Pediatrics, Late Appointments and Chaos
You never know what is behind door #2...
When people have an appointment at 10:45 AM, they more or less expect to be seen at that time, or at least, shortly thereafter. Staying on schedule is a goal that all medical providers strive to accomplish, but unfortunately, we never know what is behind door #2.
When I worked in family practice, it was not unusual for people to not be truthful about the reason for their appointment. Not wanting to share private information with the front desk, they might say "sore throat", but in reality they are having some serious pelvic pain and think they have a venereal disease. The sore throat visit can be orchestrated between physical exam appointments since it is quick and easy; but a diagnostic exam for a woman with abdominal pain is quite involved. When this happens, we have to deal with it, and unfortunately, the other patients will not be seen at their appointment times, perhaps, for the rest of the day! It takes just ONE unexpected event like this to cause schedule chaos.
Then, there are the "Oh, by the way" people. You will spend 25 minutes of a 15 minute appointment slot, only to be faced with an unexpected peripheral issue. As you are leaving the room to rush to your next patient, someone will ask, "What do you think about this black mole on my arm?" Arrrghhhhh! Not that the black mole isn't important. It may be more important than the original reason for the visit, but now we face a dilemma. Should we deal with this "Oh, by the way" now, or have the patient reschedule? Maybe they won't come back and that possible melanoma will spread? We face situations in the clinic like this every day.
In pediatrics, there is always an entourage of people in the room. It is not unusual to see several uncontrolled siblings, one or more women (one of which could be a parent), a possible grandparent, a mystery person, some strollers and luggage. At least one person is talking on a cell phone and there are sounds of a hand-held video game. (Cell phones are going to be another upcoming blog!) One kid is always rolling around on my wheeled stool, bouncing from one wall to the next. Another child is playing with a $500 medical instrument or pounding on the computer keyboard. Have I set the stage properly? Once order has been restored to the room (sort of), and once the sick child is discovered among the crowd and the proper woman is identified as the real mother, the visit can begin. No sooner than the exam is complete, the prescriptions have been written, and you are making a mad dash for the door and the quiet of the hall, you hear those words: "Can you take a look at his ears, too?" Of course, you don't have a chart; you don't have time; and you know this will be a free visit, you take a quick look at the other child. Why? It will take less time to peek in the ear, than the proper alternatives.
People are complex. When you schedule a woman for a routine pap smear, this is what you are planning to do. However, when you enter the room, you are faced with a crying, depressed individual in a paper gown. Clearly, a pap smear is not her main issue today. You patiently listen to her version of the divorce and custody issues, and what a bastard her husband is, or how she may lose her job. You wait and you listen. Tactfully, you try and look at your watch, but you always get caught. Sometimes, you will decide to triage - take care of the situational depression first, rescheduled the pap. Sometimes, and more likely, you do both. This is a 45 minute visit (at least).
Out in your waiting room, people are stirring. They are making quick arrangements for people to pick up their kids at school, or cancelling other appointments. They are waiting and people HATE to wait (even though we call it a WAITING ROOM!). And, I understand that they are ticked. I hate to wait, too.
My next patient has been waiting a nearly an hour in the room. I don't want to go in there, but this is my job. My first goal is to defuse the angry. I apologize for the wait, acknowledge their anger for being inconvenienced. "I am sorry that you had to wait today. I had an unanticipated medical crisis that took more of my time than anticipated. Sometimes, people's medical problems take more than just 15 minutes. I hope that you understand. Someday, YOU will need more time, and I hope the people that have to wait for YOU will be understanding as well. So, how can I help you today?" We both smile, tensions have released, and we complete the visit. As I exit the door, I hear, "Oh, by the way..."
Related Topics: Making the Most of Your Appointment, Kids' Medical Care is No Small Business
Technorati Tags: healthcare, pediatrics, appointments, timemanagement
When people have an appointment at 10:45 AM, they more or less expect to be seen at that time, or at least, shortly thereafter. Staying on schedule is a goal that all medical providers strive to accomplish, but unfortunately, we never know what is behind door #2.
When I worked in family practice, it was not unusual for people to not be truthful about the reason for their appointment. Not wanting to share private information with the front desk, they might say "sore throat", but in reality they are having some serious pelvic pain and think they have a venereal disease. The sore throat visit can be orchestrated between physical exam appointments since it is quick and easy; but a diagnostic exam for a woman with abdominal pain is quite involved. When this happens, we have to deal with it, and unfortunately, the other patients will not be seen at their appointment times, perhaps, for the rest of the day! It takes just ONE unexpected event like this to cause schedule chaos.
