I hate patient intake forms, don’t you?
Here’s what bothers me:
Typically, these forms are delivered to us attached to a clipboard, by a harried front desk person who is busy juggling incoming phone calls and insurance co-pays.
These forms have way too many spaces to be filled in. Empty places for the basics: name, address, city, state, zip code. Boxes for date of birth, social security number, emergency contact phone number. A whole section for insurance information. Don’t they have most of this information already on file in a database somewhere? Can’t they just print it out and ask me to edit it?
Then there’s the medical history section. I always smile when I get to the questions about recent surgeries. The forms offer a mere two lines for the patient’s response. If I’m feeling particularly ornery in the waiting room that day, I will fill the entire space by block printing:
SORRY, THERE IS NOT ENOUGH SPACE HERE FOR ME TO LIST THEM ALL. HEY, CAN YOU SPARE SOME MORE LINES? I AM A CANCER SURVIVOR.
But it wasn’t until I connected with Connie Thompson Titus’ cancer memoir that I realized that the real problem with patient intake forms is that there’s absolutely no place on them to explain to your doctor who you really are.
Read on to see what Connie shared with her oncologist in one of a series of letters to him.
Her Doctor Prescribes Dancing at Daybreak by Connie Thompson Titus
Oklahoma: Tate Publishing, 2008.
Your patient history form leaves little room for essentials. Before we talk about any treatment, please study my chemical makeup thus far.
I am dotted swiss and seersucker, black patent leather shoes, and fancy panties; I am forever plaid; I am saddle shoes, barrettes, and baby beers from A&W Root Beer stand.
I am a shiny blue Huffy bicycle capable of high speed, a metal lunch pail with milk money, a bomb scare, and a polio vaccine; I am a Brownie camera, a Brownie Girl Scout, and a chewy brownie (in my metal lunch pail).
I am Tiddly-Winks, Jacks, Hopscotch, Silly Putty, Paint by Number and View Master; I am a jump rope with red handles that give way to rip out Cassie Walker’s front teeth…
I am related to Mr. Potato Head and Chatty Cathy, Captain Kangaroo, Dick, Jane, Spot, Sally and Father Knows Best; I am a Barbie doll mixed with skullduggery in the closet; I am old Mr. and Mrs. Cotter’s pesky visitor on their porch swing – he with his pipe, she with her knitting, me talking a mile a minute.
I am an acorn, an autumn leaf; I am a lilac, a tulip, and a peony; I am several litters of furry, purring kittens; I am a bonfire and fried potatoes on camp stoves; I am a tree house and a pink fort…
Even though I have three older sisters, I represent another generation, causing me to behave as an only child. I like to establish strong contact with the teacher. I wish to be in the limelight, under the guidance and protection of older people and people in positions of authority. Superiors, colleagues, and friends are to be what my parents were for me. Please, please, please make me your dearest child.
Whew. This is a big bill. Can you fill it? No, you cannot fill it. If every only-child patient demanded this from you, you would be a dead man…
I do feel better writing down the inner chemistry of Connie Titus. Digging deep to my roots builds a bit of security. Maybe there is a survivor in there after all.
The biggest problem is my red plaid dress. It now hangs crooked on the left side. What can you do about this?
Signed, a forever plaid patient,