Life in the Fast Lane -- And the Slow Lane

— It'd be great to speed up the routine tasks and slow down our time with our patients

MedpageToday
A computer rendering of a brain plugged into a book.
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    Fred Pelzman is an associate professor of medicine at Weill Cornell, and has been a practicing internist for nearly 30 years. He is medical director of Weill Cornell Internal Medicine Associates.

Speeding up, slowing down.

My wife listens to a lot of different podcasts and online news, as well as the occasional audio book. Personally, I've never figured out how to listen to these, although I hear there's a lot of really interesting content out there, and a lot of people love listening to books on tape and podcasts and the rest. I even know a lot of people who get tons of medical content this way.

My wife always has something going on her phone, and has some favorite podcasts and newsfeeds that she listens to regularly. The funny thing is, she does it all at superfast speeds. Several years ago, she figured out how to up the speed on the audio playback, and now seems to get through these things in record time.

Once, when we were on the drive back from vacation in New Hampshire, she asked if I wanted to listen to a couple of these podcasts; she had a few that she had just listened to that she thought might interest me. She put them on her phone, connected it to the car's speakers, and I suddenly felt like I was listening to Alvin and the Chipmunks. She said it sounded perfectly normal to her, but I couldn't understand a single thing they were saying.

I know I could probably get used to this, maybe start out slowly, say at 1.25 speed, and then ramp it up to staccato superspeed over time. But somehow it just doesn't feel like anything penetrates my brain in this modality.

Wouldn't it be great if we could figure out how to get all of the content we needed to take care of our patients into our brains really rapidly, and then find a way to get it out where we needed it just as fast? Every new journal article and textbook dumped rapid-fire into our brains, and perfectly retained. Life might be a lot better and more efficient if we could all work this way.

Of course, no one wants to be fed this sort of information from a firehose. But maybe I can figure out how to read my journals at an accelerated speed and somehow still retain the essential information I need.

It would also be great if we could superspeed some of the administrative stuff that has to happen -- following up on lab results, writing letters, filling out forms, so much administrative stuff. Maybe even all those online modules that the hospital makes us do. How many times have we done the fire safety module? Don't they know that they can probably present this to us all at superspeed, and we would still know what RACE and PASS mean? And then we could get back to our already busy workdays? I've worked here over a quarter of a century, and most of the answers on the annual hospital training have not changed ...

On the other hand, I don't want to rush the time I have talking to my patients. That is when I want to slow down; that is when I went to listen to them slowly give me their story, help them tease out the details, let them take their time, let them see that I'm taking my time and really paying attention to them, focusing everything on them, not thinking about the patient that came before or the patient to come, or whatever else I have on my plate for the rest of the day.

I'm sure patients often feel like we're speaking to them at superspeed when we explain to them what their labs showed and what this means, or what their diagnosis is and what comes next, or how they should take their medicine, or what they can do to improve their health. "Less stress, more sleep, keep hydrated, quit smoking, start exercising." "Slow down, doc!"

Until we get longer appointment times, until we figure out how to take the pressure off of us to see more patients per hour, it's probably never going to not feel rushed to our patients, no matter how much we try. Somehow, we need to be given the resources to ensure that our patients feel like they're getting all the information they need, adjusted to the pace they need to perceive and receive it, to help them best understand it and move forward with their health.

Maybe we all need to learn how to slow down, and take a deep breath, and really give all of our patients all of the attention they need. If we can build a better healthcare system that helps cut out all the unnecessary stuff that bogs us down as we try to take care of our patients, then maybe there will be less pressure on us to hurry up and get to the next patient.

Stop and think about it.