Why can't hospital outpatient clinics cope with patients who can't sit for long in the waiting room? Or can they?

darrellpf said:
Another characteristic of adults with autism is "masking". We can work very hard to hide our traits and blend in. Many gay men realize that being in the closet is draining. Masking is more like being an actor in character 24/7, even with family and close friends. We are often only our true selves when completely alone.

I don't want to be special or get any attention, even in a doctor's office.
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That sounds like really hard work, @darrellpf! I don't know whether it might help you to know that I've always zero weird reactions from doctors to my request to lie on the couch. I've never got any vibe off them that it makes me feel that they're treating me or seeing me as in any way special or seeking attention. They just calmly accept it, I thank them, and get on the couch.
 
There just doesn't seem to be much consideration for the human element at all. Something they just never got around to thinking about and it's been this way for so long that no one can find the wit to point out how absurd it is. No doubt the usual response is the same we are familiar with: we've always done things this way.
hotblack said:
Hospitals are setup for the convenience of those that work there not for patients. I’m not saying they’re great for people that work there either mind! There are wider problems. But anyone who has spoken to a consultant’s secretary or read just about any hospital letter knows who is seen as the most important in this setup.
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Hospitals and clinics both are built to be utilitarian, but if androids were involved on both sides of the job. I remember one time going to see my GP who works in a medium-sized clinic. Before she had an OK office with a window, something you'd maybe give to lower-level management in a typical small business office. But this time she worked out of what is basically a closet. Just a tiny room with no window, barely any ventilation and exactly zero consideration to pretend that this is a place where humans do anything. A dreadful place to be in for 10 minutes, I can barely imagine spending 10-12h working there.

No wonder most HCPs are so unhappy. Those are worse working conditions than almost any other entry-level job outside of things like meat-packing or very dirty jobs that pay minimum wage. The facilities are built to process as many cases and equipment as possible, but there isn't any consideration that the HCPs are human as well, no more than that the patients also happen to be. I don't know who makes decisions at this level, what their expertise is, though it must vary a lot since they all seem to be made locally and independently. There is no human design or architecture involved, that's for sure. It's a warehouse mentality. Bare everything, dreadful environment that screams: you don't want to be here a minute more than you have to. But they also don't want to provide the means for people to stay away and only get there on time. Go figure what they even want, they don't want to think about it and no one makes them.

Which shows just how empty the entire biopsychosocial ideology is. It has captured the medical profession over the last few decades, and has made zero impact on one of the easiest 'holistic' thing that could be done to improve this aspect of health care. It's all empty MBA slogans and demotivational posters over there.
 
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Sasha said:
such as the bedbound elderly?
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As has been said, they are trolleyed in. I think in nurses' minds if you aint on a trolley you aint sick.

hotblack said:
Hospitals are setup for the convenience of those that work there not for patients.
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absolutely! as with Dr's surgeries, dentists, everything is about the convenience and what is best for the staff. I understand this enables them to be efficient and do their jobs, but surely their jobs would also be easier if their patiets are compos mentis when they get into the consult, not laid out collapsed barely able to string a sentence together

Sasha said:
I've always zero weird reactions from doctors to my request to lie on the couch. I've never got any vibe off them that it makes me feel that they're treating me or seeing me as in any way special or seeking attention. They just calmly accept it,
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I'm astonished by this. What do you give as your reason?
 
In my experience i always go with a carer who pushes my wheelchair. I take a little fold up step stool and a cushion and elevate my legs on it. I recline the car seat fully on the way there & I wear maximum sensory blockage - ear plugs plus ear defenders, sun glasses plus sun visor. This and the carer pushing the chair usually mentally flags me as 'unusual/has difficulties'. The carer asks for music to be turned off.
Then after about 10mins sitting there like that i usually feel faint & dizzy & carer has to say 'she's feeling very unwell is there somewhere quiet she can lie down please'?

If not I go and lie down on the floor in the corridor while the carer sits waiting for my name to be called. I usually start vomiting by this point as well - this does tend to get the attention of staff & has much, much more effect than ringing up in advance. They are usually not interested in doing anything different than what they usually do.

The problem is in their minds, at best, ME/CFS = being very tired. And they are all very tired and standing up & working, so you can certainly sit there in that chair relaxing (you wimp).
So I'd suggest, if possible, asking at least for a porter to push you to clinic in a wheelchair. Do whatever you can to give visual clues to your being ill. They seem to go by eye unless you have something they know from their training requires something out of the ordinary. Anything a little irregular simply does not 'compute', it wont go in. But if they can actually see you struggling, then the more compassionate ones will usually, in my exp try to help.

