Sloppy Is As Sloppy Does

A badly designed medical-information form provokes a rant about being sloppy and some consideration about when being careful really matters.


Are you planning to get pregnant in the next three months?

I look around. No, it’s just me and the Big Guy in the room, and he’s busy with his own clipboard. This medical information form must be talking to me.

Maybe it’s my own fault for having humoured it thus far. After all, I didn’t balk at the previous question — Are you pregnant? — so I may have lost my right to object to this line of questioning.

I look over at the Big Guy. Maybe I should get his opinion. I mean, I know I’m not pregnant now, but we often have different views on what the future will bring.

Am I planning to get pregnant in the next three months?

Playing it straight, as usual, he responds without looking up.

No.

I look for a place to write in a comment: perhaps, See date of birth, above. I look in vain.

So I check the ‘No’ box and carry on. What’s next? Are you breastfeeding? Sigh.

No.

Five minutes later, I have completed my form, providing the information that is apparently necessary for the doctor to determine which vaccinations and medications I require for the 10-day trip the Big Guy and I are taking to the Galapagos.

I have provided information that is called (disconcertingly in any remotely medical context) my ‘tombstone’ information: name, date of birth, gender.

I have dutifully recorded my Ontario Health Insurance Program number, even though neither travel vaccinations nor the doctor consultation required to get said vaccinations are, in fact, covered under this program. I wonder whether this medical office is aware of the privacy guideline that only pertinent information should be collected.

I have transcribed my previous vaccinations from my World Health Organization record-of-vaccination booklet, checked it twice, and wondered why I am copying information from one paper form to another, for further entry into an electronic record.

I have responded to not one, but two, double-columned lists of questions about my medical history. Asthma? Cancer? Heart problems? Psychiatric illness? AIDS? Lupus? Diabetes? Respiratory problems? Hypertension? No, no, no, no, no, no, no, no, and no, damn it, although the hypertension question stops me for a moment. I suspect that my blood pressure, in this exact moment, is not at its 52-week low, unlike my portfolio which seems always to be there, impossible though I know that to be.

I have answered the aforementioned questions about my reproductive and nursing status. Nuff said.

And I have answered a question about drug allergies. Twice. Are they running a data validity check on my answers, I wonder, or is it just a sloppy form?

My money is on the latter.

It costs money to do things well. I get that. To eliminate the silliness just on this two-page form, for example, would require not just an edit to eliminate the irrelevancy and redundancy, but a redesign.  As one example, it would take some thinking to divert people around questions that do not apply: to ask the pregnancy and breastfeeding questions only of women of child-bearing age.

But what’s the benefit that would justify that cost? I mean, people fill in the form whether the questions make sense for them or not, don’t they? They do.

Well, the Big Guy and I do.  I can’t speak for other people.

As we wait for the doctor, I ponder the role of sloppiness in the world. For individuals, being sloppy in some things would seem to be an expected part of being human. Indeed, we have a derogatory name for people who do absolutely everything meticulously. For organizations, being sloppy in some things is likely necessary to success. Not everything worth doing is worth doing well, as Tom West said. If quick and dirty ‘work,’ well then, Git ‘r done!, as Larry the Cable Guy tells us.

Of course, what ‘works’ is a judgement call. A form need not be a thing of beauty — it’s not the Book of Kells, after all — but it should gather necessary and valid data that can be transcribed reliably.

And here, more than on the baby-making questions that had me looking for places to write in a pointed comment, this form failed the test.

Hours after leaving the doctor’s office, I am talking to a pharmacist. One of the the prescriptions I was given cannot be filled, because it is for a medication to which I am allergic. Yes, that self-same allergy I noted twice on the form.

Some things, it turns out, really must be done well.

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14 Responses to Sloppy Is As Sloppy Does

  1. Ralph says:

    Have a wonderful trip.
    Ralph

  2. Jim Robertson says:

    Gotta love “efficiency”….
    Hope your trip is as good as ours was, being on a big boat should be smoother than our little guy

    • Isabel Gibson says:

      Jim – I do love efficiency when I encounter it . . . Ah, well, not a hanging offence. It certainly illustrates why there are independent checks built into the drug dispensing system.

  3. Dave Moryas says:

    Heard you were going to see the tortoises and marine iguanas! Have a lovely trip and remind the Big Guy that I’m pretty sure there are no golf courses on the islands.

    As for the forms, well the medical system may have to adjust to the “Boomer Bulge” soon enough and frivolous, general questions will hopefully become a thing of the past. But then, intransigence and inertia are severe symptoms of our medical system, so who knows.

    Always a pleasure to read your musings.

    • Isabel Gibson says:

      Dave – Thanks! And I’ll thank you not to mention the lack of golf courses to the Big Guy. As for better forms, I hold out more hope for the chips that will read our vitals automatically (automagically?) and eliminate all this transference of information via humans.

  4. Alison says:

    I read medical forms as part of my work, and in an attempt to know more about my clients before I meet them. You would not be surprised, given your experience, that it rarely tells me what I really want to know. Example: although it tells me what joint is being replaced, never is it mentioned that the other limb has been amputated? or that the client is paralyzed? or perhaps cognitively impaired? Thank goodness, I actually get to SEE the client before I complete the paperwork authorizing what they need for equipment before surgery! It constantly amazes me – and yet, I’m sure I’ll soon be replaced because they feel they can do my job by giving the client a “questionnaire”! There, that’s MY rant for the day! Have a wonderful trip!

    • Enjoyed your rant!

      Have you seen the British show “Getting On” – there is an American version as well. Both very funny. Here is a YouTube sample (as it were) of a BBC one.

      https://www.youtube.com/watch?v=blib3a9FLCE

      • Isabel Gibson says:

        Barbara – Yes, that’s quintessentially British, isn’t it? I had not seen it before, so thanks!

    • Isabel Gibson says:

      Alison – I have spent years fighting a rear-guard action on forms – writing notes in the margins that actually describe my condition or complaint, that sort of thing. I often feel my energy for this battle flagging. But your examples reinvigourate me. Onwards and upwards!

  5. Have a great adventure without us,
    but we will expect many postings!

  6. M.McQuillan says:

    Why do they gather all of this information then ignore the most important info given? It reminds me of the forms that needed to be filled out every time I donated blood or platelets. Theses forms were actually offensive and stupid. Now they have classified me as not fit to give, but their reasons are not clear. As for your experience; it borders on criminal to prescribe a medicine that the patient told you they were allergic to. That makes the visit a waste of time and your money. I hope you find a better travel doctor for your future travels. Enjoy the trip.

    • Isabel Gibson says:

      M – Yes, I wasn’t the happiest of healthcare consumers, that’s for sure. I have a high regard for pharmacists in matters related to pharmaceuticals. They know their stuff.

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