horrible customer care rep at my wireless phone carrier is better equipped with knowledge about me than someone at my doctor's office? Scary.

Fourth problem: No advice. When I was read my results, it was nothing but acronyms and numbers. She let me know when something was "OK" and in the case of my cholesterol that I was borderline and I should "watch it." How exactly do I "watch" my cholesterol? A microscope? She didn't give me any insight into all the acronyms or numbers, and I didn't ask either. In the end, I felt a bit confused. I didn't really understand any of the information I received and I am now on my own to do research if I want. Although it's more than likely I will not do anything more, even though I know better. This call was a great opportunity to give me some good advice about how to lower my cholesterol and keep it low. Instead, there was no advice at all.

Fifth problem: No prevention.
I'm struck now in retrospect that my doctor didn't suggest anything for me to do relative to my cholesterol. It's 201, and should be below 200. So it's not really bad, but it's not good either. Am I in trouble? Will it be worse next year? Am I trending a bad direction? When will it become a problem? Prevention is always cheaper and more effective than treatment once there is an issue. This would have been a great opportunity for my provider to suggest ways to reduce my cholesterol, change my diet, and hopefully stay healthier for a much longer time. Instead they told me nothing. I suspect many people would make no change to their lifestyle in this situation. If it ain't broke, don't fix it. I think that this pretty much sums up our society's focus on treating illness rather than sustaining health. In the end, this was an event that should have been addressed to prevent disease down the road. Instead, my doctor's office did nothing for me. I guess when I have a problem they'll give me some better advice. That sucks.

When I think about encounters like this it makes me realize we have a long way to go in health care. Many people are trying to do the right things, but we're also crippled by lack of funds, archaic systems, and inefficient work flows. However, with the right changes in technology and behaviors maybe one day we can turn it around.

— David DeRemer, Senior Strategist, frog design