Give the Doctor Somewhere to Go

Why reading your own clinical results and asking the right questions turns a consultation into a collaboration.

An AI-generated infographic on the blog content. (Click to enlarge.)

An Unexpected Appointment

Once again, I found myself in hospital, more times than I would have liked in a single year. I have lost count. I had no reason why this appointment had been scheduled, and my anxiety was not assuaged when, just over a week before, I received a call telling me to attend the diabetes centre.

It was a poorly delivered message. The department I used to attend had been relocated to what was once the Diabetes and Endocrinology Department, but you can imagine how I felt until I received clarification.

In any case, it would have come as a great shock, because nothing in my blood test results indicated any cause for concern in that area.

A Confusing Journey

When I did set off from home, I realised the bus was running seven minutes late. Although I had given myself enough time to find this new location, my appointment notice had not been updated accordingly. So I returned to the old place, where the receptionist registered me before advising me to take a seat.

A few minutes later, the receptionist came to tell me I had to go to another department. She gave directions, but the signage left me navigating a labyrinthine route, unsure whether I needed to explore further down or check with someone else. I did eventually find the place, and it was kitted out like a temporary setup, with patients barely out of a daze from the trouble of getting there.

Checks and Confusion

A nurse called out my name to check my height, weight, and blood pressure. Having arrived later than expected, and given the discombobulation that ensued, I feared the readings might be high. I took deep, controlled breaths and folded up my sleeve; they fell within the normal range. Phew!

Half an hour after my arrival, another nurse came to check what I was there for; it seemed the relocation had also introduced inefficiencies. Apparently, I had been invited for the second jab of the HPV vaccine, which, when I took it, proved quite painful.

Being My Own Advocate

This is part of my personal medical advocacy. Literate people should spend some time reading and understanding their clinical results, because doctors sometimes do not have enough time to tease out the issues with you. 

I recognise, too, that not everyone can do this alone; those constrained by education or digital access may need a trusted interpreter, whether a family member, carer, or advocate. That is precisely why those of us who can engage should and could do a little more.

When I do raise something, it is rarely idle curiosity. My questions are usually a way of satisfying myself whether a course of action is genuinely necessary. If you notice something outside the normal range in your results, bringing it up immediately elicits a response, whether an assurance that there is nothing to worry about, or an investigation requiring further tests.

Working With, Not Around

This is where prompting matters. When my consultant noticed my name on the board and invited me for a chat, my question about the creatinine levels gave the conversation somewhere to go. Those levels had been off the scale in late July, indicative of either an infection or kidney problems; if it were the latter, a change of medication might enter the fray.

Had I not raised it, the consultant might reasonably have assumed there was nothing more to discuss. Advocacy of this kind is not working around the doctor; it is working with them.

Along with the vaccine, a urine test was ordered, and late last night the results returned well within the normal range. I did not need a doctor or a consultant to tell me that, and my concerns were immediately allayed.

Essentially, we underserve ourselves in the quest for the best clinical outcomes if we leave everything to doctors as omniscient experts on our bodies, when we should be doing a bit more to keep them apprised.

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You Do Not Get A Painter to Fix Another's Art

The Value of Vindication

Vindication comes in different ways, not to gloat or to point fingers, even if, after all is said, the concern you raised has been proven true. Good communication, alongside the ability to articulate one's thoughts even in the heat of the moment, remains the most critical skill every time.

In a long-running saga of urgency and wits, from which workplace stress can be the damaging consequence for motivation and wellbeing, withstanding authority and office in the quest to improve a proposed solution, so that it works as intended and engenders confidence, is not a battle for the fainthearted.

There are so many ways to express oneself, and the power of persuasion comes in the form of words that walk people down a reasonable lane of acknowledgement, misgiving, challenge, and requirement, before acquiescing to the notion of a willingness to engage and always help.

A Question of Ownership

In this instance, after a solution did not work as intended, a project manager had the bright idea that it was now the job of the implementor to fix the problem with a complex set of orchestration scripts; scripts that the implementor had long before determined would not deploy cleanly, for various reasons previously given but seemingly ignored.

The truth was that collaboration had never quite been on offer. What passed for it at the outset was minimal, closer to an imposition than an invitation, and it was only our steady, well-argued pushbacks that drew out any real interaction. Even then, we were working with architects whose confidence outpaced their familiarity with the environment in which their solution was meant to run.

The first line of my response was that his reading of the situation was wrong, and I then went on to make the case for why, starting with a simple analogy. Because scripts and programming are an individual's way of thinking and a style of expression for what they want to achieve, and without the full immersion of others in the coding process, "You do not get a painter to fix another artist's work of art."

An AI-generated infographic on the blog content. (Click to enlarge.)

I appreciate that there was something I could do, but what was requested was input; it could not be interpreted as taking ownership of the solution. The fundamentals of the intended solution were sound, but its enterprise deployment, so that it consistently works once rolled out, requires the inside knowledge of the implementor to point out why certain constructs will fail, so that the developer takes those ideas seriously when modifying elements of the proposed solution.

Back to the Canvas

The response of the project manager was at first patronising and then emotional, but the artist, the developer, understood the import of my message and got back to work fixing their solution, which is now in its fourth iteration and possibly still a work in progress nine days on.

As far as I was concerned, what I intended was achieved: to draw out the work of the implementor, before the solution was complete, and to inform of the essential changes and improvements needed to make it deployable.

Invariably, I believe the result would not only be fit for purpose; once fully done, all sides of development, through implementation, to the end-users would see the intended benefits the solution would offer.

The whole trajectory now sits in the slipstream of practical engagement with the implementation process, rather than in acquiring accolades from promising the client outcomes that, from the onset, would never have worked, back when the first ideas were put to us over two months ago.

Authority and Consent

One higher management person did interject in the email chain, suggesting we were involved in verbose communication; the same person who used the lexicon of grief to explain the effects of change some months ago. None of these replies required a response once the artist was back to fixing their work of art, rather than hoping another might attempt a dash of graffiti to improve it.

The authority to propose still requires the consent to implement. Badly designed systems tend to be a symptom of the same thing: responsibility placed in the wrong hands, and too little respectful engagement with those who must carry a complex solution through deployment.

Had the environment been understood from the start, much of this could have been avoided. In the workplace, this is the challenge faced by many who need the kind of articulation that ensures a solution has the best set of inputs to work.

We are not seeking perfection, just something good enough to understand, implement, manage, and hand over cleanly, when the time comes.

Related blogs

Blog - Badly Designed Systems Are Just That

Blog - Authority Without Consent

Blog - When Change Borrows the Lexicon of Grief

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