Doctor's office RANT: I HATE waiting!!!

[Christine]

One more thing, is having seperate well and sick waiting rooms a normal thing in the US? We don't have that here in the UK but I think its a brilliant idea!

Only in the pediatricians' offices have I seen this. Usually because the kids are crawling all over the place and touching everything--it's good to keep the germ level down in the "well" children.

 

[Alicnwondrln]

A funny story to tie in with this thread. I went once to an optometrist and was five minutes late for my appointment (no, really.......I'm not exaggerating.....only five minutes late) and the receptionist says in a snooty voice, "Oh, you're a little late. I'll try to fit you in anyway but you know the doctor's time is valuable." That got me mad and I replied, "Yes, and so is my time. In fact, I calculate that he owes me about $100 for the hour that I waited the last time I was here. You can take today's 'overtime' out of that!" Everyone in the waiting area had a good chuckle.

thats awesome !!
i wish i thought of that
one of my last obgyn appointments before i had ds22 months was crazy
i was driving from burlington to malden for my appointments and i waited almost 2 hours to be seen
i was dressed and walking out when the doctor comes over says your next
i love the obgyn that delivered my kids but it was crazy

 

[Galahad]

Last week I went to see my surgeon. I was told that I was his first appointment after lunch. Well, apparently so were 3 other people!! We all had 2:00 appointments. My GYN also double/triple books. Now that I know this, I make sure I get there early so that at least I can be the first of the three appointments he has booked for that time slot.

Ah, I see. I guess I didn't consider having two patients that are to arrive at the same time as "double booking". If the clinic is running well, the patient should always be engaged (or waiting on the result of something). The nurse or PA has their piece and then the doc. Then there is paperwork, etc. Having two patients arrive at 2:00 doesn't mean the doctor expected to be seeing two patients at the same time. Or said another way, your 2:00 appointment should be for the "office" not necessarily for the "doctor" since there are so many other steps that have to be taken.

In a routine OB clinic DW wants 30 patients for a day scheduled, 15 in the morning and 15 in the afternoon. That's over 20 minutes a patient if they are sequential. If they dump more patients into the clinic (something the doctor usually doesn't directly control "at the time") then it will hose things up. She may have 2 or 3 scheduled to arrive at the same time since they will need basic work from the nurse, perhaps a scan from the ultrasound tech, etc. If they are organized the nurse running the clinic (a doctor does not run their clinic) should have people staged in various places to keep it moving. Obviously it doesn't always work.

Editied to add: I hate waiting too. I always call ahead to see what the delay is and tell them I'll arrive say 30 minutes late if they are 30 minutes late.

 

[NMAmy]

I adore my GP. She was my parents' doctor and even though she does not accept new patients, took on dd, dh, and I since we had moved from the area and I had gone to the dr's who owned the practice before she did when I was a teenager.

On my first office visit, she told me, "Your time is every bit as valuable as mine. If you are going to be late, please call the office and reschedule. I promise not to keep you waiting more than 5 minutes past your appointment time and if an emergency should occur, the office will call you to reschedule." She's a gem--I've been going to her for 4 years now and have never had to wait. She's an excellent dr, too--she's great with both my parents and my dd.

 

[froglady]

I agree with what Galahad and wdwmom-2, there are many, many things going on behind the scenes that can mess up the most meticulous schedule.

DH usually has at least 3 patients scheduled for each 15 min time slot, as they're USUALLY at different levels of treatment. Many have to be sent off to x-ray or the lab, some have to be seen by the cast tech and just checked when it's applied/removed, and others are for pre/post-op visits.

Since they're all children, appointments have to be scheduled during school hours. There can be delays due to slowdowns at the school, traffic, etc. which cause the patient to arrive late. MOST appointments cannot be rescheduled due to healing times, etc so the patients have to be worked in. Then you have the patients who WERE on time, but had to go to x-ray, etc who ALSO have to be reworked in. Add ER calls and OR cases running late, and it's easy for things to get way behind. THEN, since they're the "pros downtown" they get phone calls and referals from other doctors and hospitals all day, and often have to work in even more patients! Try telling a distraught parent that his/her child, who another doctor has deemed an emergency, can't be seen because all of the appointments are taken. Heck, try telling ANYONE who feels (rightly or wrongly) that he's in dire need of attention that he can't be seen, or has to wait in misery because the patients who made a well check-up appointment have to be seen first.

