We have four doctors. We do announce to the waiting room periodically that Dr. X is running however far behind and offer to reschedule (although, it doesn’t happen that often). I agree and empathize with people that have to wait long periods- I do. When I see my own PCP, I often have to wait one or two hours. But he’s so nice and thoughtful in other ways, that he doesn’t even give you the courtesy of letting you be mad at him. I love him as a doctor, and so his waits are worth it to me. If they weren’t, I’d find another doctor. But I wouldn’t go off on his staff about it.
Not when every 15 minutes is double- or triple-booked, all day long.
Re: dentist appointments taking an hour. I had my six-month check-up on Tuesday, scheduled for 4 p.m. Waited until 4:25 to be called back (I was almost at my personal limit). Called back, x-rayed, cleaned and polished by the hygienist, dentist viewed xrays, examined/poked at by the dentist, he used ultrasonic to get the tartar off the gumline, done.
25 minutes, total. I’m 42.
I’m not condoning abuse but it is your job, as the administrative staff, to take patient complaints on board and do something about them. If the doctors aren’t letting you do your job in running the office while they attend to patient care, that’s not the patients’ fault.
Who said anything about lecturing them. There’s a problem, you work together to fix it. If making sure that your office isn’t providing optimal customer satisfaction isn’t in your job description, then you don’t need to be working in a customer-facing position.
In that case even being on time wouldn’t help.
Has anyone in this thread even suggested yelling at the staff? I must have missed that.
I’m not administrative staff, I’m clinical. I don’t set policy. And two patients every 15 minutes is standard (new patients get 30), and then there are those established patients that demand to be seen, causing triple books often. My peeve here is that I have nothing to do with insurance contracts, how many patients are scheduled when, the request for you to arrive early for paperwork, or how long the doctor takes to come see you. And yet I take a lot of flack for all of those things. I really should get paid more.
So something has to give. Someone coming in for a physical takes lower precedence than the person who thinks that they have strep or a UTI. Triage is a time honored medical practice.
Bigger bolder question: if you’re part of the clinical staff, how do you ethically work in a situation where a patient gets 7.5 minutes of face time with a doctor, if they’re lucky? Is it possible in any way, shape or fashion to conduct anything more serious than a hangnail in 7.5 minutes? I wonder how many of those thousands of fatal (and even more non-fatal) medical errors are a result of attempting to treat patients in less time than it takes to scramble an egg and make some toast.
It seems to me that if more doctors and nurses (and other clinical staff, in fact, perhaps especially the nurses and other clinical staff) refused to work under these circumstances, perhaps someone might finally tell the *@&)#! insurance companies that enough is enough and things would start to improve for the better for all of us.
We’d just get more and more overbooked doctors’ offices. Plenty of doctors have bailed on high malpractice insurance specialties like OB-GYN, and those insurance companies haven’t “come to their senses” or anything.
If patients tell doctors that their overbooking practices are awful and do them a disservice, smart doctors will listen. If their staff says something and their patients don’t? Staff are being ‘whiny’. They’re ‘afraid’ of hard work.
Possibly, depending on what kind of jam they’re in, the doctors will decide they don’t have any options - the way many offices run, they need every patient they can get because insurance companies won’t pay more per visit.
What do you think insurance companies will do, by the way, if doctors complain? Because doctors do, all the time; contracts are frequently renegotiated. If doctors insist that they need to be paid more for their visits, this gets pushed back onto the payers into the insurance (the patient/policyholder, the employer). Your premiums go up, your copays go up.
I’ve seen cases where large medical centers and major insurance companies go through their negotiations and the result is that they can’t come to a decision. If your doctor complains too much, you might get a call from their office saying, “We can’t take your insurance any longer, sorry.” These impasses can go on for a year or more. As an employee of a medical center, I was once even told that our own insurance company was being cut at the end of the year and so we’d have a new provider. Thus the insurer lost thousands of insured people as customers - not to mention the business of that medical center until the dispute was settled. (That’s a good reason for confirming that a clinic will take your insurance, BTW, before you go there.)
I usually show up 15 minutes early to all my medical appointments. This is because regardless of the appointment time, most doctors work under the “first come, first served” system.. If, by chance, a doctor isn’t doing FCFS, then I’m on time. But if they are, I’m in and out that much earlier.
Cleaning with “full release”?
I had no idea Tom Coughlin was a doctor as well.
Where I work “Identifying and resolving process issues which lead to reduced customer satisfaction” is part of everyone’s job description. Money’s tight, and we need to give people a damn good reason to give us some of theirs. But hey, to each their own.
[Utopian optimism]
One of these days some bright cookie is going to open up a no-bullshit clinic and there will be much wailing and gnashing of teeth in his competitors offices.
[/UO]
(Don’t pee on my parade, let me have my dream!!)
I can just see it - everyone will come at exactly the right time and no one will have any issues that take longer than 15 minutes to deal with - or if someone does, the drs will say, “screw this, I have people waiting!”
And once again it is demonstrated that we are all being held entirely hostage by the broken profit-making machinations of the insurance companies.
People, we are a smart, industrious, imaginative nation. We can do better!
