Counting Down to 90 - Week 1561 - Ghosting - Patients, Doctors and Everyone Else

The Concept Explained

Counting Down to 90 - Week 1579

Why 1579

Bhavin's WritingsBhavin Jankharia

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A few months ago, I had two biopsies scheduled in the morning. After fixing up the appointment and paying an advance, the second patient didn’t turn up and was unreachable…in short had “ghosted” us.

Ghosting is the practice of cutting off all communication suddenly without explanation. This phrase has become popular in the context of dating, but it applies to all human interactions, including patient-doctor and doctor-doctor communication.

The worst ghosting I experienced was around a decade ago when a patient was to come from the Middle East for ablation of an osteoid osteoma. Unfortunately, we had not taken an advance amount (which we started doing after this incident). The staff was in touch with the father, up to the time they were apparently on the way from the airport to our place and then they just did not turn up and stopped taking calls on their Indian and Middle East numbers. We never could figure out what happened. Did they all get into a fatal accident or did they go somewhere else but were leading us all along? 

What would make a patient ghost a doctor? The fear of retaliation? That if they come on the phone and cancel, the staff will lash back? Or threaten them? Or is it embarrassment of some sort? 

It is not as if doctors have some hidden network of communication where they can speak to each other about patients and punish them (seriously, I have been told this by people who really think we all can connect with each other instantly through some underground channel). 

The patient who ghosted us actually came back for a biopsy two months later - apparently the patient had run away to the village and the relative who was in charge of the appointment had felt embarrassed and hence refused to pick up calls, or at least that is what they told us when we asked.

When patients don’t pick up, it also puts extra stress on the staff, who have to spend time, energy and effort trying to connect, because you never know whether it is just an old person not able to understand or whether they have landed up with some complication, or whether there is some other genuine issue. If you are a patient, it is best to pick up the phone and just say, “Sorry, we’ve changed our mind…or we are going to another doctor…or make up some excuse such as…I am not feeling well today…or my mother is not well…”, anything…but just answer the phone.

Have you’ll faced similar issues?

And…do doctors ghost patients? I don’t know. I assume there must be situations where doctors block patients or just refuse to pick up, but that would go against the very tenet of a doctor-patient relationship. And doctors have fixed places they work in and can be always found or reached…so it doesn’t make sense for them to ghost patients. Yes, it may take time to reply or to pick up the phone, sometimes up to 24 hours, depending on the workload or if they are traveling, but does a doctor actually ever ghost a patient? If a situation becomes a medicolegal issue and a patient sues a doctor, then perhaps…but otherwise?

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Bhavin's WritingsBhavin Jankharia

I have been accused of ghosting patients, but this is when patients send WhatsApp messages out of the blue and expect answers. I find WhatsApp a very difficult medium for doctor-patient communication and I transfer all such messages to the staff to deal with and if necessary, connect with the patient for a telephonic conversation. That doesn’t count as ghosting…that is just conversion to another mode of communication.

Then there is the doctor-doctor ghosting. For e.g. I received an email once from a doctor to speak at a conference in Kolkata. Twenty years ago, I would have traveled the 12 plus hours it takes (flight time, time to airport, time at airport, etc) for a 20 mins lecture. No longer. I emailed back saying, “Sorry, but I won’t be able to make it.” There was no further communication. No, “Sorry, it would have been nice if you could have made it. Perhaps another time.” Nothing. Just silence. 

Maybe emails sometimes don’t land where they are supposed to, but the same happens on WhatsApp. A doctor from Bhubaneshwar messaged for a lecture on a Sunday. I messaged back saying, “I no longer do lectures outside Mumbai on Sunday” and that was that. No further communication. Nothing. 

It may not be ghosting in the true sense, and maybe it is just part of the general lack of communication sense among many Indians that includes doctors. Perhaps people just don’t how to respond.

S, my friend from the US who believes in our hard/material progress, and who I mentioned last week sent me this message, “To prove that I’m not some naive pollyanna, I will point out that one of the most annoying things I encountered was the voltage drop - the initial enthusiasm followed by radio silence. It seems that it’s in the national psyche to over promise & under deliver. So many “hey take my Whatsapp number & let’s meet” never matured to fruition. I now take with a huge fist of salt anything”.

Counting Down to 90 - Week 1562 - Hard/Material Progress vs Soft/Non-Material Progress

My perspective bias - too locally embedded to appreciate the “amazing” progress Indian origin visitors see. Their perspective bias, a highlight reel effect of new infrastructure and other shiny changes but insulated from social and daily living issues.

Bhavin's WritingsBhavin Jankharia

Which would mean that we shouldn’t assume it is ghosting when someone refuses to take calls or does not reply. It may just be that this is who we are as a nation…poor personal communicators. 

If you have any examples to share, feel free to do so in the Comments section.