Phones are the bane of my existence.

I'm slowly beginning to realize how grossly inefficient medicine is.  You may think medicine is all about sitting at the bedside and talking to patients... but that's not it at all.  Residents, interns and med students spend most of their day calling consults, entering orders, and making follow-up appointments.

Nothing is more frustrating than phone calls.

I'm currently on a rotation away from the main university hospital.  It's a private hospital just 15 minutes away from my apartment.  I'll just call it "Grace" Hospital.  I like it a lot.  The cases are simple, "bread and butter" type things: old people with pneumonia, syncope, or venous stasis ulcers.  The only problem is that this place is grossly inefficient.  Even more so than the university hospital (ant that's saying a lot).

Let me give an example.  Let's say I want to make a follow-up appointment for Mrs. X with her primary care provider, who is affiliated with the hospital.  At the university hospital, most doctors have a nurse practitioner or secretary that knows the doctor's schedule and patients.  Things usually go something like this:

Me: Hi, I'm currently taking care of Mrs. X.  She just got admitted for pneumonia, and we want to schedule a follow-up appointment for her.

Helpful Nurse Practitioner: Oh, Mrs. X?  Of course we know her.  Dr. Blank is full this week, but we can squeeze her in next week.

Me: Great, thank you so much!

*Arrangements are made.  I hang up the phone satisfied.*

MISSION ACCOMPLISHED

Conversely, at Grace Hospital, making follow-up appointments with hospital-associated doctors is an exercise in patience.  Here's how the conversation usually goes:

Me: Hi, I'm currently taking care of Mrs. X.  She just got admitted for pneumonia, and we want to schedule a follow-up appointment with her primary care doctor.

Operator: Please hold.

*light music plays for 5 minutes*

Some person: Hello?

Me: Hi, I'm currently taking care of Mrs. X.  She just got admitted for pneumonia, and we want to schedule a follow-up appointment with her primary care doctor.

Some person:  This isn't the number you call for that.

Me:  Oh, I'm sorry, I was just transferred to this number.  Is it incorrect?

Some person:  I'm not sure.  Let me check with my superviser.

Me:  Okay... Is there an alternate number I can use?

Some person:  Um, please hold.

*light music plays for another 10 minutes*

 Some person:  You can try 123-456-7890

Me:  Thanks.

*I hang up and dutifully call the number.  It rings a million times.  No one answers.  I hang up and try again.  It continues to ring with no answer.  I wait 10 minutes, and try again.  Finally...*

Ornery Lady: What???

Me:  Hi, I'm currently taking care of Mrs. X.  She just got admitted for pneumonia, and we want to schedule a follow-up appointment with her primary care doctor.

Ornery Lady:  Who???

Me:  Ms X.  Her PCP is Dr. Blank.  We need to get an appointment in next week, if possible.  Her medical record number is...

Ornery Lady:  (interrupting) You'll have to call Dr. Blank's answering service.  I can't do that.

Me:  Wait.  I'm sorry - is this not the number I call to make appointments?

Ornery Lady:  Yes it is, but I can't make an appointment.

Me: What?  I guess I don't understand.

Ornery Lady:  I can make an appointment for February.  I can't overbook Dr. Blank.

Me:  But it's November.  What do you do if patients have to see the doctor earlier?  We had to change Mrs. X's hypertension medications, and she really needs to see Dr. Blank soon.

Ornery Lady:  (avoiding the situation) Will you hold???

*Light music plays for 10 minutes*

Ornery Lady:  Hello???  I can't make any appointments that would overbook a doctor.

Me:  (internal thoughts) So, essentially...  a computer could do your job.  Don't doctors hire people like you so they don't have to spend all day making appointments? (end bitter internal thought)

*Note:  just to give a little context, making follow-up appointments like this happens all the time.  I still don't understand why someone in charge of making appointments for a doctor has no authority to alter the schedule.  That's just silly.  And inefficient.*


Ornery Lady:  You'll have to call Dr. Blank's answering service.

Me:  Does Dr. Blank have a pager?  I could just leave a message for her.

Ornery Lady:  No, you have to call the answering service(!!!)

 Me:  (grudgingly) Okay, thanks.

*I call the answering service with the number I painfully extract from Ornery Lady.  I am immediately put on hold.  Again.*

Answering service lady:  Hello?

Me: Hi, I need to leave a message for Dr. Blank.

ASL:  Oh, you don't leave a message for the doctors here.  I need your name and number so they can call you back.

Me:  (internal thought: "Wait.  How is this different from a pager?")  Do you have any sense of when she'll call back?  I can leave a call-back number from the phone where I'm at now, but I will have to sit by this phone until she calls.

ASL:  All I know is that I need a call-back number.  I don't know when the doctor will call back.

I leave the number.  And wait for a call back.  For an hour.

Dr. Blank:  Hello.

Me: Hi Dr. Blank, I'm currently taking care of Mrs. X.  She just got admitted for pneumonia, and we want to schedule a follow-up appointment with you next week.

Dr. Blank:  Oh, I don't take care of Mrs. X anymore.  You'll have to contact my associate, Dr. Nonexistent.

MISSION FAILURE.  REPEAT PROCESS.