Saturday, 7 September 2013

How To Develop Chronic Patient Syndrome

There are many stories about waste in healthcare. Some are ridiculous and some are based on misunderstandings and lack of knowledge.

Here's my waste story: While I was being treated for RA, injectable methotrexate was prescribed for me because the pills caused too much nausea. The shots were intramuscular and I assumed that I needed to have a doctor administer the injections just like with gold shots.  

So every Wednesday afternoon I would leave work early, go to the doctors office, park and wait (and wait). This went on for seven years. That means 364+ extra doctor visits and at least 1000 hours of my time that was wasted. Not to even mention the white knuckle winter trips.


My rheumatologist then happened to suggest a clinical trial.  As part of the start up process for it I met with a nurse for an interview and in the course of the discussion she asked why I did not inject myself. Thank goodness she did. 

I had seen at least 10 different doctors in those 7 years, allowing for travel, locums and vacations and not one of them said a word about this possibility. At last I was spared the weekly visit!

That is why I suggest that in some chronic diseases there should be a resource person or advice line, ideally staffed by a nurse who has the time to discuss treatment choices, possibilities and ways to make life with a chronic disease easier. If it had not been for that one nurse a lot more time and productivity would have been wasted.
Lego Nurse
This new service would give non urgent sensible advice to patients with chronic illness online or by phone. Of course the answer may often have to be "Check with your doctor" but even that is a helpful answer because you have an opinion on the relative seriousness of the question.

And with a few stories like mine resolved every week the position would pay for itself.

Of course seeing my doctor for those hundreds of extra visits has led to us having a very good relationship based on my chronic patient syndrome. Yes, you develop that "disease" by seeing the doctor often.

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