Real-Life Decision Making -- Solution
You decide to send the letter with every case.
You give the matter a lot of thought. You think of all the pros and cons.
You know that sending the letter in every case will take some time. "But I
have time," you think. "Perhaps I work faster than Mary."
You also know that it will cost something to send the letters. The hospital
will have to pay for the paper, the photocopying, the envelopes and the stamps.
Still, you think, that is not so very much money and the letters will do a
lot of good. They will help remind the doctors that it's time to contact their
patient. Also, the information you receive will ensure your records are complete.
You decide to send the letters routinely. Every physician who treats a
patient with cancer will receive a letter.
After a few months, you realize that this is more work than you realized.
You not only have to send the letters, you have to keep track of the doctor's
responses, too. You are doing a lot more paperwork than before. And, you notice
that some doctors do not respond to your letters at all.
One day, your supervisor calls you into her office. She tells you that
some physicians have phoned her to complain. They are tired of seeing all
these letters on their desks. When there was only an occasional letter, they
noticed it and thought it was important. Now that there are many,
they do not pay as much attention.
She asks why you are suddenly sending so many letters. You explain your
decision to your supervisor. She shakes her head and says, "No, Mary was correct."
She points out that sending these letters routinely takes too much time, costs
money and annoys the physicians.
She asks you to begin making individual decisions regarding when to send
the form letter.
"You need to know that chances are fairly good (that there's been an omission)
before you send the letter," says Linda Mulvihill. She's a board member with
the National Cancer Registrar's Association. "If the physician tells you he
is not using hormone therapy for a medical reason, you need to document that
also. The registry is also the hospital's own report card to make sure their
patients are given the right care."