How Long Would You Wait?

[germdoc]

Guys, as I said I see no reason for inordinate waiting--I'm with you on that. However, just to tweak some of you a little, if the office ticks you off so much, don't go. I'm sure you could lance your own boil or thrombosed hemorrhoid with a little help from the internet...

[LinuxRandal]

Seen both sides.

Now some Dr.'s offices I know, OVERBOOK. Due to both being $$$greedy$$$ and expecting some cancelations, they just never run on time.

I have also seen people demand a discount for THEIR time. I very well understand emergency's and such, but they should have at least been able to communicate that to you, while you waited. Communication is a big part of customer service.

Then again, you could have gotten quick attention, by moving the rooms furniture around, loudly.

I am the type, that even though I know quite a few, and they would help me, I avoid medical treatment unless I am dying.

[drumpriest]

See Jeff, that's the issue. If I make an appointment I expect to be seen when that appointed time arrives. I certainly understand that in medicine there are unforeseen issues with emergency cases, but that's not usually the case. Doctor's offices know that they have patients at a disadvantage, and typically (in my experience, after doing a TON of doctor shopping) abuse it. A 30 minute wait in just about any other profession for a scheduled appointment would lose you the client, it would be considered unacceptable. So to me, if an office is 30 mins behind, they did overbook, clear and simple. They are putting greed for money before the interests of their patients.

I personally know that every minute I'm alive that ticks by while waiting for someone else's poor scheduling skills is a minute drained from my life, and isn't the point of seeing a doctor to lengthen that?

I'm sure with sufficient looking on the internet that you could write a soft shadow shader, or learn 4 limb independence, or learn how to track a kit, or how to produce DVDs, or just about any other job on earth. Heck, I learned from the internet that my orthopedic specialist was full of crap, and I should go to another one. Also learned that my wife's endocrinologist was too lazy to help her until she gets diabetes.

Doctors save lives, a noble profession to be sure, but to me it's brash arrogance to treat patients as though their time is worth less.

And yeah, I'm a little bitter with the medical profession, perhaps it is the sliding hiatal hernia that I now have because the specialist didn't read my chart before trying to destroy my esophagus. Or telling me to ignore a severe loss of motion in an elbow, because they are were used to treating 80 year olds.

[Uncle Cracker]

The thing about appointments is that it's really a misnomer. Those times you are given are merely marking places, to determine the order in which you are seen, and keep you from having to show up first thing in the morning when there are twenty people to be seen before you. Trying to predict what time in the day that the doctor will actually get to you, after seeing everybody else with earlier appointments, is impossible. It would be more relevant if you got those little paper thingies with numbers on them, like the deli or the tag office uses. Otherwise, the only way to keep on time is to cut off the service to those in front at a prescribed time, whether or not all their needs have been met, kind of like a shrink would do.

That said, let me switch sides here for a minute, and say that the practice of scheduling appointments in the morning, an hour before the Doc even arrives for work, is very inconsiderate as well.

[gjat]

The rule of thumb I use to judge whether or not it was too much time waiting for a doctor, is how much attention he/she gives me when they see me.

The doctor can't know exactly what issues and questions every patient has when the appointment is made. If the patient has some issues and questions, I expect the Doctor to give that patient his full attention, even if I'm kept waiting. By the same token, I expect the Doctor to give me his full attention if I have questions, even if the next appointment is kept waiting. When I make an appointment for a Doctor, I view it as a suggested starting time for as long as I need to get looked and and ask questions. I don't make an appointment for 1:20 to 1:30 for 10 minutes of the doctor's time. I always bring a bit of paperwork or a good magazine.

[germdoc]

One thing to point out is that there are a lot of cancellations. Some days 30% of the patients cancel or don't show up. Some practices, not mine, feel that the only way to approach 100% efficiency is to overbook.

Also, a doctor may be booked solid, then Mrs. Smith calls in and says, my foot is turning red, can't the doctor squeeze me in this morning? YOU try telling her no.

Finally, unlike other businesses, medical clinics don't actually charge patients for missed appointments, phone calls, paperwork, appointments that go over the allotted slot, etc. Some insurers like Medicaid don't come close to covering the costs of the service. (Which is why YOUR medical bills are so high, but that's another story.)

[MilDoc]

And then there is the patient who comes in for a simple "cold," which is just what it is, and at the end of the appointment:

"Oh, by the way, I've been having this crushing chest pain every time I cut the grass... and ..."

I guess that patient could be told to schedule another appointment and hope he doesn't DIE the next time the grass needs to be cut.

[cabinetman]

Would the ultimate wait be the one that your appointment is with a pediatrician, and the doctor you need when seen is a gerontologist?
.

[eccentrictinkerer]

Three years ago I took my mother to see her doctor. Mom has Alzheimer's and gets very agitated in strange places. We were taken to an exam room and waited 45 minutes before I asked when we would be seen.

The nurse turned red, apologized, and said she had forgotten to tell the doctor. The Doc also apologized and said that if no one shows in 15 minutes always check with the desk. An honest mistake, I guess.

My own physician is also my friend and neighbor (also a fine woodworker). He is always late, but you have his undivided attention for however long it takes to solve the problem.

I try to make sure I have the first appointment of the day. ( I have needled him about the drug reps that seem to bop in and out ahead of me, so he makes sure it doesnt happen when I'm around. )

[MilDoc]

T...but you have his undivided attention for however long it takes to solve the problem.

Yep. That's what everyone wants and expects, even if it is a 15 minute appointment. So if your appointment takes 20 minutes, and the next patient takes 25 minutes ..... someone is going to be behind.