 

[clarabelle]

YOU REALLY DON'T WANT TO GET ME STARTED ON THIS SUBJECT. As far as I am concern doctors are the vultures of society, along with lawyers. Hope I am not stepping on any toes right now, but the moment you are at your weakess point they hit you were it hurts the most, the pocket book. Only their time is important, not yours.
At least my drs are like that. What it takes me a month to make they take from me and my insurance for a few moments of their time. Watch out if you are really sick. Wew!

ok, my vent is over

Of course you are stepping on toes. How can you call two entire professions vutures and not step on toes?
Do you expect them to do it for free? Do you work for free?
Did you train for your job for 11+ years?
Do you work an 80hr week?
Yes I know they are not perfect -but they are not vultures

 

[jgmklmhem]

My only problem is with not giving the patients the knowledge to try and reschedule. Yes sometimes things do come up but many times the staff know when they are running behind and approximately how far behind. I want information to be avaibale to the patients waiting. If at the OB for my wife and she gets called into a C-section they should tell all the patients in her office so that they can plan accordingly. The sitting and waiting with no information as to when even approximately I will be seen gets me. Some offices are good about letting you know but others will just let you sit for 2 hours by yourself with no one informing you of anything. Just give me the best possible information you can and let me make the decision is it worth my time to stay or reschedule.

 

[mickman1962]

I agree with what Galahad and wdwmom-2, there are many, many things going on behind the scenes that can mess up the most meticulous schedule.

DH usually has at least 3 patients scheduled for each 15 min time slot, as they're USUALLY at different levels of treatment. Many have to be sent off to x-ray or the lab, some have to be seen by the cast tech and just checked when it's applied/removed, and others are for pre/post-op visits.

Since they're all children, appointments have to be scheduled during school hours. There can be delays due to slowdowns at the school, traffic, etc. which cause the patient to arrive late. MOST appointments cannot be rescheduled due to healing times, etc so the patients have to be worked in. Then you have the patients who WERE on time, but had to go to x-ray, etc who ALSO have to be reworked in. Add ER calls and OR cases running late, and it's easy for things to get way behind. THEN, since they're the "pros downtown" they get phone calls and referals from other doctors and hospitals all day, and often have to work in even more patients! Try telling a distraught parent that his/her child, who another doctor has deemed an emergency, can't be seen because all of the appointments are taken. Heck, try telling ANYONE who feels (rightly or wrongly) that he's in dire need of attention that he can't be seen, or has to wait in misery because the patients who made a well check-up appointment have to be seen first.

That's all well and good, but if the Dr. is consistently late seeing patients, then he is overscheduling. It seems to me that most Dr.'s booked patients based on a perfect day i.e. no emergencies, every patient takes 7 minutes etc. I'm sure it doesn't happen often so why plan the day that way? In my field I average 2 hours of emergencies a day, so I plan on 6 hours of regular work. Why can't doctors?

 

[clarabelle]

That's all well and good, but if the Dr. is consistently late seeing patients, then he is overscheduling. It seems to me that most Dr.'s booked patients based on a perfect day i.e. no emergencies, every patient takes 7 minutes etc. I'm sure it doesn't happen often so why plan the day that way? In my field I average 2 hours of emergencies a day, so I plan on 6 hours of regular work. Why can't doctors?

Its kind of like airlines. If you overbook an then someone cancels- you work out even. If you overbook and everyone shows up and you get an emergency -then you make people wait and they get ticked.

If you book exactly what you can see -then you may have a bunch of no-shows and you wind up being slow.

If you have a Doctor who is consistently incredibly slow then you should change docs. If you are in a Managed care situation -complain to the Insurance company -they keep statistics on that kind of thing and don't want providers who make patients wait an unreasonable amount of time.

A well ran medical office has around 50% expenses. So at least half usually more is going to pay staff , rent, malpractice insurance etc...
The docs need a pretty high volume of patients to come out ahead.

 

[SunFloridaDisney]

My GP I usually only wait about 15 minutes or so. Not bad.

When I was having my babies, my OB at the time had a wonderful office staff. I lived close by the office, and if I came in for my appt. and they were running way behind, I'd ask how long. If it was over 30 minutes, I'd go back home, and call in later to see how they were doing, spending my time at home rather that sitting there doing nothing.

Another doctor's office I know of gives patients pagers (like they use in restaurants) and when your time is near, you get beeped. Still have to wait, but I'd rather be shopping, or doing something that just sitting there!

 

[wdwmom2]

wdwmom2, how does it work in a doctor's office? When do the doctors write their notes? Personally, I'd prefer my doctor write notes about my visit right after she sees me. That way details don't get lost, forgotten, or confused with another patient. All this takes time. Think of how many people they see in a day, and how complex the details are generally.

