Cherry-picking in healthcare

Cherries are delicious and wild fruits that grow on trees. If you want to pick some cherries, you would normally select the ripest and the healthiest. And you want to expend minimal efforts, by picking the easier ones to reach, and possibly ignoring some juicier ones higher up the cherry tree.

Few Nairobians realize that healthcare is to some extent similar to cherry-picking. Walk randomly into selected doctors’ offices, and this may become clearer. You are likely to see lots of smiley faces, not so sickly. More like ripe and juicy cherries. Ever wondered whether this happens by default, or by design?

Cherry-picking in healthcare involves pre-selection of patients who are already in relatively good health. This translates into less demand from the health service. Many practices want to expend less energy and resources. Complex cases require longer consultation time, more tests and cross-references among specialists. Why not make things simpler by deliberately seeing mostly healthier patients and filtering the rest to others? May all sound unfair, but makes sense in many aspects if you think about it.

You are likely to get filtered out by a practice depending on many factors. If you have chronic and complex illnesses, you may not be particularly favored. You might be unlucky to have diabetes, hypertension, obesity and heart disease all in one. It takes some extra effort and resources to sort all that at once. You can therefore understand why you may not be wanted, despite carefully selecting your care providers. It takes too much time to see you, go through all your problems, do some tests, give advice and finally fill in a prescription with multiple drugs.Phew, much easier to cherry-pick a simpler patient and get you to be seen by others!

Other reasons for cherry-picking include patients who are disrespectful, or those who accumulate unpaid bills. Clinicians will find it hard to stand you if you are discourteous.They would rather have you delisted from their practice, and be seen elsewhere. Not honoring your bills in good time means the practice may struggle running an efficient service. You will not be wanted.

So what can you do to get cherry-picked by your favored clinicians? For starters, keep yourself as healthy as possible. Maintain a normal weight with healthier foods and physical exercises. Get new symptoms checked in good time. Be up to date with routine preventive tests, be courteous and pay your doctor’s bills timely.

If constantly told all appointment slots are full, or you hear suggestions to try the practice next door, your time may be up. If a practice weeds you out, you can always seek some redress. Ask why they don’t want you anymore. You are owed an explanation and a referral to another care provider. Physicians have the right not to see you, unless it’s a life-threatening emergency. Unfair yes, but happens more often than you think.