The doctor I visit prescribes me blood pressure medication; my blood pressure is high when the doctor’s office takes measurements.
When measurements are taken, the nurse asks me to rest my arm on my leg. The measurements are taken after in the morning after a cup of coffee. Usually my arm is dangling next to my side. Additionally, healthcare and the system it belongs to challenges my patience. It’s no wonder that my blood pressure is elevated, 138/68 in the office. The doctor is concerned, and contemplates increasing the blood pressure medication.
I take my blood pressure at home, almost at the same time every day. The diastolic (top) number is 112 on average, with a standard deviation of 13 points. I don’t see much volatility between the numbers for the last 5 days, most however around 108 or 113. When I take measurements I use all of the measurement best practices — my arm is level with the top of my heart, the blood pressure cuff is correctly situated, I’m sat down with both feet on the floor, and I don’t attempt to zen out. I’m puling these best practices from Nature — source.
The doctor’s office measurement is 2 standard deviations above the mean, almost 3 — which would make it more significant data-wise. The nurse is not adopting established best practices when taking measurements — it’s clear that the arm position matters. And, I’m starting to experience some dizziness when I change position — my hypothesis is that this is caused by my current dosing of blood pressure medication. I decide to share my thoughts.
I fail to understand why healthcare professionals become so extremely offended at feedback from non-professionals.
Healthcare people appear extremely direct, their bedside manner more-often-than-not leaves a lot to desire, and when I attempt to mirror that bedside manner they find me rude.
Perhaps they’re stressed out and overworked? Well, I’m stressed out and overworked, and I don’t prefer to be on more medication — and I prefer better collected data.
Maybe they believe their expensive credentials are being challenged? That’s a good thing! We learn when we fail. And, at least as it relates to medication that goes into my body, I prefer to be open to data — I am my own n=1 experiment.
Perhaps they’re aware and wish they could do better but this is not the time and place? Then I argue, when is the time and place? Perhaps I should leave feedback on the “healthcare survey” form? I’m convinced that data is used in the aggregate, and any system change is made to appease the median patient — I’m probably an outlier and it wouldn’t make sense to change a system for an outlier.
Of the people that are the hardest for me to understand — healthcare professionals continue to be the subset of humanity that my connection efforts fail. Mirroring communication patterns doesn’t work. Showing the peer-reviewed human/clinical trial preponderance of data doesn’t move the needle, and being gentle only allows the bully to be more of a bully.
I’m not ready to give up… Call me Ahab.
