Some time back, the parents of an 8-years old Indian-origin boy from Dubai came to me to get a bone tumor in the left hip treated.
A tentative date was fixed for the surgery after a detailed con-call with the parents who had returned to Dubai. My coordinator, S, took over and he was in touch with the father up to two days of the appointment date.
The evening before the procedure, the team normally interacts with the patient or relatives to go through the protocol one last time. S was unable to get in touch with the father, both on his Dubai as well as on his Indian cell number. Our standard policy in such situations is to cancel the appointment. In this case, since the patient was a child and was coming from Dubai only for this, I made a judgment call to keep the appointment. When I reached the center the next morning, I found the patient had not turned up. When the team tried to contact the father and he refused to pick up his phone, I canceled the procedure. I asked S to email the father one last time, just in case they were stuck or in some difficulty…there was no reply and there hasn’t been till date.
This happens with doctors all the time. The operation theatre (OT) is booked, the team is ready with if necessary, special instrumentation…and the patient just does not turn up.
Doctors are human as well and not immune from the emotional storm a “no-show” kicks up!
First, there is anger. What an a@@ole! How could the patient be such a *@&#*! If he was shopping around and checking rates and expertise levels, couldn’t he have had the decency to call or email and say that he was going somewhere else and spare us all this trouble?
It then raises self-doubts! Did I fail to create a congenial atmosphere where he could have trusted me to at least tell me he was going somewhere else? Am I not the best for this particular procedure? What happened that changed his trust and faith in me? What did I do wrong? Do people now perceive that I am not good enough?
And then after some time, comes the acceptance of the fact that people are people, and especially as patients, and that too when the patient is a child, unpredictable and sometimes irrational as well.
It is a patient’s right to take multiple opinions especially in complicated situations or when the condition is uncommon or unusual and requires special expertise or experience that just a few possess. A patient then makes a choice to go with a particular physician or surgeon based on a combination of faith, personal comfort levels and some subjective assessment of the doctor’s abilities.
But if a patient has made multiple appointments or fixed dates for procedures or surgeries, it is common courtesy to inform all the others that he won’t be coming, once the treating doctor has been decided. And it’s not as if doctors work like Sicilian mafia cartels and will make a patient’s life miserable if he goes somewhere else.
In the days before cell-phones and email, people often had the excuse of not being able to communicate with doctors in time. Today, that is no longer an excuse.
Doctors are humans too! And common courtesies work both ways. If doctors are expected to be upfront, empathic and nice, patients also need to respond in a similar manner. Not being a “no-show” is a good place to start!