How a Doctor’s Visit Can Be Like a Bad Night’s Sleep

One of the most common complaints that I hear about is that you keep waking up at night during sleep. Even if you don’t consciously “wake up,” the sleep study hypnogram (a graphic summary of your sleep stages) shows that your sleep is interrupted 10 to 20 times every hour by obstructed breathing, snoring, leg movements, and even teeth grinding. Frequent, interrupted sleep can lead to unproductive sleep, leading to increased fatigue, poor body healing and lack of brain regeneration.

As I was looking at a patient’s hypnogram, I realized that it also looks like our daily work schedules. With constant interruptions, it can be difficult to get any productive work done. It’s been said that only 20% of our time at work is truly productive. With the barrage of emails, colleagues and staff dropping by, phone calls and pages, It’s a wonder that we can get anything done at all. If you plotted all the interruptions through an 8 hour workday, I bet it’ll look very similar to what you see on a hypnogram with interrupted sleep. The first figure is a relatively “normal” night’s sleep, except that it took a while to fall asleep. Notice that the person reached all the sleep stages and for the most part, had extended periods of all sleep stages. In the second figure, notice how the person keeps waking up repeatedly.

"Normal" sleep

 hypnogram1

 

 

 

 

 

 

 

 

 

Even during a session with a patient, there are just too many interruptions. Here are the 5 most common interruptions that can disrupt your visit with your doctor:

 1. Phone calls for the doctor or the patient. Needless to say, they can be really annoying, and counterproductive to developing a positive patient-doctor relationship. I make it a point not to take any phone calls, unless it’s a true life-or-death emergency.

2. Staff members popping in for various reasons, such as asking a non-urgent question, or getting supplies. I consider the time that I spend with patients precious, and any interruptions can be very disruptive.

3. The doctor is looking at the computer screen rather than looking at you. Unfortunately, it’s one of the necessary evils of modern medicine. Until Apple creates their own electronic medical record, patient visits will become more impersonal.

4. Computer/technology glitches. For me, it’s rare that an hour goes by without minor or major computer problems. It can range from hardware issue to software glitches. Calling tech support is painful while seeing patients. Once in a while, the electronic medical records goes down, and we have to use (gasp!)—paper.

5. Missing or broken medical equipment. There are dozens if not hundreds of supplies, instruments or equipment that must be stocked, maintained or serviced. Even one missing ear speculum size can be disruptive, even in the best of circumstances.

For the writers out there, you know that it takes about 15 to 30 minutes to get into the creative “groove.” Even is you can start writing again, you’ve lost about 30 minutes of your best material. Similarly, once you’ve developed a productive patient-doctor interaction, any interruption will diminish the quality and outcome of the relationship. As you can see, frequent interruptions during the work day can can be just as damaging as interrupted sleep.

When you see your doctor, what’s the one most annoying thing that interrupts your visit?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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