The majority of the time the chart is finished before the next patient. Occasionally if we are very busy, the doc may not totally finish an "easy" visit right away(sore throat, ear infection, etc.). But they right enough down, such as diagnosis and any meds prescribed, so that when they do finish, everything necessary is there. They always finish by the end of the day. They will finish these charts between patients if there is time, before taking their lunch, or whenever they may have a few precious extra minutes.

 

[Deb in IA]

YOU REALLY DON'T WANT TO GET ME STARTED ON THIS SUBJECT. As far as I am concern doctors are the vultures of society, along with lawyers. Hope I am not stepping on any toes right now, but the moment you are at your weakess point they hit you were it hurts the most, the pocket book. Only their time is important, not yours.
At least my drs are like that. What it takes me a month to make they take from me and my insurance for a few moments of their time. Watch out if you are really sick. Wew!

Of course you are stepping on toes. How can you call two entire professions vutures and not step on toes?
Do you expect them to do it for free? Do you work for free?
Did you train for your job for 11+ years?
Do you work an 80hr week?
Yes I know they are not perfect -but they are not vultures

Thanks, clara.

I also take issue with the "vulture" label. I can assure you, in my over 20 years of academic medicine, that almost all physicians go into medicine with a strong desire to help other people. And believe me, we wouldn't have gone through 4 years of medical school, endless tests and board exams, 3 to 8+ years of residency, LOADS of debt, long hours on call away from family and loved ones, the ever-present threat of ligitation, and the continued need to maintain ongoing medical education and current practice guidelines if we weren't.

Are we compensated well? Of course. But you know, $$$ isn't everything. I find it more personally rewarding to hear a word of thanks, some appreciation, instead of someone calling me names.

Why do you wait? Well, of course, there are emergencies, and some patients need more time (a new diagnosis of cancer, for example). And endless paperwork, medical-legal documentation, billing forms, insurance forms, excuse from work/school forms, prescriptions to write, pre-authorization forms, consults and referrals to complete, lab requisition forms, x-ray forms, test results to review, phone calls to return, etc, etc, etc.

And as for waiting in the exam rooms, I would suggest that when you go to the doctor's office, you could ask at the desk or when you are put into a room, how long the expected wait will be.

 

[barkley]

i was just speaking with my pediatrician's office yesterday about this very thing.

my dd had an orthopedic emergency last may that resulted in surgery and will require follow up x-rays and appointments every 3 months for the next several years. we were referred out of our medical group (by thier orthopedist who initialy made the diagnosis) to a pediatric orthopedic surgeon. i have the ultimate respect for this man's knowledge and skills as well as his tremendous manner with patients and their parents.

what drives me INSANE is the way his office is staffed and organized (and i lay this squarly on the doctor's shoulders-he is in private practice and is therefore not held to any registration or procedural practices other than what he has chosen to implement). i have yet to ever go to an appointment that has resulted in less than a 1 1/2 hour wait to be seen. when my child is seen it is first by the nurse who takes all of the pertinant information, then 20-45 minutes later by the p.a. who ask the identical questions, and then FINALY by the doctor who repeats the same questions (and stays no more than 5 minutes in the room with us sending back the p.a. or nurse to diseminate any information-and if you have questions-THEY CAN'T ANSWER THEM!!!).

i can understand being kept waiting if the doctor is called to an emergency at the hospital (next door to his office) or in the case of an urgent case demanding his immediate attention, but to regularly double book appointments (i overheard his staff person using this to calm another patient's parent the other day who had endured a multi hour wait) in a specialty with a very low "no show" for appointment rate and then only spend a few minutes with a patient (i understand that a follow up appointment is not as pressing as a presurgical, but this was the case with all of her presurgical appointments as well-and it was maddening to desparatly need information only to be told by the nurse or p.a. "well, i can't answer that-let me confer with the doctor and we can call you back with the information" HELLO, I'M SITTING HERE TO CONFER ON THIS NOW, I'VE WAITED 3 MONTHS FOR THIS APPOINTMENT, IF HE HAD TAKEN THE TIME TO GIVE ME THIS INFO. I COULD HAVE ASKED HIM FACE TO FACE.

i also have a problem in that he has only ONE person who works in his reception area who must check in patients, answer the phones, do all calling for any referals, insurance approvals...the woman can't do everything at once so she is constantly answering phones and telling callers "i'm with a patient now-can i call you back to take your message" (and during a 2-3 hour wait in reception you never see her have time to do one outgoing call-i've waited 2 or 3 days for her to return a call), and it can take 30 minutes to be able to interact with her to schedual your next appointment.

it just seems like the doctor is taking on much more than he can handle caseload wise and overextending at least one member of his staff.

i've asked my pediatrician to refer my daughter back to an orthopedist in our medical group who can monitor her situation. if a need comes up for the other's specialization we can be referred back-but for ongoing care this just isnt working for me.