Then, there are the "Oh, by the way" people. You will spend 25 minutes of a 15 minute appointment slot, only to be faced with an unexpected peripheral issue. As you are leaving the room to rush to your next patient, someone will ask, "What do you think about this black mole on my arm?" Arrrghhhhh! Not that the black mole isn't important. It may be more important than the original reason for the visit, but now we face a dilemma. Should we deal with this "Oh, by the way" now, or have the patient reschedule? Maybe they won't come back and that possible melanoma will spread? We face situations in the clinic like this every day.
In pediatrics, there is always an entourage of people in the room. It is not unusual to see several uncontrolled siblings, one or more women (one of which could be a parent), a possible grandparent, a mystery person, some strollers and luggage. At least one person is talking on a cell phone and there are sounds of a hand-held video game. (Cell phones are going to be another upcoming blog!) One kid is always rolling around on my wheeled stool, bouncing from one wall to the next. Another child is playing with a $500 medical instrument or pounding on the computer keyboard. Have I set the stage properly? Once order has been restored to the room (sort of), and once the sick child is discovered among the crowd and the proper woman is identified as the real mother, the visit can begin. No sooner than the exam is complete, the prescriptions have been written, and you are making a mad dash for the door and the quiet of the hall, you hear those words: "Can you take a look at his ears, too?" Of course, you don't have a chart; you don't have time; and you know this will be a free visit, you take a quick look at the other child. Why? It will take less time to peek in the ear, than the proper alternatives.
People are complex. When you schedule a woman for a routine pap smear, this is what you are planning to do. However, when you enter the room, you are faced with a crying, depressed individual in a paper gown. Clearly, a pap smear is not her main issue today. You patiently listen to her version of the divorce and custody issues, and what a bastard her husband is, or how she may lose her job. You wait and you listen. Tactfully, you try and look at your watch, but you always get caught. Sometimes, you will decide to triage - take care of the situational depression first, rescheduled the pap. Sometimes, and more likely, you do both. This is a 45 minute visit (at least).
Out in your waiting room, people are stirring. They are making quick arrangements for people to pick up their kids at school, or cancelling other appointments. They are waiting and people HATE to wait (even though we call it a WAITING ROOM!). And, I understand that they are ticked. I hate to wait, too.
My next patient has been waiting a nearly an hour in the room. I don't want to go in there, but this is my job. My first goal is to defuse the angry. I apologize for the wait, acknowledge their anger for being inconvenienced. "I am sorry that you had to wait today. I had an unanticipated medical crisis that took more of my time than anticipated. Sometimes, people's medical problems take more than just 15 minutes. I hope that you understand. Someday, YOU will need more time, and I hope the people that have to wait for YOU will be understanding as well. So, how can I help you today?" We both smile, tensions have released, and we complete the visit. As I exit the door, I hear, "Oh, by the way..."
Related Topics: Making the Most of Your Appointment, Kids' Medical Care is No Small Business
Technorati Tags: healthcare, pediatrics, appointments, timemanagement
62 Comments:
Wow....I'm happy that my doctor's office is fairly 'on schedule' most of the time, but I certainly do see if from a different angle the way you explained it. Patients really do appreciate it when an apology is offered, so it's good that you do that. I also think that I'm very blessed with my family doctor....I never feel rushed and I truly think that the appointment personnel help a lot with that. I always feel that all of my issues are addressed and that if I need to phone my doctor, he always calls back. Being 'prepared' too (take a list with you so you don't forget...now THAT saves everyone time and you don't forget things) helps and talking to the doctor while you're still fully clothed is the best option in my opinion. YES, it means he comes in once to chat/discuss and then returns a few minutes later, but it's very effective and comforting too.
On a different note -- thanks for all you do on this board....I always enjoy reading what you have to say!
Thank you for your honesty and for your level of professionalism. I admit I get very impatient when I have to wait more than 10-15 minutes past my scheduled time, particularly when I have a sick child. But your truthful and humorous explanation makes it seem bearable... it's nice to know you are suffering as much as those in the waiting room. Thanks and continued success!
I am not good at waiting, but what I really hate is waiting in the exam room because they want to clear the waiting room and make it look like they got to the patient sooner. I would much rather wait in the more comfortable waiting room with the TV and magazines than the sterile exam room. I normally don't have to wait for my PCP or my children's doctor, but when I see the specialists in my medical group that is when I am left waiting. I understand that doctor's get behind and appreciate being told that a doctor is running behind and given the option of waiting or re-scheduling.
