Healthcare and Executive Functions

Why accessing healthcare is neither inclusive nor equitable

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Healthcare and executive functions

Something healthcare professionals and policy-makers often seem to overlook is this: It takes a lot of executive functioning and mental energy to regularly access healthcare (or to access it at all).

First, we have to figure out when we want to schedule the appointment and what dates and times will work best for us.

Then we have to contact the doctor’s office.

Many clinics still don’t have online booking, so we have to contact them by phone. This is not accessible for non-speakers, Deaf and Hard of Hearing patients, as well as people who have severe anxiety around phone calls.

Getting through to the office can pose a challenge. Sometimes we repeatedly get a busy signal and have to remember to call back later.

Medical administrators are not secretaries, they often have specialized training for doing admin work in the medical field. This means they have duties which take them away from their desk, including assisting the doctor with patients.

At my GP, if the admin person is away from their desk, the call goes to voicemail. The problem is, the outgoing message instructions patients not to leave a voicemail message unless they need to cancel their appointment. It specifically states that messages will not be returned, and they must call back at a later time to schedule an appointment.

I always leave a message anyway because I am 99% certain I will not remember to call back later, or I won’t have time to continue calling until I happen to get lucky and get through to a human being. I hate the phone to begin with, so I am not interested in having to call multiple times throughout the day.

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Inaccessibility

Eventually we get through to our doctor’s office and connect with a real, live person. While navigating a phone call, we then have to compare the doctor’s (usually limited) availability with our own, finally agreeing on a date and time.

We must remember to write down the appointment, or put it into our electronic calendars, and set reminders (*don’t forget to set extra reminders!).

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Then actually getting to the appointment is a lot of work for many of us.