Monday, November 2, 2009


What part of your job don't you like?

A medical student asked me that as part of a Career Dialogue Q&A session last week. I'm lucky to have a great work-life, so I had to think a bit about that question. Later that afternoon, back at my office, I was reminded about one of the worst parts of my job: Telling my patients they have to wait.

Wait to see me. Wait for tests. Wait for results. Wait for treatment.

It really shouldn't bother me to have to do this. After all, it's so easy to do – my patients actually expect to hear it! When I apologize for wait times, they are usually sympathetic and rarely press the matter any further.

Someone did press the matter further last week. This man was in to see me for a problem that requires surgical treatment. We talked about the procedure and I told him I would put a booking in. And, that he would have to wait several months. He wasn't too bothered by that news, as he planned to spend the winter in British Columbia. In fact, he was passing through Saskatoon, on his way to B.C. from his home in eastern Saskatchewan. He had scheduled his appointment with me to coincide with his trip out west. Perhaps, he asked, his surgery could be scheduled so he could stop in Saskatoon on his way home in the spring. In fact, after checking his calendar, he suggested a couple of days that would work well for him.

The look on my face gave him his answer: Not very likely!

I started to explain that:

  • the wait time was out of my hands
  • we couldn't offer him a time of his choice
  • he would be out of the province, and wouldn't be able to complete his pre-op assessment and testing

And then I caught myself. Why was I being an apologist for the healthcare system’s failures? My job is to advocate for my patient, yet I was reflexively excusing those failures. I don’t think I’m alone in this. I suspect that many healthcare providers find themselves defending the status quo. (Of course, if we condemn the status quo, we’re compelled to take action...)

At this point, my patient was putting away his calendar, resigned to his fate. Wait a minute, I told him, maybe we can make this work for you. I imagined the story he could tell to his buddies: Yup, I saw the surgeon for a checkup as we were driving through Saskatoon on our way out to B.C. Then, on the way back, we stopped in Saskatoon, I had my surgery, and we drove home the next day. Nothin' to it!

That would be amazing service! We're going to try to make it happen for this man:

  • We'll send him the forms he'll need to have completed by a physician in BC.
  • His condition is considered to be in the urgent category, so his request to have it done in the spring should fall within the time limits for that type of surgery.
  • If I am unavailable on the days of his choice, I can offer to have one of my partners perform his surgery.

It all sounded so simple, once I made the mental switch to "Can Do!"

I would love to be able to tell medical students, at Career Dialogues 5 years from now, "I remember when patients had to wait many, many months for their surgery, and they took whatever date we offered them. And, they were grateful that they were getting any care at all!" The students would smile, and nudge each other behind their desks. Oh, the stories the old-timers tell!

(Come on, Sask Health, I'm pulling for you!)

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