Medical Onboarding: The Problem

I was born with a congenital heart defect, something that has given me a lot of experience with doctors and hospitals. Unless I’m talking to my cardiologist, I know a lot more about my heart defect than anyone else in the room and I’ve learned how to navigate those conversations with everyone from urgent care to my primary doctor.

The ease of these conversations are helped by the usual things: money, good insurance, whiteness, etc. But they’re also helped because as the patient I have confidence in what I know and also how to get more information as needed. My heart defect has taught me how to spot with doctors as partners, with all the good and bad of any partnership.

And then in 2019 I broke my arm. I don’t recommend this. Moreover, I had to switch my follow up care from the hospital where I had gone to another hospital and the process made me remember how frustrating it is when not only do you not know what you don’t know, but you are the doctor aren’t even on the same page about that knowledge. I barely knew the name of the type of break I had and suddenly I was having to make a decision about surgery. It wasn’t fun and reminded me that so often going to a new doctor is chaotic, confusing, and limits your ability to advocate for yourself. It also made me think about how to fix it.

There are obviously more issues and complexities with the medical system than I, a lay person, could ever understand. But the specific issue of how to get you and a new doctor on the same page—and moreover, how to make communication easier—does seem solvable. I think doctors need to improve onboarding.

So often the first experience people have of a doctor’s office is filling out lots and lots of forms related to insurance and medical history and everything else depends on your level of preparation and what kind of person the doctor is. If you’re like me you might write down some questions beforehand, but you may also be sick and healing and not have the presence of mind for that. You may not even know what questions to ask.

There are many places where the appointment can become stressful, but so often that stress is generated by not being aligned with the doctor about why you’re there, what you know, and what your goals are. We need better ways to let patients talk about their knowledge and fears and offer the time and space for doctors to prepare for that.

My project, which I’ll continue to update on, is to take the ideas I have about what I look like and flesh them out. I have some ideas about the look, the personas, and how this could be used—I don’t think I will solve any great problem, but ideally I’ll make it a little easier to speak with a new doctor.