Waiting for over a half hour annoys me. I am also very busy. My complaint is not about the doctor running late but that the office didn't phone me to say they were running late even when the wait was almost two hours. Although they knew this when I arrived, they still didn't tell me. I had had other long waits for this doctor. My solution was to find a new doctor whose staff is honest and polite showing that they value MY time also.
I understand that situations arise that were not planned. What I do not understand is why a doctor's office only allows 15 minutes per patient. This hardly allows time for the doctor to get to know the patient let alone treat even the most simple of problems. I do not like waiting in the doctor's office then only to be rushed thru because appointments are running behind. I believe every patient regardless of the problem deserves more than 15 minutes.
Well to those who believe most visits should last more then 15 minutes, maybe you should pony up more than the 10 or 15 dollar copay for the visit, or stop expecting the doctor to respond to all the free calls that you do.
Best face it, you get what you pay for. For those who are probably not aware even the best insurance plan won't pay more than 50-80 bucks for the visit, and that is if your doctor can collect it, which only happens 50% of the time.
So either you shell out the money from your pocket for your insatiable needs, or be thankful you still have a thoughtful physician to speak too, albeit for 15 minutes. If you want to have your cake and eat it too, then very soon the primary care folks will be out of business, then it is the ER cattle farm, where the waits are bound to be much longer.
Something to think about :(
I have repeatedly seen a drug rep. take precedence over my sick child and this is really annoys me. Surely they don't have an appointment and if they do how is it the same time as mine.
I appreciate the candor with which this was explained. I have had waits over an hour for a doctor who come in the room with no apologies and rushed me through the appt. This doctor always runs behind. Everyone understands the occasional late appointment but when I get charged for a missed appointment and have to take time off from work to go to an appointment that ends up taking over 3 times longer than expected, consistently, it rubs me wrong.
Something is very wrong with your practice management if your office is ALWAYS this chaotic and behind schedule. Sorry, but it's MY time, money (not just my co-pay, but my exhorbitant insurance premiums, loss of wages), and my health. I understand that sometimes unforseeable circumstances do occur. I expect the office staff to tell me - how far behind the dr. is, give me the option to reschedule, etc. Every appointment with my PCP always results in a whole day being shot. The last time I had an appointment, I waited one hour past my scheduled apppointment with not so much as a single word of explanation. I finally just walked out...evidently I wasn't missed - haven't heard a word from the office since. I am thoroughly disgusted!
During a recent visit to my overworked doctor, the waiting room was overcrowded and in the seat next to me was a young school teacher complaining about the long wait. She failed to mention that she only has to work 183 days a year, no nights, no sat. or sundays no holidays etc etc. and makes as much as the poor doctor and more that his hardworking assistants. The teachers unions are the most greedy and sneaky culprits in this dumb country (USA)
This explanation would be great if it were true for most doctors, but it's not. Patients are scheduled for the most part in most doctors offices in 15 minute increments, so it's not the patient that is the problem.
It's the doctor who wants to line them up like an assembly line because he only works four days a week and because he wants to make the most money each day.
No medical appointment should ever take 15 minutes, and no doctor should ever schedule people one after another. If doctors practiced better time management, and didn't overbook, then the wait would never happen.
Again here's a perfect example of what's wrong with medicine today - doctors blaming patients for their problems, and greed being the prime motivating factor.
If doctors weren't as greedy (and don't blame it on insurance - I don't know of a single doctor who has ever filed for bankruptcy), then we would have a better health care system.
Believe me I doubt someone waiting for a pap smear is going to tell you about her husband. Arrogance at its finest which is what doctors are - arrogant.
Over the years of taking off work and not getting paid for the time off I decided some time ago to wait 20 minutes in the Dr's. office if Iam not called in to the examinating room I ask how much longer it will be, if the receptionist does not know, I leave and if she gives me a waiting time of more than 10 minutes I leave. If I get to the examinating room within 20 minutes and again wait more than 10 minutes I ask the nurse how much longer and again do the samething. I believe a patient should be told if they have to wait either in the office of examinating room more than 20 minutes. I am loosing money waiting for the Dr. and I am on a very tight budget. My time is also money.
Everyone should expect delays at any medical office. It's the way of the world. It's why I go to the Vets. They have everyone on an alloted time
I find it very hard to beleive all that you said. One to two hour wait and no reason is given, thats hard to take. Yes I did change doctor. I still don't believe you, I think the insurance companies dictate what you do and how you do it. If I have to wait for 30 minutes to 60 minutes and only see the doctor for maybe (if I'm lucky) 10 minutes, thats a cattle call. Thank God I only have to go to the Doctor once a year. No matter what you say it is all about the MONEY and you know it.