I have never yet seen an outpatient clinic that schedules like this. In the world of outpatient medicine, a UTI does not necessarily take precedence over a physical. And I’ve never seen a doc move a physical just so the UTI or strep can be seen first. Triage applies to the ER - where time differences could affect care and patient outcome. Getting your antibiotics script to treat the UTI two hours earlier isn’t going to change a damn thing for the patient. Odds are they’ll end up waiting another two hours in a CVS to actually fill the script anyway.
Actually, now that I think about it - triage doesn’t even apply to inpatient medicine either. We typically round by room order, not by degree of patient illness.
I hate outpatient medicine, so I will otherwise stay out of this discussion. As far as I’m concerned, hell is outpatient clinic and a waiting room full of people with back pain.
It means two hours of more pain if the patient has to wait that time. The waiting room is not a great place to be in pain. It’s a public place, and there’s no place to lie down and moan, and there’s usually only one restroom, so one cannot go there to deal with diarrhea and suchlike. In a couple of instances, I’ve seen someone brought in by a spouse, obviously in severe pain, and I have gone up to the front office and offered up my slot. Once, I stayed, and accepted a longer wait in the lounge. Once, I rescheduled, because it was just a followup appointment. I don’t expect the doctor or front office to do triage according to pain. However, if I have an appointment, and don’t have another time-critical task, and I see someone in pain…I’ll offer to take a later office visit.
The doctors and dentist I go to take pain seriously. And so does everyone on their staffs. They will do their best to get a patient comfortable as soon as possible. IME, getting an antibiotic scrip, getting it filled, and getting home to recover as soon as possible leads to quicker pain relief, if only because I find my own home more comfortable than a waiting room.
It means two hours of more pain if the patient has to wait that time. The waiting room is not a great place to be in pain. It’s a public place, and there’s no place to lie down and moan, and there’s usually only one restroom, so one cannot go there to deal with diarrhea and suchlike. In a couple of instances, I’ve seen someone brought in by a spouse, obviously in severe pain, and I have gone up to the front office and offered up my slot. Once, I stayed, and accepted a longer wait in the lounge. Once, I rescheduled, because it was just a followup appointment. I don’t expect the doctor or front office to do triage according to pain. However, if I have an appointment, and don’t have another time-critical task, and I see someone in pain…I’ll offer to take a later office visit.
The doctors and dentist I go to take pain seriously. And so does everyone on their staffs. They will do their best to get a patient comfortable as soon as possible. IME, getting an antibiotic scrip, getting it filled, and getting home to recover as soon as possible leads to quicker pain relief, if only because I find my own home more comfortable than a waiting room.
So…if you do have a time-critical task, you are okay making them wait? “Man, I’d let you go first, but I really have to get my daughter from school - guess you’ll have to sit there and moan. Sorry.”
Look - I don’t know what to say here. Most people come to the doctor’s because they have a medical problem. Even if they are “just” in for a physical, they probably have other medical conditions that need to be managed. Maybe they have terrible arthritis and sitting in the waiting room chairs is painful. This doesn’t mean that the doc is not taking someone’s pain seriously. In an ideal world, everyone would be seen instantly, at home. But that’s not how it works, and scheduling appointments is the most practical thing to do. If you want to give up your appointment for someone else, that is very kind of you. It shouldn’t affect outpatient scheduling though. If you are in really, really terrible pain, go to the ER. They have all the good drugs anyway.
Honestly - stuff like this is why I hate outpatient medicine. You work long hours, get yelled at constantly because all doctors are quacks and out to screw the patients over, and at the end of the day, no one is ever happy.
Getting older doesn’t necessarily mean cleaning appointments take longer; it depends on your individual physiology and tooth care. I floss after every single time I eat, my cleaning appointments take about 15 minutes total, and I’m in my 50s. My husband’s take a bit longer because apparently he has some weird physiology that contributes to the growth of plaque, but that gets resolved by him going in more frequently for cleanings rather than them taking an hour. Plus they use some sonic equipment or some such at our dentist’s office that definitely is faster than the old scrape-scrape-scrape method, and seems to be far more effective, too.
As for waiting times at doctors’ offices, if I walk in to a full waiting room I ask how long the wait is, and if I really can’t spare the time, I’ll reschedule on the spot. Worst case scenario I don’t give them more than half an hour before starting to ask them when I’ll get seen. I don’t abuse the staff, but I also don’t turn into a little sheep and just sit there all day, either. I point out that I’m self-employed, so when I’m not working I’m not getting paid. If I get a reasonable explanation, I’ll sit tight; but if it’s nothing urgent, I’ll often reschedule. I usually deal with only two doctors, and they both know that I’m impatient but reasonable if I’m treated fairly, so we get along fine.
My favorite family doctor was one who let new patients know that he booked patients based on needing no more than 10 minutes per patient, so if you needed extra time, you had to book it in advance; in return, he was always on time. I never saw more than one person in his (very small) waiting room at any time. And it was no problem booking extra time when I needed it. I’m sure, in a real emergency, he wouldn’t begrudge extra time, but he at least tried to extend the courtesy to his patients of not making us wait all day long.
But I never, ever go armed with less than four hours’ worth of knitting and a good book; emergencies happen to the most careful planners.