Dear Patient,

[Burnedout]

So you're happy to work for free? And all the people you work with are happy to work for free? Because yes, while medicine does deal with people, there is a business aspect to it as well.

An office has expenses. Lights, equipment, salaries etc. So should the doctor shrink his practice? OK...so lay off some staff. Choose which patients he/she is going to cut loose and tell that they need to find another MD. If you like your doctor, are you going to volunteer to go to someone new? To shrink the practice to make it affordable to schedule only enough patients so that no one has a wait, these are the things MDs need to do.

Of course it does. Don't be ridiculous.

How an office is run however and the profit expected is most certainly negotiable. As a therapist I can do what I need to bill in 20 minutes. Instead I see people for a more effective appt and take a smaller profit.

Dad's ofc is 3 people. Him, front and back ofc. He chooses a smaller income to do what is right by his patients.

Drs aren't victims. Treating patients with respect is always a good thing. Respecting that I lose time with my business if I go to my docs ofc and am an hour late is respect. Just as I need to show up on time to hers. Luckily all but my rheumatologist seem to have a clue of that

 

[pigletgirl]

Our doctors all have a policy where they will not see you if you are more than 20 min late. (This includes my son's surgeon who we see every 6 weeks).
My husband had the same policy with his practice and often turned late pts away in order to stay on time. (Of course he is now a sell out and no longer practices medicine in that form. Management pays far more then pediatrics. A sad reality.)

Yep that's how all of my providers run too! My OB that delivered my daughter was one of the most on the spot docs I've ever encountered. She made it a priority to not make us wait. If she was at the hospital, the staff would call to see if I wanted to see one of the other doctors in the practice or be re scheduled that week. I chose to see another doc because I wanted to be seen that day. I always appreciate their motivation to put the patient first.

I will definitely use them with future children.

 

[Disney Doll]

Yep, this is exactly what needs to happen. And I've had it happen at two doctors' offices. My kids' pediatrician wanted to spend more time at home, so she encouraged many of her more recent patients to switch to her partner (or face long waits to schedule an appt). We switched so we would have the better availability.

And my primary physician did the same thing so she could be home more. She brought in an RNP to cover for her twice a week. RNPs are "cheaper," but still a great provider option. I chose to stay with my dr and deal with less availability. My son sees the RNP. And I have never waited more than 15 minutes to be seen. On occasion I've waited in the paper gown, but my dr is always extremely apologetic. And she spends as much time with me as I need. So when I'm sitting there clothed in paper, waiting, I know it's because she's doing the same for someone else. She has also fit me in for emergency appointments (she sets a certain number aside each day) and has always gone above and beyond for me. Not all doctors are greedy money-grubbers. Some really do love what they do and prove it every day.

Well there aren't many people who would be as agreeable asyou with regard to switching doctors. Most people have a relationship with their MD and don't want to start over. Their basic response would be "let someone else switch".

Your first MD was quite fortunate to have such an understanding patient.

 

[Lanshark]

I honestly expect to wait but I'd rather wait in my car then in a waiting room with a bunch of sick people when I'm there for med refills or an ear infection. If my appointment is at 2 but the office knows I won't be seen until 3 or 4 just tell me so I can go get a cup of coffee or sit outside. I have accepted the fact that I will have to wait. I like my doctor and know that she spends the necessary time. Just tell me when I sign in to come back in an hour or give me a call when ready.

 

[mom2rtk]

So how much would everyone pay to have FP at the doctor's office?

 

[yeahdisney]

Schedule one patient every 15 minutes. Doctor rounds first or maybe not.

First app starts 10:45 five patients seen only - then lunch. The 11:45 person gets 15 minutes which leads to lunch. Staff back to desk. First pt 1:00 o'clock.

New patients equal 30 minutes slots with only four new patients being allowed a day and every day you do see four new patients. 2 hours gone for new patients say 1, 1:30, 2, and 2:30 till 3 pm used for new patients. Last patient appt 4:30 that leaves 6 appt left for established patients. 10 afternoon visits.

Equal 15 people a day being seen. No more, if one pt in 15 minute block to 30 minute block. Not all doctors work everyday. 20 people on average can call everyday to request a visit.

