Does That Make Sense?
Recently, a friend told me about the challenge of going for a sleep test. He had complained to his doctor of being chronically tired, and when questioned about his sleep, he told his doctor that he often woke up in the middle of the night, tossed and turned in his sleep, and snored loudly. His doctor told him that he may have sleep apnea, and set him up for series of tests. The first involved attaching a monitor to his hand and wearing it for a night while sleeping at home. A few days later, he was called and told that the result of this test showed signs of mild to moderate sleep apnea, so he was scheduled for an overnight test, during which he would be in a sleep lab, wired up to machines that would measure his breathing, airflow, and other indicators of apnea. The entire idea filled him with dread. He is someone who has, at best, a healthy distrust of the medical system, and was convinced that this was another scam by which doctors lined their wallets. However, after talking with me and other friends, he agreed that he would do the study.
The entire idea filled him with dread. He is someone who has, at best, a healthy distrust of the medical system
On the appointed night, he went to the sleep lab, where a very nice nurse attached the electrodes to him and helped him get into bed with the monitor leads attached. After a relatively uneventful night, the nurse told him that everything went well and that she didn’t see anything to worry about.
A few days later, my friend received a call from a physician at the sleep lab. The doctor said that he was calling to review the results of the sleep test. He explained that the results showed a severe degree of obstructive sleep apnea, and then proceeded to talk like a human machine gun, rattling out medical words at a rate per minute that would make an assault rifle proud. At the end of each burst, he would tack on “does that make sense?”, and then go on to the next burst of information without pausing to let my friend ask any questions. This went on for a few minutes. When he finished, the doctor chuckled and said, “I hope I haven’t shocked you!” My friend understood virtually none of the information being shot at him, and hung up the phone frustrated and angry.
People are often surprised at how much of medicine is an inexact science. The reality is that much of it is inexact, even if the language that is used often fails to reflect this.
My friend had received three pieces of information at three different times, and none of them was consistent with the others. The result of the first test was “mild to moderate”, the informal result of the second test was “nothing to worry about”, and the formal result of the second test was “severe”. Obviously, there are good reasons why test results vary from one test to another. Some tests are better for screening rather than diagnosing a condition. Just because a screening test says that a condition may be present doesn’t mean that it is present. More specific tests are usually needed, and even these can have varying results. This is one of the headaches of modern medicine- the fact that things are often gray when we would like them to be black or white. People are often surprised at how much of medicine is an inexact science. The reality is that much of it is inexact, even if the language that is used often fails to reflect this.
…the hurried “does that make sense?” without pausing to listen to an answer made my friend feel unheard and unimportant, even though the conversation was about him!
With just a little training in good communication or customer service, the doctor in this story could have been an effective communicator. Instead, he added to my friend’s anxiety by talking much too fast and giving too much information at once. He did not review the results of the two tests and why they may show different findings, or explain why the results of one test would be more reliable than the other one. My friend was left to sort this out for himself, which is unfortunately all too common after receiving medical results. The chuckling at the end of his monologue did not endear the doctor to my friend. Yes, this was startling news to receive- why would that be amusing? Worst of all, the hurriedly repeated “does that make sense?” without pausing to listen to an answer made my friend feel unheard and unimportant, even though the conversation was about him! There are far better ways to present test results to patients, but unfortunately, there is little incentive for doctors to do a better job, and a lot of pressure on them to get these tasks done as quickly and efficiently as possible.
