Curbside Consult with Dr. Jayne 12/1/25

It’s been a bumpy couple of weeks. I have spent more time than I generally prefer in the patient, family, and caregiver role.

I hate to say that I saw mostly the bad and the ugly of the processes I have encountered, with barely any of the good. A solution is available for each of these issues, but when organizations fail to see problems with their processes, it’s unlikely that patients will see any change.

The first situation I ran into was with an elderly family member who was having an upcoming procedure. I’m essentially her healthcare proxy and receive her written communications. I also manage her phone calls because of her hearing impairment.

I received a voice mail a week prior to her procedure. It said that they had sent a financial responsibility letter and just wanted to make sure that I received it. The message went on to say that if I had indeed received it and didn’t have any questions, I didn’t need to call the office.

Although I hadn’t seen the letter yet, I looked at my Informed Delivery digest from the US Postal Service and saw that it would be in that day’s mail. I read the letter and had no questions, so I did as instructed and didn’t call back. I thought that was the end of it.

I had received written materials about the procedure six weeks before it was scheduled. They stated that I would receive a pre-registration call three days before the procedure. The call arrived as scheduled, but I was seeing patients, so I called back as soon as possible. I then learned that the department manages pre-registrations only between 1:00 p.m. and 4:00 p.m. and was now closed.

I called back the next day at 1:00 p.m. I was given the option to leave a voice mail, which wasn’t going to work because I was again seeing patients. I dutifully hit 0 to speak to an operator, who told me that the nurses are “still tied up with today’s patients because we’re running behind” and to “call back in a half hour or so.”

I gave it a full hour just to be safe. I was directed to voice mail again and was asked to leave a number where I could be reached from 1:00  to 3:00 p.m. I did so and didn’t hear back, so I called back at 3:45 since I knew that they close at 4:00. I was told “If they don’t reach you, they will just do her pre-registration when she gets here. But that’s not ideal, so we really need a number where we can reach you and have you answer.”

I received a call at 4:15 p.m. I just about broke my ankle trying to answer it, only to find that it was the financial office calling to see if I had any questions about the financial letter since they hadn’t heard from me. I let them know that the original message said not to call unless I had questions. The representative acted like she had no idea why the original message contained that information.

By this point, my read on the procedure center was that they have zero respect for people who have work or life situations where they can’t just drop everything and take a phone call during a narrow window of time. Also, that they don’t have their act together in making sure that the messages they leave are accurate. It didn’t make me feel respected as a potential patient or a caregiver.

I wasn’t seeing patients the day before the procedure, so I called in at 1:30 p.m. and finally reached a nurse. She went down a list of questions asking for information that was already on the chart. None of the questions was a curveball or tricky, so all of them could have been managed through an electronic check-in via the patient portal or through a secure messaging platform.

The nurse then read me all the pre-procedure instructions that had been mailed. That explains why the registration process takes so long and why the nurses aren’t easily available when patients call in as instructed.

In addition, the nurse paused periodically during our conversation to say goodbye to people in the office who were leaving. That seems unprofessional.

On procedure day, we arrived to find that the guarantor name on the insurance that was correct in the pre-registration conversation was now wrong. The check-in person also failed to collect the patient co-pay, which meant having an elderly person with a walker get up and down a couple of times rather than just once. The check-in desk was tall and didn’t have the option for a patient to sit, which was also a negative in my book.

The nurse was trying to ask rooming questions while we were walking to the dressing room. That isn’t ideal for an elderly person who is hard of hearing and who is focused on using her walker. I had to ask the nurse to stop asking questions until we were in a situation where she could directly address the patient without distractions.

Fortunately, the procedure went without a hitch. I returned her to her home and another family member tagged in.

Meanwhile, the second situation found me waiting for my own important test results. Their arrival was dragging into the holiday weekend. Physicians don’t always make the best patients, We are as anxious as anyone when we’re waiting to learn what is going on with our health.

I had been waiting a couple of days when I received a text telling me that a message was available in the patient portal. I was driving at the time, so I psyched myself up as I returned home and woke up my laptop so I could learn my fate.

It was a blast message from the surgeon’s office to let me know their office hours for the Thanksgiving holiday. Also, to remind me to call 911 if I had an immediate medical emergency.

I initially questioned whether this is a limitation of the patient portal. A quick chat with one of my favorite experts reassured me that the practice isn’t using the tool as designed. They could have used other options to convey the information that wouldn’t potentially trigger the hundreds of patients who are awaiting pathology results.

I know the EHR leaders at the institution in question. I wonder if they are aware how various departments are using the available tools and how deviation from published best practices can have a negative impact on their patients. This is the same practice that failed to notify patients that the office had moved, which caused quite a bit of hardship for patients. This workflow adds insult to injury.

Does your organization consider patient preferences and impact when creating patient-facing workflows? Do you leverage patient and family advisors to help you review new features? Leave a comment or email me.

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