Strange Brouhaha

Tuesday, August 21, 2007

I "love" going to the doctor

Presented for your perusal, two different medical care scenarios. My doctor has told me to get my blood pressure checked a couple of times before my next appointment. This is something he always wants me to do between appointments. It is something I always put off.

Recently, they changed things at our health care provider. Let's see if you can spot the difference between the old scenario and the new scenario.

Old scenario:

I go into the closest UW clinic. I go to the check-in desk and say "I need my blood pressure checked." They say "Okay, have a seat, we'll get a nurse." I get my blood pressure checked and leave. I have done this before. This is what my doctor tells me to do.

New scenario:

I go into the closest clinic. I go to the check-in desk and say "I need my blood pressure checked." Idiot behind the counter stares at me like I have a third head. I can hear the gears grinding away behind her eyes. I'm thinking that she wants to say "Do we do that here?" but instead she says, "Do you have an appointment?"


Is my third head sprouting a fourth? STOP LOOKING AT ME LIKE YOU'RE A CHIPMUNK AND I'M A NUT. "Who's your doctor?"

"Dr. Nick Riviera."

The campfire's burning but the scouts are away. She looks even more like a chipmunk. A puzzled, drunk chipmunk. "Is that someone here?"


She points vaguely upwards towards Internal Medicine. "Maybe they can help you."

I go up. I dutifully wait behind the red sign for the next open desk, and I'll refrain from complaining about their stupid layout and the fact that three of the four stations are unoccupied.

"I can help you over here," says the only person there.

"I need to get my blood pressure checked." As a concept, I don't believe this one is terribly difficult: here I am, please check my blood pressure.

Apparently, we're having trouble with the easy stuff today. The second idiot stares at me. I reflexively check my shoulder for the presence of a third head. Maybe I have a giant booger hanging out of my nose.

Nope. "Who's your doctor?"

"Dr. Nick Riviera."

Silence. "Did he tell you to just come in at random?"


Silence. Then she asks for my name. I give it to her. "For future reference," she says, "you need to make an appointment. I'll set one up for you now, and you'll need to go downstairs and check in."

Uh...what? What moron invented that system?

"That's okay," I said. "I'll just make an appointment later and come back."

So...who's the idiot? Me, for not making an appointment? Idiot number one, for staring at me like a chipmunk? Idiot number two, because I'm feeling malevolent? Or their new computer system, which apparently really was going to make me create an appointment with idiot two, then walk back to idiot one to check in, then WALK BACK TO IDIOT TWO to say that I'd checked in and was there for my appointment?

Needless to say, no blood pressure check today. It would have been stroke/heart attack.


This is probably as good a place as any to talk about processes. I'm all in favor of having processes and procedures. I'm all in favor of making people follow them, even if it's just because some computer screen says so.

What I'm not in favor of is this rigid approach on the part of software designers and system administrators. I think I would have been okay if the upstairs office had been able to create an appointment on the fly and check me in. But she couldn't. She absolutely couldn't, because she only had access to the part of the system that let her create appointments, rather than having access to everything that she needed to take care of me or any other patient.

Who comes up with this workflow?


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