I have a love-hate relationship with the no-show patient. Like most doctors, I’m a reasonably good multitasker, adept enough at charting while emailing while waiting on hold with insurance companies and planning what to prepare for dinner when I get home. But there are days, more than I’d like to admit, when I feel like I need just a little bit more time, and I find myself compulsively refreshing my schedule in the EMR, fingers crossed that the next patient’s name won’t light up as “arrived.”
The healer in me feels a bit ashamed about this. I went into medicine because I wanted to work with people, to sit in a room with someone who is suffering and do my best to make him feel better. Why on earth would I want to swap out face time with a patient for alone time with my computer? How often do I rant about the paperwork and the bureaucracy, lamenting that “I should be seeing patients right now!”? It’s a nonsequitur to crave time with patients and then hope for a no-show, isn’t it?
I suppose it has to do with feeling stretched too thin. There’s always more than enough to do in a busy clinic, so I rationalize my sense of relief about the no-show patient with self-assurances: It’s not like I’m using that extra chunk of time to play solitaire or catch up on Netflix; it’s not like the phone calls I make or prescriptions I write in that time aren’t helping some other patient; it’s not like that bonus bathroom break is going to pamper my kidneys or spoil my work ethic.
What’s more, I know that the extra time isn’t really extra time at all, that the patient who no-showed will have to be squished into my schedule sometime in the future and I’ll have to call in a refill or send home a letter such that less work today will almost certainly mean more work tomorrow. What inevitably follows is that my rationalizing morphs into frustration about the system and all its dysfunctions, and before I know it my love for the no-show patient transforms into indignation.
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