Poor babies... The typical 3 or 4 doctor office makes over $1000 per hour because they ALWAYS schedule appointments in 15 minute increments. even with a nursing and front-desk staff, rent, and other costs of doing business, they still manage to drive Mercedes or Beemers and he has the gaul to complain and blaim the PATIENT who PAYS HIS FREAKIN SALARY! Remember, jerk, we pay you. If you were my doctor and gave me your "have patience" speech, I'd tell you where to shove it and walk out. I'd also let my insurance provider know about the crap you pulled and watch you lose you PCP status.
Now quit yer bitchin and don't overbook.
In reference to lying to the receptionist - I often feel compelled to do so because, I'm sorry, but most doctor's office's receptionists are brusque, callous, and sometimes seem just plain stupid. I am not comfortable discussing my vaginal discharge or other embarassing problem with someone like this. Also, when you arrive the nurse asks "what are you here for today" and then the doctor asks the same. Now I've explained myself three times. Now THAT is a waste of time.
Having an illness is stressful and frightening enough, besides the added worry for many of us about how we're going to pay for care. Medical personnel, especially the people at the desk ought to be much more respectful of a person's fear and discomfort.
I understand that 'life happens', but if I have to wait more than 15 or 20 minutes I expect the office staff to let me know and allow me to decide if I can/want to wait. I've seen pharmacy reps, etc. without appointments get in before me. Excuse me, but I made an appointment! If doctors know that 'life happens' then they should schedule appointments accordingly. I complained to my primary doctor and my son's ENT and never again had to wait. I've walked out of doctors offices before when I've had to wait too long or when office staff has been rude. My time is valuable - one appointment ends up shooting at least half a day, with no pay, in addition to the bill. I have no insurance, so every time I go to the doctor it hurts!
I understand that 'life happens', but if I have to wait more than 15 or 20 minutes I expect the office staff to let me know and allow me to decide if I can/want to wait. I've seen pharmacy reps, etc. without appointments get in before me. Excuse me, but I made an appointment! If doctors know that 'life happens' then they should schedule appointments accordingly. I complained to my primary doctor and my son's ENT and never again had to wait. I've walked out of doctors offices before when I've had to wait too long or when office staff has been rude. My time is valuable - one appointment ends up shooting at least half a day, with no pay, in addition to the bill. I have no insurance, so every time I go to the doctor it hurts!
Whoever it was earlier that said that maybe we should pay more than the $10-15 co-pay to get our money's worth...
Um...some of us don't have insurance and might spend upwards of $300 a visit, 3 or 4 times a year.
I agree with the others...doctors and staff know that "life happens" and should schedule accordingly or at least be courteous and let you know if they are running behind, especially if it's 30 minutes or more. That just makes sense, IMO.
One factor that people don't mention is that an additional wait in the wait room is just more time exposed to all the sickness and illness of all the other patients. If my newborn gets sick, its hard on the little fellow and just misery for the whole family. I shopped around to get a punctual but still thorough pediatrician. He'll answer all my questions but boy, does he talk quickly!
I think this explanation was very helpful. I had to wait at a specialist's office on almost every occasion I went. It would be nice for doctors to give longer appointment times or see less patients, but I think that would just extend time it would be before you could see the doctor. Already, I have to schedule visits 1-2 weeks in advance for problems I'd like to get checked out in a matter of days.
Although I get ticked off having to wait, the politeness of the staff and doctor goes a long way. When I was in the exam room waiting for the specialist, I could see him practically running from room to room, and when he got to me, he's apologize and would never rush my visit.
Amazing! I am a tunisian family practitioner and I was smiling as I read this article : it was as if you were describing what is happening in my every day office work!
May God help us with our "patients" (Oh! by the way, did you know that the verb "patienter" in french means "to wait"? :) )
Dr Foued Bouzaouache M.D. Tunisia
Wow.... Let me start off by saying that I almost always have a long wait at my OB/GYN, but I love her and I will put up with it. I almost never have a wait at my family MD, but even if I did, I love him too and would put up with it. Because I know what the offices go thru.
To the person who said the doctors should "quit yer bitchin and don't overbook", and all the rest of you complaining about the waits: OK, that's fine. So when you have a DIRE EMERGENCY and MUST GET IN to see the doctor within the next day or you'll SIMPLY DIE, please remember that YOU don't want that doctor to overbook his/her schedule.
