Should healthcare be inconvenient by design? And should slow medicine be the default option in some circumstances?
Slow medicine is a movement calling for change in medical practice which is inspired by the slow food movement. “Like for the slow food movement, slow medicine is a call to balance over-emphasis on fast processes which reduce quality.”
But real-time person-to-person connection is the way we operate. And it’s bleeding in to patient care. Text-based communication allows us to access healthcare at the speed of now. In some circumstances these technologies are a helpful in improving communication.
But there may be a good reason why focused deep dive encounters have a role. There may be a place for slightly inconvenient healthcare.
How health professionals remember their patients
Consider what happens in my clinic. My nurse Andrea asks me a question about a particular patient with celiac disease. I have many patients with celiac disease. So I ask, ‘Remind me, who is this again?’
What I’m really asking is, ‘give me some context so that I can recall the specifics of this child.’ So she goes on and typically tells me a story about the mother or the child. Not a long story, but something unique about their problem.
Then it comes together. But even after I remember the specific patient in question we hover together over the chart to recall the specifics of the evaluation we’ve done to date.
At that point I’ve been pulled into that patient’s orbit, so to speak. For me it’s when I have full awareness of their situation coupled with my focused attention. It’s a state of mindfulness. My capacity for shaping a meaningful solution tailored to their unique story at that point is exponentially bigger.
Then consider what happens on call when Andrea isn’t around. A mother pages me and opens up the discussion, “Brianna’s having another one of her episodes…” As if I immediately remember Brianna and the details of her episodes from 8 weeks earlier. In some circustances I do remember Brianna. But when I do the details are likely fuzzy. With details that I draw from a few very specific and diplomatically placed questions I can put the story together and remember the sequence of Brianna’s most recent course.
Slow medicine makes sense in certain circumstances
Enter real-time connection applications that offer immediate answers. You can see the problem here. De novo messages are unlikely to draw meaningful answers without catch up and context. In the media you would think that this is the answer to our prayers. Quick healthcare when we need it.
Of course, once I’m activated and engaged in a problem it’s a different situation. If something has happened during a weekend on call and we’ve had that conversation or ER visit a quick exchange by text makes sense. Follow-up questions, quick hits, prescription questions all make sense around an episode of care.
Despite Silicon Valley self-interests pressing us to see new forms of media as the core way to connect, different circumstances call for different kinds of connection with a health professional. Text, phone call, teleconnection, and IRL visits are all have their place in the care delivery continuum.
And some of these types of connection of course, are more convenient than others. I wrote about this dilemma in The Problem with Human Communication.
Inconvenient healthcare can sometimes trump convenience
While I’ve been an advocate for tech-mediated access to care, there‘s something to the occasional deep dive. Chart open and and attention transfixed, a time and place to catch-up and drill down. Convenience is good, but a careful connection from time-to-time trumps convenience.
Inconvenient healthcare, it seems, may have its place.