A single day we triaged over 40 adult sick calls for that day plus had two doctors double booked, no one complained, all patients were thankful to be seen sick or happy they were not sick. No staff offered to leave when stopping time came and went. We knew our two local ERs were slammed. Patients told us they went to the immediate care and were told the wait time is over 3 hours, we will not be able to see you.

 

[Burnedout]

One dr saw 40 people in one day? Surely that isn't what you are suggestion to be quality care. People are often made to feel grateful for crumbs thrown their way. That doesn't mean quality care was given.

 

[Pea-n-Me]

Dear moms doctor, Next time you are "held up" at the hospital, I would appreciate a call so I could reschedule. Or I will kindly leave my mom with Alzheimer's, with your nurses so they can explain to her every 5 minutes for an hour and a half why she's there and how much longer. Then I won't need a prescription too by the time I walk out

Why with the nurses?

 

[Burnedout]

Why with the nurses?

Because nurses garner no respect. :/ mom was an rn and you would believe the stories.

 

[Jaime4004]

Just a few things that lead to wait times that have nothing to do with the Doctor/Provider just wanting to make your day go badly (or them just sitting on their butt twiddling their thumbs):

Patient before you called in saying they have a sinus infection, we put them in for 15 minutes and they come in with a laundry list of things they really want to talk about.

Patient before you comes in for their 15 minute follow up appointment, at end of appointment when provider is leaving the room they mention "oh by the way I have been having chest pain." Which leads to an unscheduled ekg, stat lab work that has to be taken directly to the lab and a 30 minute exam.

Providers having to double book appointments due to people constantly no-showing and them needing to get their RVUs in for the month. If they have too many no shows and don't get their RVUs in the for the month the PTB dock their pay and threaten to fire them (this is only for the providers that work in a health system not the private practice doctors). Risk management says we can't fire a patient due to no shows alone so we have to double book them.

Person walking in off the street with an emergency situation (heart attack, stroke, etc). Everyone in the clinic has to help out and go into triage mode when this happens, leading to all the providers schedules getting back up.

Every single one of these situations happens about 4 days out of 5 in the clinic I work for and I live in a small city. If more than one happens in the same hour our day is pretty much shot.

Every one of these is spot on and happens everyday. The doctor is generally not in their office playing flappy bird while patients sit in the waiting room. And they are too busy running from one room to another to watch the clock or be worried about who's time is more important, their own, the suicidal patient in the exam room, or the person in the waiting room, etc.

I worked as a NP in a large health system and usually ran on time, because I am a bit obsessed with being punctual in life (not just work). I would have people reschedule if they missed their appt. Ex 20mins late for a 20 min appt. Because seeing them would make every patient the rest of the day seen late, when they showed up ontime. Generally appointments could be rescheduled later that day or the next day, not 3 month waiting periods...

But working for a large health system, you are told how many patients you need to see. I think most people see doctors working in rich private practices, setting their own schedules, when that's not always the case. If I had a no show appt in the morning or afternoon, nurses were told to book an extra patient at the end of the morning or at the end of the afternoon (aka lunch, or when it was time to leave.) It was rare to get a real lunch time, usually bites in between patients. I negotiated patients every 20mins when I started, the doctors saw patients every 15 mins, and were often double booked. A few years later, apparently I wasn't making enough money and they were going to change my appts to every 15 mins also. Not acceptable to me to shuttle patients in like cattle, so I decided (along with several other reasons) that it was time for me to quit and hang out with my kids more. Worked out for me, but I don't think it's realistic to tell doctors they should just see less patients/day. That would mean getting a new job or going into business for themselves, not as simple as it sounds...

 

[dakcp2001]

[QUOTE=Mokat76;51140782]Then perhaps you need to find a line of work where 67 percent of your contacts suck. Your attitude probably isn't helping the business.[/QUOTE]

What does that even mean? Contacts? What are you talking about? Your statement makes no sense. And my attitude is just fine, I get paid hourly so I don't care if you show up 5 hours late and your surgery gets cancelled. And actually I work in this dept when I need a break. It's about a million times nicer than working on the floor. In this dept. I only have one patient at a time ( a luxury), and I'm not trying to keep them alive for 12 hours. I also don't go home covered in blood, vomit, and other bodily fluids. It's like a vacation.

 

[dakcp2001]

Why with the nurses?

Right!?!

