Can I Have My Time Back?

If life is, as William James suggested, what you pay attention to, then healthcare takes up too much of our lives. 

Health, of course, is supposed to be an integral part of our lives, but seeking and/or receiving health care is not supposed to be.  Our healthcare -- a.k.a., medical care -- system is becoming too much of a focus of our lives.   

Credit: Cloudpixel

Think about just the time we spend that revolves around healthcare:

• we wait to get an appointment with a healthcare professional;
• we wait at the healthcare professional's office/facility;
• our actual time with the healthcare professional is usually shorter than we'd like, and we often feel he/she is too distracted (by their EHR and/or time constraints);
• if the healthcare professional orders a prescription, a test/procedure, or a follow-up visit (and he/she probably will do at least one of those things), we then have to wait to arrange those, and wait there all over again;
• if we get a test, we have to wait to get the results, often until the healthcare professional has reviewed; 
• we wait in between visits, often not quite sure if what we're feeling is to be expected or when we should take what action other than to go on waiting;
• we wait for our healthcare professional to bill us for their services, and for our health plan to decide how much we actually have to pay;
• if we happened to be hospitalized or in a nursing home, our time is all about waiting, never quite sure when what is going to happen to us.

Once you have a encounter with the healthcare system, you're probably going to have another.  Once you have an encounter, you're probably going to get a prescription, and, at some point, at least a test.  Once you get a test, you're likely to need more tests.  Do enough tests and something will be found, leading perhaps to more invasive action. 


Healthcare becomes self-perpetuating. 


And, of course, many of us spend way too much time worrying about how we're going to afford to pay for health care we've already received, or worrying about how we would pay for it should something "major" happen to us. 

We want to spend our lives doing things that are important to us.  We want to spend time doing things that make us happy or that help the people we care about be happy.  We begrudge spending time on anything else. 

To be sure, we spend time on many things we don't especially enjoy -- we go to work, we exercise, we go to the grocery store, etc. -- but they are in furtherance of the things that matter.  Getting healthcare falls into that category.  But some people enjoy working, some people like exercising, and some people enjoy going to the grocery, but I doubt many people enjoy getting healthcare. 

We may enjoy the outcomes of healthcare -- hopefully, feeling better -- but we rarely enjoy the process of healthcare.  That's why that process should take as little time away from the rest of tour lives as possible.   

If I like Avengers movies, I'm delighted when I find that Avenger's Endgame is three hours instead of two; that's extra time I get to enjoy it.  Same for overtime games in sports.  But I don't feel that way when, say, meetings run long, and I definitely don't feel that way when I have to wait in the healthcare system.  Of my limited time, that's not how I want to spend any extra minutes. 

Healthcare needs to respect our time more.  Healthcare needs to make us feel like our time is more valuable than the time of the people working in it.  Healthcare needs to make us feel like it is ready for us, when we need it, not like it is somehow doing us a favor and it will get to us when it can. 

Just recently, Tesla announced that it was going to keep track of certain components for its cars in real-time, let you know when it was time to replace them, and ship the replacement parts to the closest service center.  "Like skipping the doctor and going right to the pharmacy," Tesla says.

Except, of course, healthcare doesn't do anything like that.  Not yet.

NEJM Catalyst featured a talk by Judith Baumhauer of the University of Rochester Medical Center about the importance of using patient-reported outcomes to "predict the future."  It uses such information to help patients understand how they might benefit, and how they might expect to progress, from different courses of treatment.  "We needed for our patients to tell us how they’re doing,” Professor Baumhauer said. “We didn’t like telling them how they’re doing. We like them telling us.”

Figuring out how to identify which patients would benefit from which treatments "...is the holy grail of health care,” Professor Baumhauer believes. “We’re going to do preventative actions to improve the health care that we provide for patients.”

Don't waste our time collecting information that won't be used to help our care.  Don't waste our time with treatments that won't help us.  Don't waste our time fixing problems that could and should have been prevented.  Don't waste our time, period. 

Give us more time to spend on our health, and less on our health care.  Give us more time living our lives, and less dealing with the healthcare system.  And, when we do have to interact with the healthcare system, treat our time as precious, just like our health.

The hot phrase in healthcare for the past several years has been "patient-centered."  The idea is well-intentioned, but misses the larger point.  We don't want to be patients.  We don't want to spend time being in the healthcare system.  We're people, and the goal of the healthcare system has to be maximizing the time in, and quality of, our lives outside it.

It's bad enough that healthcare has so much of our money, but it's even worse that it takes so much of our time.