I dont believe i would ever go to A&E unless i was taken there by ambulance with heart attack/stroke, compound fracture, bleeding uncontrollably - ie something that was "properly" an emergency that could be seen obviously by staff. If not then frankly I'd sooner just die quietly at home.
 
Stand-off at A&E . . .

Frustrated patient was involved in a stand-off with staff in a busy A&E after his friend brought in a mattress for him to lie down on.

The makeshift bed was dragged into the middle of the emergency unit at Ashford’s William Harvey Hospital as the man grew tired of waiting to be seen.
LINK

I'm glad Sasha brought this issue up because I've been thinking about this for years. I considered rolling up a thin latex foam, tied with a rope, and just big enough for my body to lie on. I wonder if this would be allowed with a letter from your GP?
 
Mij said:
I considered rolling up a thin latex foam, tied with a rope, and just big enough for my body to lie on. I wonder if this would be allowed with a letter from your GP?
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I've thought about the same thing but again, that's us basically lying on the floor. Something needs to happen to give us the same provision made to those making it onto a bed, couch, or trolley - if that's happening for others.
 
Doctors don't even listen to other doctors

I once drove my partner to the ER in Calgary because he was having stomach pains. I told him it was probably appendicitis.

The ER doc admitted him overnight. I'm guessing he didn't meet all the criteria for appendicitis. His appendix burst. They inserted a drain and kept him on lots of antibiotics to let the appendix heal.

When my partner was released the surgeon explained that even those the appendix had healed, chances of another incident were much higher. The surgeon gave him a letter and told him to present it at the hospital in similar circumstances.

A couple of years later we moved to Victoria. When I took my partner to the ER this time, he presented the letter and explained he had the same feeling, etc that he had the previous time. The doc did tests and sent him home. Told him to come back the next day if the pain persisted. When we returned the next day they removed the appendix.

Appendicitis has got to be one of the primordial surgeries in modern medicine. It is far from a rare condition.

If multiple doctors in major hospitals can't get a relatively simple condition right, with no other underlying problems in a healthy 25 year old male, treatment of complex and chronic conditions lags much farther behind.
 
darrellpf said:
Doctors don't even listen to other doctors

I once drove my partner to the ER in Calgary because he was having stomach pains. I told him it was probably appendicitis.

The ER doc admitted him overnight. I'm guessing he didn't meet all the criteria for appendicitis. His appendix burst. They inserted a drain and kept him on lots of antibiotics to let the appendix heal.

When my partner was released the surgeon explained that even those the appendix had healed, chances of another incident were much higher. The surgeon gave him a letter and told him to present it at the hospital in similar circumstances.

A couple of years later we moved to Victoria. When I took my partner to the ER this time, he presented the letter and explained he had the same feeling, etc that he had the previous time. The doc did tests and sent him home. Told him to come back the next day if the pain persisted. When we returned the next day they removed the appendix.

Appendicitis has got to be one of the primordial surgeries in modern medicine. It is far from a rare condition.

If multiple doctors in major hospitals can't get a relatively simple condition right, with no other underlying problems in a healthy 25 year old male, treatment of complex and chronic conditions lags much farther behind.
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In the UK everything has a “pathway” and criteria. He probably didn’t meet the criteria in some way and that’s what they do. Doctors at hospitals seem to be practical working from a call-centre script these days.
 
Last year I had to take myself to the A&E. I arrived about 8am and was sent to an assessment area beside the main A&E dept. What a day it was. I was fortunate enough to grab one of the two lazyboy chairs but lost it temporarily when I had to visit the bathroom.

When I came back I had to sit on a cold hard plastic chair. I felt sorry for everyone. Sick people having to sit on these chairs for hours on end is appalling. I was still there at 6pm.

When I got an email from the hospital a few days later asking how well I was treated I said I was shocked that sick people were having to sit on these cold hard plastic chairs for hours on end. I had a sore cold bum after a half hour.

Really, we should all be taken straight to a bed.

I tolerate sitting for longer now but when my ME was severe I could feel my symptoms flaring up and have to ask if I could lie down somewhere. It is a real problem and I don't like waiting rooms.
 
As an aside: If anyone needs a more robust version of this kind of portable chair (perhaps not for hospital, but maybe the garden), search for fishing bed chairs. You can lie completely flat if need be. I spent an hour on a borrowed one whilst I waited for someone who's been delayed in traffic, and they're definitely comfy!
 
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