Dear Doctors,
Today, let’s talk about transparency and expectations, specifically regarding Preparation For A Clinic (or other) Appointment.
I know you have a set of metrics or other information you’d like from me at our appointments. “How is x going” or “how many times does he y a day” or “exactly how much z does he get?” Some of these things are pretty predictable, some of them you seem to invent during the appointment.
And I’m sure you think I track all of this stuff. I mean, I do a great job tracking the things you specifically ask me to track, so why wouldn’t I be conversant with other tiny numerical details of his life? I should know this stuff simply because I live with him and obviously I’m paying attention, right?
But here’s the thing. I can pay attention to anything you want. And I can write it down, I can make charts, I can be so thoughtfully focused on that thing. But I can’t be doing that for all of the things, at all times. Remember, you are not our only provider. You are not the only one wanting us to be observing things, tracking things. And after 8 years of remembering medical details and getting hardly any sleep, my ability to remember details is really waning. (And, let’s be honest, my ability to remember details like numbers has never been strong.)
So while I can tell from his labs that the amount of water he’s getting a day is pretty OK, and I could absolutely bring you an exact number of how much water he’s getting if you asked in advance, I can’t necessarily pull an accurate estimate out of thin air when you unexpectedly ask me for this detail. Sitting here writing this post, I can’t even remember how much water he gets overnight – I’d have to check the pump settings.
Also, I could absolutely tell you something like whether it seems like he’s holding his head up more than he used to… but unless you warn me in advance that you’re going to want to know that, I won’t likely have been paying enough specific attention to that detail to be able to accurately answer with more than a vague feeling.
You’re surprised when you ask me about things like poop and I stumble to answer. I mean, yes, I guess I see his poop every day, but… I mean, come on, guys. I can’t even remember why I walked into a room half the time, you’re really expecting me to remember the details of his poop going back to a month ago? Nope. I can give you vague feelings about his poop, but I can’t give you details unless you asked. A month ago. Then I would have jotted it down every day.
And that’s the key. I know you’re busy but hey – so am I. Our upcoming appointment is NOT a surprise to you. You were likely there when we scheduled it. And at that time, you likely knew what sort of information you would want to discuss. That’s the time to tell me what you’ll want to know when we see you next. “Why don’t we check back in four months? At that time, I’ll want to know details about his poop, like consistency (use the chart), frequency, and whether you notice a difference with the medication.)”
That isn’t HARD. 95% of the time when you schedule a followup, you know EXACTLY what you’re going to want to know at that followup appointment – why not let me in on the secret, and then I can be prepared?
Our Teddy Bear's Journey 