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Nutrition Informatics Blog



Expectations and Boundaries

(Posted by Lindsey B. Hoggle RD MS) It’s time for the next chapter in my mother’s dilemma with health care—and how it sometimes seems that just navigating the health care system is more traumatizing than the diagnosis itself.  Long story short—she has refined the art of getting the best care, having the information she wants and within a reasonable timeframe. And she’s on great terms with her doctor.

Several weeks ago, when she was discharged from the hospital after her test (with no results), she received in the mail what was labeled a “Reminder” that she had an appointment with the nurse practitioner at a specified time in two weeks. This was new information, as she was not aware that there was an appointment. Upon calling the doctor’s office, she was told that this was “standard procedure”—assigning an appointment with the nurse practitioner after hospital discharge. Obviously, the “reminder” (Webster would be mortified)—was not one at all, as she was never aware of the appointment in the first place.

My mother’s discussion with the doctor’s staff was:

“Why would I want to see someone I have never seen before when my doctor is aware of my situation?” (Expectation identified.)


OK-yes her doctor will see her.


Next hurdle: “Will he have the new results at the appointment so we can discuss them?” (Another Expectation identified.)


Yes—he will discuss your results.


“I would like to come sooner than in 2 weeks.” (Boundary verbalized.)


Appointment made for 1 week rather than two.


My mom identified what she wants and expects from her doctor and the system. She still feels that she and her cardiologist of 10 years are together as a team, researching the options and making decisions on what is best for her specific situation.

And yes—there is a place for “Reminders” in patient care and even within criteria for meaningful use.  Great topic for the next post!

Add a Comment
Comments (1):
11/8/2010 1:03:03 AM by Cathy Welsh

I was reminded of this posting when I had my father in the hospital this week. From admission to surgery, to the ICU, and then to stepdown, each nurse and many others asked the same questions over and over. Although this facility had an electronic medical record, I did not see them referring to the screen. They wrote the answers down on a piece of paper. And it did not seem to make much difference how the answers changed. In one day, my Dad went from 6'" to 6'. I guess there is no real danger of information getting populated once and then pulling into forms over and over. I understand from some of the analysts I work with, that departments who ask for data from other parts of the EMR to populate their forms, often change their minds. Any thoughts?

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