 

[Mkrop]

What is the answer than? Bc most people cant afford to take all morning or afternoon for a dr appt. Than you have people who should schedule them not sheduling them bc they dont have that time away from work or the kids etc.

 

[FlightlessDuck]

Why with the nurses?

Because the Doctor is hiding in his/her office. Or on the golf range.

 

[mhsjax]

I pick up shifts in the surgical department. You have a pre surgery appointment so you can get cleared for elective types of surgery. You miss it, your surgery is cancelled. Period. That makes surgeons angry, so we pretty much have to take people when they come. We schedule 70 appointments a day. Last month 63% of our patients were "more than an hour late". Only 9% checked in within 15 minutes of their scheduled appointment time. People come whenever they want. It' really makes you lose your faith in humanity. And you get 2 auto calls with reminders the week leading up, and one human calling you the day before. People suck. If you come at your scheduled time, you are seen within 15 minutes. If you come whenever you want, you wait. Sometimes a little sometimes a lot. If you call ahead to say you are late, we can work with that. It is extremely difficult to staff appropriately since surgery volumes fluctuate at different times of year, and since most people don't come at their appointment time.

This is very true. Now lets talk about how patients don't want to wait, or they think that Dr's over schedule, yet these are the same people who cant understand why it can take a month to get an appointment with a Dr. YOu can't have it both ways.. No one wants to wait, but if you need a Dr, you better believe that you want to get in as soon as possible. Don't even get me started on those that call on a Friday saying they have been sick all week and just to come in right now. SCREAM.

There is no real good answer. Patients are demanding, they don't want to wait, they don't want Drs to over schedule, yet these same patients will flip out of they have to wait for 3-4 week for an appointment. The public, this is why I don't work for them.
And yes, insurance companies can and do put the pressure on. It will only get worse.

 

[wallawallakids]

What is the answer than? Bc most people cant afford to take all morning or afternoon for a dr appt. Than you have people who should schedule them not sheduling them bc they dont have that time away from work or the kids etc.

This is really hard. I am not sure there is an answer. We find this hard as parents as well. Our son has a disease that must be closely watched and managed. We are like a lot of parents in this situation, forced to take a day off from work once every 6 weeks for our VERY long apt. Our child sees 2 doctors. Each manages a different issue regarding his disease process. One is only 20 min away and we see him every 3 months, the other is a 2 hour drive away and we see him every 6 weeks. We are constantly juggling work, the other three kids, and apts. for our son. We always have long waits with both drs. However, I am not putting the blame on them. I wish it was different, but I am not sure how much control they have over the situation? Sure they could schedule less per day. But some people have to be worked in due to situations. Surgeries go over the time they were booked.

I know both Drs. have a long wait list for pts and his surgeon, who we wait the longest for, does a lot of work for free. He is a really nice guy who travels to Japan and other countries to do surgeries on kids like my son who have this rare disease that not many know how to treat.

I hate waiting, just as much as everyone else but I am resigned to it now. It is part of our life.

I hate that my son has this disease even more. I hate knowing if I don't keep up on it that he will never lead a "normal" life. I hate that he is behind in school because of surgeries and dr apts and various other things. I hate that he will be doing this for the rest of his life because there is no cure for his disease.

There is a lot I do not like and that I wish I could change. The wait in the office has become the least important issue. Sadly, it took this experience for me to learn patience.

Not saying anyone is wrong who doesn't like to wait. Just giving my perspective and how it has changed since DS's diagnosis. (I shutter to think of the hours I have spent in waiting rooms with him. I could have built a house or something. )

 

[Mkrop]

This is really hard. I am not sure there is an answer. We find this hard as parents as well. Our son has a disease that must be closely watched and managed. We are like a lot of parents in this situation, forced to take a day off from work once every 6 weeks for our VERY long apt. Our child sees 2 doctors. Each manages a different issue regarding his disease process. One is only 20 min away and we see him every 3 months, the other is a 2 hour drive away and we see him every 6 weeks. We are constantly juggling work, the other three kids, and apts. for our son. We always have long waits with both drs. However, I am not putting the blame on them. I wish it was different, but I am not sure how much control they have over the situation? Sure they could schedule less per day. But some people have to be worked in due to situations. Surgeries go over the time they were booked.

