Thursday, November 4, 2010

I Need to Reschedule You

Over the past 20 years, there have been very few times I have asked patients to reschedule.  Even though I tell patients they have nothing to apologize for when they then to cancel, I always apologize.   This is especially true when it comes to asking them to reschedule surgery.
Yes, I know you have asked for time of work.  Yes, I know you have arranged for someone to help care for you, for your children, etc.  Yes, I realize you may have airline tickets to come into town to stay with family here while recovering.
Yes, I keep all that in mind, so if I ask you to reschedule it truly will be a handful of good reasons:
I am sick or need surgery myself.  I had to ask a patient to reschedule her breast reduction early in my solo career.  I had an acute herniated disc (C6-C7) which left me with numbness in my left  index and long fingers and loss of triceps function, not to mention the pain.  I had to explain to her that it was not safe for me to do her surgery until after my own.  [She did reschedule.]
A family member is sick or dying.   I had to ask a patient last May to reschedule after my mother had her stroke during her CABA.  After we made the decision to AND (allow natural death), we did not know how long it would be.  I did not want to be in surgery when it happened.  I thought it was reasonable.  [She never rescheduled.]
I have a funeral to attend.  I have not canceled or rescheduled a surgery for this (yet), but have rescheduled a few office visits.  As I and my friends get older, I can see this happening more frequently in the future.  I will try to be considerate of both my friend/family and my patients.
Usually, when I ask a patient to reschedule it will be a last minute thing.  I regret this, but as you can see from the reasons I allow myself to make this request it will always be last minute.  Some things are tough to plan.
Believe me when I say I am sorry to have to ask you to reschedule.  I truly mean it.


Kate said...

Found you from the Dona Nobis Pacem. I love your site. I’m going to poke around a little bit, but don’t worry I’ll put everything back where I found it!!

rlbates said...

Make yourself right at home, Kate! :)

Debbie said...

I really like these thought that you expressed here. I so agree with them! While my husband is not a doctor, sometimes people think he is. He does home repairs and renovations locally and we get "What do you mean you can't come NOW?" While there is such a thing as customer service, there's also the reverse, customer appreciation for that service.

About a month or so ago, you replied to my question about your hexagon quilt. I wanted to thank you, but I prefer to reply privately, rather than through the comments, but you are a no-reply commenter, as your email address is not in your profile.

Same story with your nice comment on my blog. So, thank you!

rlbates said...

Debbie, thank you for your comment. By the way, my email is on the left sidebar just below the photo of my dog Girlfriend (who died in 2007)

ER's Mom said...

in OB, we reschedule on a regular basis. But I hate doing it. Most women understand, that when they are in labor, they are the most important patient that day.

As for rescheduling for my health, I had to do that last year after my own surgery with prolonged recovery. A few patients were PISSED! I couldn't believe the entitlement that I heard.

Cynthia Bailey MD said...

This is a great topic because it's one that will rattle around in my brain for hours if it happens to me. Patients are disappointing if the schedule changes and like you I only do it as a last resort and for really good reasons. Some people act out things like disappointment by projecting it on to the other person with blame, anger etc. The issue really is their trouble providing self soothing care when disappointment happens for them. I try to help with that by acknowledging their suffering, providing some soothing comments and then telling myself that it's ok that I have needs too and I'm justified in changing the schedule. Lot's of phych work here yet it still rattles around in my head for a while. Why is this so hard?

BrainDame said...

Great post. Unfortunately I do know some surgeons who jostle their patients around for a variety of non-urgent reasons and it gives us all a bad rap. I wish all my patients were as conscientious and thoughtful about the impact of our action on others as you are.