In working through minimally disruptive medicine, we are uncovering how the healthcare system has been developing habits — I think this is the right term — that essentially transfer complex work from the healthcare system to the patient.
Take appointment scheduling – some back offices have different schedulers for different types of appointments resulting in uncoordinated visits. A patient with whom we are currently working made more than 30 trips to the clinic, often times for one or two visits each time. This was particularly problematic because she could not drive. A family member ended up moving to town to help with this task…her life being disrupted by this “need”.
Take prescription refilling – some insurers do not enable pharmacies to refill prescriptions before a particular date even if this was the day that worked for this patient to ask for the refill. Some specialists will write their own prescriptions and these will get renewed at different times than those of others. Thus, the patient is left with multiple prescriptions refilled and renewed by different providers. One of our patients went to the pharmacy 43 times in a year to refill prescriptions!
Take e-health interventions. Many of the new technologies require patients to interact with machines and devices, often times in quite extensive ways. The designers of these technologies have not clearly acknowledged that the purpose of healthcare is to enable patients to pursue their life’s goals and dreams unhindered by health concerns (or by healthcare itself). Healthcare should get out of the way, not be “the way”.
More to come as we get deeper into ‘Goldilocks’ care.
Minimally Disruptive Medicine 
Well said. Sad, and challenging.
One wonders how many of those 30 clinic visits and 43 refills were truly “needed”.