The 10 Most Annoying Things That Happen During My Work Day—and Perhaps in Yours as Well

Last month I enumerated most during my work day. In this issue I will list the 10 most annoying items that can occur during my daily routine. However, let me say from the outset that despite these unpleasant events, the positive features of the day far outweigh the negative ones. As always, I look forward to receiving comments from readers on .

Irritation Number 1: Form letters from insurance companies suggesting alternative medications for me to prescribe for my patients. I cannot imagine that a functionary sitting at a desk in an insurance company office, someone who has had no contact with my patient, could possibly have anything interesting or valuable to say to me concerning the carefully considered therapeutic program that I have ordered for my patients. I have never found even one of these letters useful. They are a waste of paper and postage. And what is more, they never add to a fund of useful knowledge about the product. I am always open to learning more, but these letters fail to accomplish even the most basic rule of communication.

Irritation Number 2: Direct-to-consumer advertisements on television for various drugs that the announcer suggests should be “discussed with your doctor.” These ads are frequently misleading in their implications, and physicians have too little time now to spend with patients. Conversations about drug advertisements on television only shorten the really important time that needs to be spent discussing the patient’s clinical condition and therapeutic options. Not once in the many years that these commercial messages have been advertised have I written a prescription as a result of these conversations. Patients are invariably taking similar agents already or the drug is contraindicated.

Irritation Number 3: The need to remember or, at least, maintain a constantly changing list of passwords to gain access to various clinical and nonclinical websites. Our hospital and university are constantly requesting changes in these passwords. Although I understand the need for security, there seems to be very little thought behind how to manage this process so that the busy clinician can get to the most important function they fulfill: taking care of patients. I look forward to the day when retinal or fingerprint scans will become the norm for these security measures.

Irritation Number 4: Requiring multiple signatures on various hospital and practice documents. Many of you must also be asked to sign the many orders, statements, and communications that pass across our desks. I have found that electronic signing takes even longer than doing this activity manually. All we can do, I guess, is to hope that some technical advance will obviate the need to sign my name continuously.

Irritation Number 5: Patients who lie to me. These lies often involve the use of illegal street drugs. Of course, the lie becomes immediately evident when we run urine or blood toxicology screening tests. Perhaps I should tell patients up front that we always discover when such agents have been used, and so the best policy is to be truthful right from the beginning of our interaction. These lies, whether based on drug use or not, often prevent me from giving the best medical care as quickly as possible.

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— — Joseph S. Alpert, MD, editor-in-chief, The American Journal of Medicine

This article originally appeared in the September 2011 issue of The American Journal of Medicine.