Medication and Marginalization

I am the last liberal-arts-major on earth I ever thought would be messing around with my own medication.

Why I am... how I have come to this... makes for a nice little study of marginalization.

Like most medical offices, my specialist is set up to communicate by phone.  
Of course, one can't just call in and expect the doctor to pick up the line.  One leaves a message, and, in between handling scheduled appointments and immediate emergencies and other business, one's care provider calls back as soon as they can.

You know how this goes-- you leave a message with the front desk, a care provider calls back while you're in a meeting or in traffic, you call back and they are with another patient again, and the game of tag continues for a couple-three days until the lucky window lines up where you actually speak with each other.

Unless you're working blue-collar.

Is it common for a barista stop midorder to grab her ringing phone? For a customer to have to bag their own groceries because the bagger got in a call he just had to take? To see a member of the road crew hand off their stop sign to take an important call?

The great majority of blue collar jobs-- which are the great majority of jobs-- have a *zero* tolerance policy for personal calls.  

We're not talking about the white collar "no-personal-calls-except-your-doctor-your-mechanic-and-your-family-emergency" policy of office spaces, we are talking, if you are on the clock and your cell phone even rings you get fired.  

You can try to listen to your messages and make your calls on your break, when and if you get your break, if you have a cell phone and if the area provided to you to take your break in is a place you can actually hear somebody on the phone.  I remember going three days without food, sitting down or bathroom breaks for six hours at a stretch trying to get through to one particular office. In other words, if you work blue collar... your odds of lining up that lucky window to actually talk to your care provider within a week may be very slim indeed.

That's the class barrier.  Now let's talk capacity. 
What if you don't speak English well and need to set up ahead of time to have a translator with you when you are talking to your doctor?  
What if you have hearing impairments or speech impediments or neurological challenges or whatnot and need to be at the one location with your special equipment to return that call?
What if you have psychiatric issues, cognitive fog, fatigue, arthritis or any other "flare-up" conditions where you do not know ahead of time day by day when or if you will be capable of making and receiving a phone call?

Now, right now, medical office communications are set up by centering what's possible for able-bodied white-collar English-speakers.
What would an alternative look like?

It would look like increasing the options.  My husband's Health Co-op makes sure every patient has a way to EMAIL their care team.  For a non-English speaker working a blue collar day job, this could look like going to the library after work with a friend to check messages and reply.  Then there is the actual dedicated voicemail option, where a patient gets to leave a detailed message directly with the care provider they need an answer from, creating the possibility of getting an answer without actually having to make the magic real-time window happen.  An office could create a phone tree that allows the patient to choose a formal phone appointment the next day-- giving them time to get their assistant or equipment or manager's support all lined up ready for when that phone call comes in.

It's not instant, it's not easy, but it isn't impossible, either.
Any one of these would have saved me from taking the steroids leftover from the last time I went through this... because I can't get through.

Resource List: How to Dialogue

Deborah Tannen's _Argument Culture_ Introduction online as featured by the Washington Post

"The Other Side is Not Dumb"  by Sean Blanda, 1/2016
Discussion of how social media snowballs into echo-chambers

"How to Criticize with Kindness" Marie Popova's summary of Daniel Dennett's four steps to arguing intelligently.