 

[wdwmom2]

It is my understanding that the reason most doctor's offices are overcrowded and the waiting times are long is that they overbook the appointments. 2 or 3 appointments to ONE time slot, thus increasing wait time.

Some time slots have 2 visits booked, some single visits. When double booked, one is always what we call a recheck spot. This is a short visit, example, to recheck an ear infection after the antibiotics. The other visit is a check up, comsumes much more time. I get the recheck ready first, and as the doc is seeing that patient, I am getting the check up ready. Depending on the age of the child, there can be several forms for the parents to fill out(Denver developmental screening, lead screening, TB screening, vaccination records to sign, etc.) Then there is actual time that I spend with the patient(weight, height, eyes, ears, BP, pulse). By the time all of this is done, the doc is done with the recheck and ready to see the check up. That's why we double book.

 

[Galahad]

A clinic day does not go by for DW when at least one patient doesn't show up and hour or more late and demand, with great volume, to be seen immediately. In the case of her practice, they have too few docs for the patient load. They don't get overbooked for any other reason. And they can't just go out and hire more docs that easily because it is not a common specialty, and in many parts of the country it commands more money that it can here, etc.

 

[Jennasis]

When I complained about this waiting nonsense to my mom (who worked for YEARS as my gynos medical assistant, where I never waited, but that's cause my mom was the med assistant she said always try to book the first or last appointment of the day. You get in before other people start slowing the doctor down with emergencies or latenesses or they will expedit getting you seen so everybody can go home for the day.

I also had to take exception finally with my general practitioner. I was seeing our pracitces PA (I don't mind seeing a PA versus the doctor. I always have even as a kid). However, they were apparently training a new PA who was still in school and kept sending me in to her even though I did NOT book my appointment with this trainee and she was always unaccompanied by a resident doctor or my regular PA. I don't feel comfortable with that particularly since my doctors office is not a teaching facility or affiliated with any medical learning institution. I understand that doctors must intern etc...but at least have them supervised until they graduate. I am not a guinea pig! I could go to the very large well known medical college a few towns over if I wanted med students working on me.

 

[froglady]

That's all well and good, but if the Dr. is consistently late seeing patients, then he is overscheduling. It seems to me that most Dr.'s booked patients based on a perfect day i.e. no emergencies, every patient takes 7 minutes etc. I'm sure it doesn't happen often so why plan the day that way? In my field I average 2 hours of emergencies a day, so I plan on 6 hours of regular work. Why can't doctors?

I guess it becomes a choice of making a patient wait in the waiting room for minutes or hours to be seen, or making them wait at home for weeks or months for an appointment so that they can schedule more time per patient, and have more time for overuns. OR, the patient can try to find a different doctor who isn't as busy.

Also, how many people would want to wait for a different appointment if they reschedule? If I've traveled any distance, or have taken the day off from school or work, I would rather wait than try to do all over it again.

 

[mafibisha]

Great thread!

Unless I missed it, I don't think we've heard from "DisneySteve" - the DIS resident "doctor"!(?)

Would love to have him weigh in with his thoughts; he might have something interesting to add!?

 

[Dakota_Lynn]

This is why I always see the physician's assistant instead of the regular doctor. She always gets me right in and has plenty of time to spend with me. I have always felt I got my absolute best medical care not from the doctor, but from his assistants. On the rare occasion that I need to see my regular doctor it takes as much as two hours to get in and he is always in such a rush that he is outta there in two minutes.

 

[crz4mm2]

I also hate to wait. If I had to wait more than a few minutes at my care provider's office, I would find a new provider.
I try very hard to keep on schedule at my office. I do not double book unless it is absolutely necessary (emergency add on patients). I do not leave openings either as I usually have at least 2 or 3 no shows every single day.
I rarely have patients wait, but it does happen occassionally. Once in awhile a patient needs extra time to discuss issues or whatever. If I am late seeing a patient or have kept someone waiting I always appologize and make sure I give that patient just as much time. If I get called out to do a delivery, then the patients are called and or told that I am gone and what for.
I believe that everyone else's time is every bit as valuable as mine is.
I remember a doctor once told me that he couldn't understand why patients got upset if they had to wait an hour or more to see him because "I am very busy. I am a DOCTOR after all". I responded" NO ONE is worth waiting more than an hour for, including you". And I really believe that. I know that emergencies happen, but the patients should be informed and offered the opportunity to reschedule if they want to.It's all about respect if you ask me.
I do think it makes a difference if you are self employed, or employed by a HMO etc..... Some dictate how many patients you MUST see a day and how much time you can spend with each patient.