Yesterday I went to the doctor for a check up and blood test because I’ve been having a fever, headaches and breaking out in a hives-like rash (along with my broken thumb this is turning into my year of medical misfortunes!)

Talking to my Doctor In Training (DIT) friend that night I was upset about 3 things: the sharps bin was filled above the line that says “Don’t fill above this line”, the nurse taking my blood test didn’t wear gloves (!) and finally that the nurse told me that they would only contact me if the blood tests revealed anything unusual, and that “no news is good news”.

DIT was most concerned with the medical hygiene issues with the sharps bin and the lack of gloves. Really their is no excuse for this and this is seriously bad practice, but I want to talk about the mental stress that I experienced as a patient from the “no news/good news” comment.

I accepted the comment at the time, but almost immediately started worrying about the logic of this. I might spend the entire next week  waiting anxiously for a phone call delivering bad news, when in reality the results may have been returned with results of no particular consequence and I would never know. I wasn’t sure how long I was supposed to wait before I could relax.

Not really the best process for caring for a patients mental health as well as their physical health!

It seemed so silly I thought that maybe I’d misunderstood the nurse so I called the medical center the next morning and explained my concern. As it turned out, my results had already been returned, and that I’d not misheard – because they do so many blood tests, they do not contact a patient with the results unless there is something of concern with the result.

I appreciate that people working in health are working with stretched resources, but I wonder if they are saving resources here or just moving them about – since in my case I called, spoke with reception, who had to look up which nurse I needed to speak with, transfer to me, then that nurse had to look up my notes, speak with the doctor and call me back with the results. That’s 3 conversations. If only one third of people with a blood test has a similar call they will only then just be breaking even on the resource needed to a more proactive approach to communicating with patients.

At least that’s my perspective – does anyone have their own view? I’d love to hear your thoughts!

Have you heard the one about the 71 year old man who was discharged from hospital being told that he was pregnant? It’s not a joke – but it is a bit of an exaggeration. No one actually tried to tell the grandfather he was pregnant, but an errant keystroke printed the wrong information onto the discharge papers.

The ironic diagnosis caused no physical harm, and probably gave the man some great new material for new stories to tell at the local pub, but at the same time is concerning because while this was an obvious mistake, it was still not spotted. It raises questions about how frequent subtle mistakes may pass scrutiny. Patients may consult with multiple different medical staff over the period of any single treatment and it’s essential that communication is accurate and consistent.

Thankfully, I’ve not had much need to personally experience public health, but a month ago I did break my thumb. Since then I’ve met with 7 different doctors in 3 different clinics who (I assume) have at some point passed on communications with each other.

I have complete confidence in the care that I’ve received, but I have been somewhat amazed at the lack of communication I’ve received around my diagnosis, options for treatment and future consequences.

Reflecting on my experience I have several streams of thought:

• the optimist in me thinks that I would have received more communication as a patient if the situation had been more serious or if I had simply asked;
• the anthropologist in me emphasises with the mental stress a patient may suffer when personal health is in question, and that the degree of their stress may not have any relation to the magnitute of their illness, and also understands that in the heat of the moment patients may not be able to think of all the appropriate questions to ask;
• the pragmatist in me understands that staff in public health are incredibly busy with their skills being stretched between many patients – and that given a choice in satisfying the physical and mental health of patients, the physical care takes priority; and finally
• the designer in me wonders what solutions might exist that allows patients to receive the communication they deserve, that doesn’t cost the physical treatment and care of other patients.

Is this something where process or technology could help? Or is it simply a matter of the number of staff to patients that are avaliable?