Richard Gunderman, M.D., Ph.D. correctly observes:
Americans tend to like fast things: instant coffee, sports cars, and speed dating. Many share a fascination with record holders, such as the world’s fastest runner or texter. And increasingly, the same goes for medicine. The number of minute clinics is exploding. Some emergency rooms now post their current wait times on roadside billboards. And increasingly, physicians and other health professionals are under pressure to increase the speed at which they see patients.
Lately, I’ve been apologizing to families waiting longer than they should to see me. While all of my excuses may be valid (“Everyone seems to be sick today!”; “A patient walked in and needed to be added to my schedule”; “I was on the phone with a worried parent/doctor/insurance company”; “The patient before you came ten minutes late”; or, “Really — I had to go to the bathroom!”), the excuse that is most valid, and most common, at least for me, is: “I needed to spend some extra time with the patients/families before you.”
I wear a watch but hardly look at it. I review my schedule first thing every morning with my medical assistant, so nothing should come as a surprise to me when I enter the exam room to see you. Except there is always something new and surprising to talk about! Your baby is spitting up; your toddler isn’t speaking as quickly as you expect; your preschooler is melting down when you leave him there; your first grader is struggling with learning; your third grader is being picked on; your sixth grader is getting really good playing the piano; your middle schooler’s got pimples; your high schooler is planning for college; you (mom) are pregnant again! That’s a typical daily list just off the top of my head!
Some things simply cannot be rushed, at least not if high quality is the objective. Part of the problem is the fact that haste leads to errors. But moving too fast can also rob life of meaning. Consider conversation, friendship, and intimacy. When it comes to such relationship-based activities, going too fast can prevent them from really happening at all.
Pediatrics is a “relationship-based” activity and, for the sake of parents and their children, it should not be rushed. So, I’m sorry if you wait so long sometimes. I know how valuable your time is and how stressful life can be. But there’s a really good reason why you’ve had to wait. I promise to give you the same attention I gave the last family, asking all of my questions and answering all of yours, hoping in some small way that I can find a positive and meaningful place in your lives.
Medicine at its best is not just a collection of clinical processes, such as delivering the right immunizations or prescribing the right antibiotics. It isn’t merely a matter of optimizing throughput, cutting costs, or enhancing efficiencies. Truly great medicine is built on relationships. It is about people. And taking good care of people means taking the time to know and care for them as persons. Regardless the effect on the bottom line, sometimes we simply need to slow down.