Where’s Your Hut?
By David E McCarty, MD FAASM (but you can call me Dave)
People feel comfortable at the Coffee Hut.
Walk right in…set right down…
That was our opening premise, our core truth, our Ground Zero.
People feel comfortable at the Coffee Hut.
If you’ve read our book, traipsed around our website, or listened to our podcast (hint: Episode 3!) you’ll know that the Coffee Hut is where the most important discussion about Sleep Apnea takes place.
The Coffee Hut is where you talk about the Five Reasons To Treat, you see.
The Coffee Hut is distinct from the FIVE REASONS MONUMENT, which is towering, imposing, and permanent. The FIVE REASONS MONUMENT is supposed to make you say: Whoah!
It’s supposed to make you gasp, just a bit. It’s a Sphinx.
The Coffee Hut, by comparison, is a human-scaled place, a comforting place, a place where time stands still.
At the Coffee Hut, there’s no rush. At the Coffee Hut, nobody else is waiting for you to leave. At the Coffee Hut, the music is always sweet and unnameable, and the staff are always good-humored and available.
At the Coffee Hut, you don’t have to pay for the service, or the food.
Not money, anyway.
You DO have to… pay attention… (tee hee!).
In modern medicine, the clock is always ticking, you see? The demand for Sleep Medicine services is high, and most schedules are full, with a waiting list lasting weeks to months. Most providers have 15-30 minutes of time to complete the entire encounter, which includes the interview, physical exam, discussion, education, counseling, and charting.
Read that again: the doc walks in the room and they’ve gotta be done with their note and moving on to the next patient in less than 30 minutes.
When you parse out all the different things going on, it leaves maybe 10 minutes for education, and that’s being generous. For 15-minute encounters, you’ll be lucky to get 5 minutes of teaching.
As I said: the clock is ticking.
Everybody’s heard the story about that research study, where they surreptitiously videotaped doctors talking to their patients, and it took them, on average, about 12 seconds to interrupt their patient and start mansplaining everything.
Alright. That’s not exactly how it went. But, you get the idea. It’s not that doctors are naturally rude. It’s that…DOCTORS FEEL RUSHED.
Doctors—particularly primary care doctors—have so many things to think about for EVERY SINGLE ENCOUNTER.
In addition to thinking about you, your medical problems, your personal safety, your refills, and your preventative care health (have you ever tried talking to a science-denying flat-earther about blood-pressure management?), your doctor must also come up with a plan for the random things you happen to bring up during the visit, and still somehow micromanage the allocation of all these data into specific parts of the electronic health record, failing which…they may not get paid for the encounter at all.
It's like a carnival game. Step up! Step up! Find the code that’ll get you compensated! Try put the ball in the hole! Everybody step up! Play to win!
You ever wonder why your doctor is spending so much time looking at their computer screen?
Well, now you know.
All of this is to say that our current medical healthcare system is an inhospitable place to introduce nuanced, individualized education about the complex beast known as Sleep Apnea.
There is just no time for it.
There are valiant exceptions, of course. There are providers who run perpetually behind, because they’ll always take the time needed, to square their patients away. There are providers who work well past darkness, and on weekends, and on holidays, with no expectation that they’ll be compensated financially for working on their time off. There are providers who’ll return phone calls, stay on interminable hold for insurance coverage reviews, fill out pointless barrier-inducing forms for medications that have already been approved, and generally go the extra mile for their patients, even at the risk of early professional burnout.
These providers carry the burden of our fragmented system on their very backs. So, the next time your provider runs a little late, consider a genuine face-looking stare and a thank you. It’s not easy, and it’s often the opposite of fun to work that way, but sometimes, it’s the only way.
So: feel me. My hand on my heart to you, siblings-in-arms! This educational crisis is not your fault!
Carry on, with courage, good people. Fight for your patients!
Courage! Courage!
However.
This recognition of individual provider valor DOES NOT change the fact that, when it comes to education and nuanced coaching for Sleep Apnea, there’s just no time for it, not with the current fee-structure, anyway.
It’s too complicated a discussion, and ten minutes is just not enough.
At the Coffee Hut, on the other hand, you can slow down. At the Coffee Hut, you can digest the information at your own rate. Back up and ask questions, if you want.
At the Coffee Hut, nobody’s even talking about treatment strategies. It’s way too soon for that.
The Coffee Hut is our mental projection of the place where we’d feel utterly at peace, looking over a new map, a cool unknown object, a fascinating puzzle. The Coffee Hut is nonthreatening, and unpressured.
The Coffee Hit is our private space, where that enviable brain state known as flow is possible.
So, with that in mind…where’s your Hut? Where’s your zen-like peaceful space, where new adventures are met with giddy excitement? Where’s your spot, where newness means fun?
Can you picture it? You know you’ve got it when your eyes get wide and your ears prick up. You’ll know you’ve got it when you start to smile before your face changes.
Is it a beach? A porch? On the side of a mountain?
Or is it a converted Denver & Rio Grande dining car, with a Wurlitzer jukebox in the corner?
Find it, Life-Fans. Find it!
For some of us, the Hut may be the most important place of all.
With that said, and with no further introduction, I’ll take us back to the adventures of our friends Claudio and Kate…a little something I’m calling…Where’s Your Hut?
Happy Friday, Life-Fans!
