I was a strong and energetic young man and I was brought to tears.
It was 2:20am Sunday morning. I was an intern and only 74 hours into my 84 hour shift. With two kids under the age of 2 at home, I was working every other night and every other weekend. I was in a brand new hospital in an intimidating city. The hospital building itself was infuriatingly (and sometimes spookily) difficult to navigate. There were a lot of locks and many discontinuous hallways. Five buildings built over a span of 150 years came together in angled landings, half-flights of stairs, and doors to nowhere, which didn't open most of the time.
On this particular night, the beeper, which I was so proud to have been awarded, was going off continually. Some numbers were new. Some were repeats -- not a good thing. I needed to get to a phone to answer the pages.
Somehow, I had gotten myself into a corner of the hospital that I wasn't familiar with and had no idea where a phone might be. Up to the right was a locked door. Further up to the right was a very dark clinic waiting room. Behind was a long hall with the very few administrative offices for the extremely few administrators. Nobody was in the hall at all. Ahead: another dead end. And down, down was the dreaded, hot, humid noisy boiler room. So like a rat in a maze (and, unfortunately, not possessing a great sense of direction) I went up and down, the beeper going off with increasing frequency. I was not going to keep the chief happy. No phone, and certainly no cell phone. I was near tears. I had tried every door and none of them led anywhere.
Except one. The most scary, improbable of success, the one I had not tried. I had to walk downstairs to the boiler room, around the furnaces, and take the metal door back up again. The stairwell spat me into a lit area, with a desk, a phone, and a chair. I was free, free at at last, to pick up the phone and catch up on my pages.
We are in the same situation today. There are locked doors almost everywhere we look. There might be cell phones now, but they are banned. You certainly can’t take a picture. We have discontinuous hallways of reimbursement, efficiency, value centered care, coordination, documentation, accreditation, recertification, multiple masters, and increased demand. Truthfully, it can lead us as medical providers to feel near tears on any given afternoon. We just want to get to the place where we can care for patients, but it feels like a labyrinth.
One way out, the most probable, is to take the stairs back down to the basics. Make the effort to collaborate. Do it properly, be aware of HIPAA, use tools that help. Trust yourself to do what matters, and start with that. In other words, do what the younger version of myself didn't know how to do -- keep trying doors as calmly as you can until you find the one that leads the right direction.
Have you tried the "door" of hybrid store-and-forward telemedicine yet? It's not as scary as it sounds: