June 7, 2018

Today I Bring You a Mini Health Care Mystery Starring . . . Tylenol!

Vince Talotta/The Toronto Star/ZUMA

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Here’s a peculiar health care story. It is extremely non-momentous, but entertaining in its own way. I’m not sure if there are any lessons to be drawn from it.

Every Thursday I go to my local infusion center for chemotherapy. However, I’m supposed to wake up early and take both Zyrtec and the evil dex a couple of hours before I go in.

So I did this on the first day, and when I got there they gave me a couple of Tylenol just in case the meds produce a fever. No problem. I gulped them down. Then this:

OK, I’m ready to go.

First we have to wait an hour for the Tylenol to kick in.

Wait. What? I’m taking all this other stuff beforehand, why not take the Tylenol at home too?

Oh, they have us give the Tylenol here.

But if you trust me take the other stuff, why not trust me to take the Tylenol?

Um…no one’s ever asked that before.

I’ll be the first! Next week can I take the Tylenol at home so we can start right away?

Well…

A couple of hours later, the nurse came by and whispered to me in faux conspiratorial tones: Go ahead and take the Tylenol at home next week. Better to beg forgiveness than ask permission, eh?

So I did and there was indeed no problem. I did the same this week, and happened to have a nurse I’ve never seen before:

Did you take your meds?

You bet. Zyrtec, dex, and Tylenol.

[Eyes little cup of Tylenol she already has out.] Oh, you took the Tylenol too?

You bet.

You’re the first person who’s ever done that! We can get started right away.

So what’s the deal here? Taking the Tylenol at home seems obvious. It occurred to me immediately because—well, truthfully, because it instantly tripped my annoyance alarm. But annoyance aside, taking the Tylenol at home does cut down the visit by an hour. That’s good for the patients (nobody wants to while away their day in an infusion center) and good for the infusion center (it opens up a chair sooner).

How is it possible that no one has ever thought of this before? The nurses seemed genuinely surprised when I asked about it, and it can’t be part of an explicit procedure since they agreed to change things for me. What’s more, they also seemed genuinely pleased by this revelation since it pretty obviously improves efficiency at no cost.

Today’s nurse suggested that they administered the Tylenol because not everyone has Tylenol at home. True, but it’s cheap and easy to get. And that doesn’t explain why no patient has ever asked about this. What am I missing?

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