I know both Drs. have a long wait list for pts and his surgeon, who we wait the longest for, does a lot of work for free. He is a really nice guy who travels to Japan and other countries to do surgeries on kids like my son who have this rare disease that not many know how to treat.

I hate waiting, just as much as everyone else but I am resigned to it now. It is part of our life.

I hate that my son has this disease even more. I hate knowing if I don't keep up on it that he will never lead a "normal" life. I hate that he is behind in school because of surgeries and dr apts and various other things. I hate that he will be doing this for the rest of his life because there is no cure for his disease.

There is a lot I do not like and that I wish I could change. The wait in the office has become the least important issue. Sadly, it took this experience for me to learn patience.

Not saying anyone is wrong who doesn't like to wait. Just giving my perspective and how it has changed since DS's diagnosis. (I shutter to think of the hours I have spent in waiting rooms with him. I could have built a house or something. )

That has to be tough, I know we have one with the allergist and the ADD specialist for my DS11 but we are fortunate that MOST times we are not delayed.

I guess in my mind I was thinking about my DH who waited until his blood pressure was causing dizzy spells bc he did not have time to wait around in a drs office for a routine physical, he had just started a new job and didnt want to take the time away from work to sit in a exam room all afternoon. Now was he right, no, but I am sure there are may patients just like him who will blow off symptoms or routine health screenings bc of the time it takes, then you are dealing with bigger health issues.

 

[OceanAnnie]

Sometimes you have to take the good with the bad. If you like your doctor, you can keep your doctor. Oh. Wait. That was something else.

Sometimes, it boils down to if you like your doctor, you wait. I'm not one to cause a fuss. I'm not going to waste the time I do have on an appointment by going into it with the doctor about how long I waited. I like him. He's popular because he has a good bedside manner and is a straight talker. The long wait a lot of times is because he is popular. Plus, I know there are others worse off than any one of us in our family. We are fortunate.

Sure the wait is inconvenient. It registers. But the day goes on and you adjust. When you find a doctor with all the qualities you require they are a gem and you know it. So you take the good with the bad.

 

[NotUrsula]

Technology makes it a lot easier to mitigate these problems and relieve a lot of the resentment.

Just about everyone still of working age has a cell phone these days. If I am unavoidably running late, I call the office and let them make the call about whether or not they want me to come in anyway, or reschedule.

I would very much appreciate a text message from the office if the physician is running late: it can be generic, something like, "due to an unforeseen number of complex cases, Dr. X is running behind today; your wait time in our office may exceed 30 minutes. If your schedule today is inflexible, please call us ASAP to ask about rescheduling your appt. for another day."

Allow and ENCOURAGE patients to fill out pre-visit complaint description forms online or on paper sent in via FAX. I've been doing this for years on my own initiative, and my physicians appreciate it, because it is MUCH more efficient for the Dr. to read a list I've sent in myself and had time to write carefully, rather than a nurse's notes from a phone call, or listening to me recite it in person. It also lets the Dr. have a staff member call me to arrange lab work prior to my visit if that is indicated; it's a lot easier to tell me what my options are when the lab results are already in hand when I come in.

 

[DopeyDame]

Our first pediatrician was great - friendly, reassuring, helpful, etc. But the wait times in her office were HORRID. I finally had enough when I waited 3 hours with my sick kiddo. At the 3 hour point, I asked how much longer, and they said maybe an hour or so. Oh hell no. So that day I ended up at urgent care with my sick kid during regular office hours. Ridiculous. The nurse did call us back the next day to make sure we'd been seen and to apologize (evidently they had computer problems that backed them up that day )
After that, I decided we needed a change. We switched to another local ped who is also awesome and who I have never waited for more than about 15 minutes. I don't know exactly what the difference is, but one office makes it work beautfiully and the other clearly doesn't. (For whatever it's worth, the office staff at the new place is SO much nicer as well. Not sure if there's a connection there or not.)

As for those docs/nurses complaining that patients talk about more than what they origianlly called for... OF COURSE if I go to the doctor I'm going to let you know about how my body is doing on the whole. That's what all of my doctors tell me to do. They need to know ALL my symptoms so that they can accurately diagnose me. I shudder to think abou the medical care people get if the doctors are pissed because someone called for a sinus infection and also mentions that their neck hurts, thinking that just maybe this could be important information for the doctor to differentiate between a cold and menengitis.