When your best laid plans don’t work out

“The best laid plans of mice and men often go awry.” And so is true in a medical practice. While careful planning is essential to making things run smoothly in an office, the unexpected happens and things don’t always go as anticipated.

Sometimes, it’s a minor inconvenience. We had a couple of episodes of a backed-up toilet several years ago. It overflowed and, needless to say, it was unpleasant. At least we have another restroom that the patients could use. In both instances, the paper towels had been flushed down the toilet (and we suspect by the same patient). At that point, we eliminated paper towels completely from the room and had an electric hand dryer installed. Hasn’t happened since.

At times, the disruption can really throw a wrench into the works.  Earlier this year, we had trouble with our fax server. Faxes were not being received and they were not being sent. We typically get dozens of lab results, prescription requests and certificates of medical necessity forms, and those forms need to be filled out and sent back in order for patients to get their medications and supplies. Many calls and texts and emails went between us and our IT service provider.  A technician came in more than once before it all got straightened out. But it was a couple of weeks struggling with the issue.

Weather can wreak havoc on a schedule, too. One snow day can cause significant delays in patients being seen for follow up appointments when your schedule is already packed. I don’t know why it took me 10 years to think of this, but I recently told my staff to block one day in January and February as emergency snow days. If we’re lucky and this winter is mild, it is easy enough to fill an empty day with patients on the wait list. Much easier than trying to squeeze 20 patients into a full schedule.

And while one day of bad weather can be hard to deal with, some storms can be truly catastrophic. Granted, we were far enough inland when hurricane Sandy hit New Jersey that we did not sustain physical damage to the building, but we did lose power for several days. And no power means no EHR, no phone, no fax, in addition to no lights. So not only could we not see patients, but I couldn’t even look at patients’ records or send prescriptions. Fortunately, at the time, voicemail was being forwarded to my cell phone (which I charged in my car) so I could call in some prescriptions, but patients with Medicare need to have their prescriptions for testing supplies either sent electronically or by fax, verbal orders are not accepted. I had to go to the hospital and use the fax there to send prescriptions.

So while we do our best each day to lay out plans to keep things efficient, one must be prepared to deal with the unexpected and to accept that some things are beyond our control.