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Thursday, August 13, 2009

Been thinking a lot recently about patients' appointment-making habits. They come in all different shapes and sizes here:

1. The patient who calls bright and early with a freshly-sharpened pencil in her hand and an extra behind her ear, with her Day Runner open to the page that represents the day she'd never take lightly. Inside the lines are neatly printed numbers and bullet points, names and contact information, addresses, directions, and price ranges to encompass any possible abortion procedure.

2. The patient who can't quite remember the name of the receptionist she talked to, but it was something like Stacey (Tracey?). She can't remember the clinic name off the top of her head, but has the number circled in the phone book and could access it in a few seconds ("Janie, pass me the yellow pages!"). She may have to reschedule the first appointment she made, but will, rest assured, make the one next Wednesday.

3. The patient might have called three weeks ago. Might have been wrote down pricing information on a Taco Bell napkin while riding shotgun and balancing the cell phone on her shoulder. Said napkin was then used to blot garish lipstick, or so blow a baby's nose, or inadvertently tossed into the bag full of discarded burrito wrappers and cinnamon twist crumbles. An appointment is never actually set.

Having spoken to hundreds of women over the course of my abortion career, I can safely guess by having a quick conversation with them which ones will be OK and which will need some help. I try to be extra careful with those ones. I also try to pinpoint the determinants of patient organization: what is it, demographically, psychosocially, that makes a patient more likely to put all the necessary information in a safe place and stick to a plan to make the appointment happen? Does this have to do with the patient's actually willingness to go through with the abortion? Her sense of self-efficacy for actually achieving an abortion? Or is it a general lack of organizational talent and communication skills? Anything else, or a combination of the above?



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