And if you get 15 minutes and the doc says "Time's up..." well, then you get mad at that too.

Or maybe you call for an apointment but there are none available. But you are really sick and need to be seen. They "squeeze you in" and someone will have to wait.

Some docs just can't stay on schedule, and some overbook, and that shouldn't happen. Rather than just get upset, try asking why your wait was so long. If there isn't a good reason go elsewhere.

If there is, it's usually because you will get the time you need too, even if we have to squeeze you in. That's the way my office runs.

[leehljp]

Or maybe you call for an apointment but there are none available. But you are really sick and need to be seen. They "squeeze you in" and someone will have to wait.

I did that 2 years ago when I had a run in with a rotted tree and broke out in all kinds of welps and swelling. Office said "no appointment available. Come tomorrow."

I went anyway; they took one look at me when I walked in the door and put me straight into a room. Doc came in about 2 minutes, gave me a shot and some strong medicine and I was out in 5 minutes. I guess they didn't want someone that looked worse than ebola and bird flu combined sitting in the lobby!

I do appreciate that emergencies are recognized and dealt with. I could have gone to a hospital emergency room but I didn't feel like I was dying or anything. I might be wrong but I feel like hospital emergency is for such serious cases as to possibly be hospitalized.

[Rslaugh]

Most people forget that they are the doctor's customer (including the doctor). The medical profession has done such a great job of removing any expectations of customer service from their patients minds. We feel like these people are some demi-gods who must be obeyed and are always right. If you're not happy with your doctor's performance find another one. If you're not sure of a diagnosis get a second opinion. They call it "practicing medicine" for a reason.

[billwmeyer]

With no disrespect to Mildoc and Germdoc, this is a hot button issue with me also. I understand that people need to be squeezed in, but unless they are need of immediate attenton, they should not be put in front of someone who has had an appointment for a week or longer. I feel that if this happens all of the time, the doctor or his staff, and usually his staff, needs some organizational training.

Some places just don't try. I took my dad who has bladder cancer in to have his bladder lining scraped out. His appointment was at 11:00 AM, and of course he could not eat or drink after midnight. He was taken to a room to be prepared for surgery at 4:30 PM. Talking to others in the room, there were many other 11:00 AM appointments for the same doctor. My dad is 87 years old, and didn't need that kind of stress. He finally got some crackers around 8:30 and a bowl of soup around midnight. The doctor is good and the staff was polite, but this is apprehensible. He is having treatments, and towards the end of April, he will have his bladder scraped again, so we will have to go through the entire ordeal again.

I appreciate what Doctors do, and I cannot imagine the stress they go through each day, but I just feel they ought to make sure that there patients are treated the same way that they would want their 87 year old father to be treated.

Bill

[MilDoc]

I agree with you Bill. That kind of scheduling is not good for the patient at all. And in my clinic, a "walk-in" does not get to go ahead of scheduled patients unless they are critical (a severe asthmatic for example will get in before you with a sore throat).

As for "customer service," the emphasis is on that today, ever since Wall Street took over medicine. This doesn't apply to docs in a private practice, but if you are employed as many are, "customer service" is the mantra. Keep the patient happy. And the there is great pressure to see more and more patients. (Luckily not where I work). We are judged by the number of "RVUs" we generate, not necessarily by the quality of care.

How about the "customers?" In an average day, 5 will show up late for their appointment and still expect to be seen now, 1-2 will be no-shows, and most will bring up an "oh by the way" at the end of their appointment and expect it to be taken care of.

So, here's my rant. When I open the door turn off your freakin' cell phone! (Lots don't.) Be on time so I don't get behind. Tell me what you need - I don't need to hear about the family's or your friend's history in most cases. Don't wait until the end of your appointment to bring up something else. Try writing down questions so you don't sit there like you don't know what is going on. If you don't know what medicines you take write them down! I can't guess what the "little blue pill" is! Don't tell me you take your medicine - when I look in the computer and see no refills for the past 6 months! Don't tell me what medicine you want today - this isn't Wal-Mart. And when you tell me what you must have is the Ebola Virus - 'cause you looked it up on the internet - don't be surprised if I roll my eyes.

I could go on, but why? "Customers" in most cases today are far more ingnorant of basic health care then they were 30 years ago. And far more bad mannered, demanding, aggressive. Believe me folks, it gets tiresome having to put up with a lot of cr*p every day.

And, what about the "customer service" I get? I have had bad service from plumbers, carpet cleaners, cable repair folks, mechanics, etc etc etc. "Customer Service" has deteriorated in every walk of life since I've been a kid.

There are bad doctors (and mechanics and etc). But I believe most try to do the best they can.

What's my take? You are not my customer. You are my patient. There's a big difference there that most people don't get (especially the MBA office managers who have no medical knowledge at all).

Well, that's enough.

[Ed62]

This is turning out to be a good thread. We get to see the problems from both sides.

I don't need to hear about the family's or your friend's history in most cases.

It works both ways. Our old doc liked to shoot the bull. He had one patient who traveled the U.S. all year, in a motor home. He had a yearly appointment with the doc for a checkup. When he'd come in, he and the doc would talk about his travels, and how they compared to those of the doc. The conversations would go on for at least 15 minutes! These bull sessions did not take place during the checkup. This information came from the office staff, whom we got to know pretty well after many visits.

The bull sessions weren't limited to the above patient. He talked about all kinds of things with all his patients, including us. He initiated the conversations, in most cases.

While he was a good doc (medically), and a nice guy, he left something to be desired for the patients sitting in the waiting room.

Ed