From the
President
Wayne Tuckson, MD
GLMS President | [email protected]
ANSWER The Call
A
lexander Graham Bell made the
first phone call on March 10,
1876. His call was to his assis-
tant, Thomas Watson, and he
said, “Mr. Watson come here,
I want to see you.” Three things occurred.
First, Mr. Watson answered the call. Second,
both parties understood a clear and concise
message. Third, an action was initiated.
“Damnit, Why Don’t Doctors Commu-
nicate—With Each Other?” is the title of an
article, no doubt written in frustration, by
Mervyn Kauffman after a visit to one of his
many physicians. He had to endure a repeat
of tests and procedures which had already
been done, but the results of which were
not available to the examining physician.
Admittedly, many of us have experienced
this same level of frustration when seeing
a patient on whom we have no information
as to prior tests, procedures or why we are
seeing them. It doesn’t help to hear the pa-
tient say, “the doctor said they were sending
the results to you.”
Physicians as a group are busy doing
what, by any measure, is important and
meaningful work. However, as Mr. Kauff-
man also noted, being busy is not a justifi-
cation for feeling that we are “too burdened
to write things down, or to communicate
with their staffs or colleagues.”
The phone remains an elegant yet sim-
ple means with which to communicate
with one another. Yet, when compared
to texting, emails and leaving notes on
our electronic health record message
boards, it is perceived as being antedi-
luvian. When we talk on the phone, we
can in real time and (at least for me) far
less time than it takes to text, email or
leave a note, be made aware of pertinent
information which may not be reflected
in the medical record, discuss findings,
and afford preparation for the arrival of
the patient to either another physicians
office, the emergency room or hospital.
In “Is your doctor talking to your other
doctors?” the question is raised of wheth-
er technological advances like electronic
medical charts are having a negative im-
pact on patient care, because “no one talks
to each other anymore.” Dr. Val Jones,
an internist, wondered if our fixation on
the electronic non-direct means of com-
munication reflected “a general cultural
shift away from oral communication to
text-based digital intermediaries, or if it’s
related to sheer time constraints.” 2 Per-
haps, as Dr. Jones says, when physicians
feel overworked it is easier to check box-
es and order consults via the electronic
medical chart, rather than picking up a
phone and constructing a coherent pa-
tient presentation to provide context for
the consultation or to obtain clarification
about a patient.
At what point did we deem our time
too valuable to speak to another physi-
cian? Especially one who felt concerned
enough to stop what they were doing to
reach out to a colleague on a matter of
patient care? Yes, we may not be able to
talk at that exact moment, but in those
cases, we can get back to one another in
a reasonable amount of time, even before
seeing our next patient.
Since we are failing at communication,
some hospital systems are now employing
tertiary entities to coordinate communi-
cation between physicians and hospitals.
Frankly, I find waiting online for connec-
tions to be made a waste of both precious
time and financial resources, and a needless
intrusion. If we shared our cell phones with
the hospital, emergency rooms and other
practices, that would eliminate the angst of
being on hold and the third wheel.
Our reliance upon electronic commu-
nication sets us up for failure. Even when
primary care physicians said they sent pa-
tient information to a consulting physician,
only a third of the consultants said they
received it. “Physicians who did not receive
timely communication regarding referrals
and consultations were more likely to report
that their ability to provide high-quality care
was threatened.”
When Alexander Graham Bell called
Watson, the call was answered and the mat-
ter immediately settled. I think the least we
can do for our patients is that when we’re
called by a colleague, answer the damn
phone.
Dr. Tuckson is a practicing colon and rectal
surgeon.
MARCH 2019
5