A Low Bar

If you watch TV with commercials, it is impossible to avoid the Zocdoc ads, especially during flu season. In theory, Zocdoc is a great idea. I always thought finding a clinician who works for you is sort of like dating. It’s as much about matching with their personality as it is evaluating their skills.

And much like dating it can take a lot of tries to find a good one. Zocdoc has set itself up as the tool to make the process easier.

Except.

In the most recent ad, we have a woman who is obviously sick. She looks miserable in her bathrobe with a red nose and messy hair. She somehow finds herself unable to move, with her face pressed to the cool tiles of her bathroom floor.

We have all been there, and if you have a compromised immune system, you have been there more than most.  To us, her ability to scroll through Zocdoc coherently while reading through doctor reviews looks a little questionable.

Her roommate comes to check on her, and as she rolls over, she begins to extoll -- in an appropriately weary voice -- the virtues of a couple of the doctors she has discovered. One “doesn’t rush appointments” and another “makes patients feel heard”. And the second one has an opening!

As patients, I bet some of you know exactly what my initial reaction was.

Why can’t we have both?

If this was actually dating, how would you feel if, on the first date, you were paired with someone who either was hyper focused on you but left after 15 minutes or hung around for a couple of hours but spent half the time scrolling on their phone? Would there be a second date?

Pretty sure the answer is no. You would look for someone who would be present and show some interest in you as a person.

And even if you only wanted some companionship for the night and didn’t plan on seeing them again, it would help if the date was good. Otherwise, it might put you off dating entirely for a while.

Now, we know the system itself can have an impact on how much time a clinician is allowed to see a patient, so that is a factor. But for the illness implied in this ad, an acute, common condition, there are steps that could be taken to make a short appointment effective and not feel rushed. I could go into some steps that would help, but that is not the point of this post.

The point of this post is that the fact that a doctor who has just one of those qualities somehow is extraordinary. So it is more than enough to get only that much. A doctor that has both qualities would be some kind of mythical creature, so don’t expect to find one.

How did our bar drop so low?

The stakes in healthcare are high. These are our lives, and we have a right to expect, at a minimum, clinicians who listen, who have enough time to make an accurate diagnosis and the flexibility to see a course of treatment through to its conclusion. We even have the right to add to our clinician/dating checklist (you know you have one). For example:

·         Did the clinician communicate enough information to me about the diagnosis and treatment?

·         Is this a treatment I am comfortable with?

·         Did the clinician ask about anything else that might affect the diagnosis aside from the obvious symptoms?

Of course, it’s not Zocdoc’s fault that we have such low expectations of our clinical options, and I know plenty of clinicians who far exceed the expectations implied by this ad. Plus, the woman in the ad was not looking for someone to treat a chronic condition, so the needs of the patient in this situation are different from what I would look for. But I do wish their messaging didn’t reinforce the idea of the bare minimum somehow being extraordinary.

Generally speaking, if we raise our expectations and make that the new normal, we give people the opportunity to rise to them, and many will.

I know we can do better.

 

P.S. Of course, if we all had established relationships with primary care providers before we got sick, this would be a lot less of an issue. We wouldn’t have to scramble on Zocdoc when we got sick.