A few months ago I began to receive e-mails from Fraser Health concerning discharge summaries. Previously, entering a patient’s details about his or her hospital stay by hand on the form provided had been acceptable. These forms were being phased out and, going forward, all discharges would have to be dictated. Now, I don’t like being told what to do, so when these e-mails began to infiltrate my inbox, imagine my surprise when Fraser Health thanked me for my over 20 years of service and apologized for any inconvenience the new process might cause, asking for my patience during this transition phase. Except that’s not what happened. To paraphrase, the gist of the e-mails was start dictating your summaries or your hospital privileges will be suspended. 

It is entirely possible that this got my back up and I began to dream of ways to sabotage the process. I might have uttered these words while pouting, “Take away my privileges and see if I care; they are more like onerous duties anyway.”

After receiving even more e-mails, now stating that I had overdue summaries, which if not dictated within a week would result in my suspension, I might have vented in the hospital mailroom about this draconian action. Upon hearing my rant one of my more level-headed colleagues might have mentioned that the practice of dictating discharge summaries was actually good for patient care so I should swallow my pride and just do it. Since I don’t want to embarrass this clearly misguided but rational, excellent physician, Dr Philip Cilliers, I won’t mention him by name.

Now shamed, I presented myself to the hospital dictation room on my next available rounds day to complete my dictations. Following the helpful instructions plastered all over the walls, I dialed the dictation number and entered my unique ID (MSP number) as prompted, which is 7787. The system then told me to contact dictation services as there was a problem (how do they know about all my unpaid parking tickets, I wondered). The conversation with the nice woman who answered went something like this: “What is your first and last name?” she asked.

“David Richardson,” I answered.

“David R. Richardson from Langley?” she queried, and upon hearing the affirmative she added, “What is your e-mail address?”

Taking a moment to bite my tongue, I replied, “Since you have sent me close to 10 threatening e-mails about this issue, I think you already have it!”

After a pause, “Well, if you don’t give it to me I can’t send you your unique ID.”

“blahblah@gmail.com [11]”

“Thank you, and now could you please give me your office address?”

Biting harder, “How is it possible you don’t have it as I have been working in Langley at the same location for over 20 years and you just looked me up in the system?” But remembering Rational Phil, I gave it to her.

Another pause, “What is your phone number?” Thud (sound of my head hitting the table), and so it went until, when she was finally done, I pleaded, “So now can I have my dictation number?”

“No, I have to send your request to a systems analyst.”

“But I am ready to dictate now and, seriously, how complicated can it be to give me a number?”

“Well, I will put a rush on it and you will get it later today.”

“Listen, I’m not coming back today and in fact I won’t be back for 2 weeks, so how about in the meantime you stop sending me threatening e-mails?”

“That isn’t our department.” Double thud!

I eventually received my ID and it is possible that one of my dictations states, “patient was sick, we did some tests, gave some treatment, and they got better, not sure why.”

By the way, the unique dictation ID I received after a few days of intense analysis was 7787.
—DRR