Can you tell yet that I work with doctors?
Thank God I do NOT work IN the clinic - but I'm an administrative assistant to a couple of VERY busy ophthalmologists (that would be eye MD's for the un-knowing). One is a retinal specialist. Guess what? A person with a retinal emergency could very well go blind unless it is taken care of very quickly. Do you really want people to go blind just so you don't have to wait an extra 1/2 hour to be seen while the doctor is performing a sight-saving procedure??
Our scheduling department tells our patients that for anything other than a simple follow-up, they should plan on being in the building 1-2 hours. We are also a teaching facility, so about 1/3 of all patients see a medical student and/or resident prior to the specialist.
Technically, I am not supposed to have to deal with patient issues - the clinic staff is supposed to do that. However, I can't even count how many times a day I get calls from patients that are unhappy with the Schedulers, and are INSISTING that they must be seen immediately. One of my doc's books out four months in advance, and the patients know this, but will wait until little Susie gets home from college for Christmas break and then expect to get her in for a refraction within the next 7-10 days. Or they blow off appointments and then beg to be re-scheduled ASAP because, gee, they have trouble driving at night.
You don't know how much I want to tell those people, "That's what LensCrafters is for - walk-in's welcome!"
Sometimes we have to say NO, but of course in a case where an established patient does have a chronic medical condition we want to provide proper care and we will "squeeze them in" - so this does, of course, throw off the schedule.
Add to that the unplanned absences (illness) of your technicians/nurses, residents, or even the ladies at the registration desk, or the MD being on-call and having a trauma case brought in to the ER, and you now have a logjam that is simply unavoidable.
So GROW UP and stop assuming that the overbooking is the fault of the "money-grubbing doctors". Take a little responsibility for your own life and CALL THE OFFICE IN ADVANCE to see if the MD is running on time or way behind, and adjust your arrival - or at least your attitude - accordingly.
"When you schedule a woman for a routine pap smear, this is what you are planning to do. However, when you enter the room, you are faced with a crying, depressed individual in a paper gown. Clearly, a pap smear is not her main issue today...."
This is rarely the case. Your ObGyn has very little time and you are tired waiting outside and inside(in a paper gown only !). Having said this, I understand the other side of the table. I wish the doctors also understand our side. Agreed that the fatalities/emergencies/accidents come un announced.
I am an IT professional and the phrases like: take a short break every hour, change your position:"ergonomics" ... etc are told to us by occupational hazard specialists. You can even download such screen savers to remind you to relax. What about doctors ?just seeing patients back2back ... My obGyn's office is no better than my daughter's Paediatrician's office ... very chaotic. The appointments are given 10 AM+ the doctor walks in at 11:00. Again agreed there could have been an emergency. Strangly most of the patients have the same complaint. I am +tive that at least 50% of the time, there is no emergency.
If the doctors and their staff do some time management, they have at least tried !, they would certainly know what works.
On the other hand my HMO's office is so organized. She and her staff are on top of the patients. I always got an appt the same week: mostly same evening and was seen in time: I do not consider 15-20 minutes waiting as wait: nor I am in a paper gown for a long time!. Infact she would ask me how is my job: my stress levels, family ... etc. After examining she would explain to me the problem,referal requirement(if necessary), course of action. IF I have to wait for her for 30+ minutes, I understand this is a real emergency for her. Alternatively I plan ahed forfor traffic delays etc.
Some physicians I know overbook by scheduling three or four people for the SAME time period every fifteen minutes or so. They are ALWAYS behind and make patients wait. Emergencies happen, but overbooking is not an emergency.
I am shocked at the attitude of this physcian assistant. What a pompus ass. I can see lots of people talking to him about their intimate problems because he is so caring. NOT!
Back to the issue
I am frequently waiting an hour before I am ushered back to the examing room of my childrens PCP, only to wait another 20 minutes-with my 3 kids. I am always shocked that the examining room has no toys or activities for children. Last I checked this was a pediatric office. They had a heads up that a child and their siblings may pop in all day long, everyday. The kids can only be entertained with the colors and crayons I brought for so long. I do my best but by the time I see my doctor an hour and half after my scheduled appt., I and the kids are climbing the walls. I know that my doctor is overbooking. Everytime I leave I think, we are never coming back again, but it is hard once you develop a relationship with the doctor and staff.
As I read this, I'm seeing the point of the Dr, but yet I see something that Dr's do not consider or do not think about.
I work, if I am not at work I don't get paid. Therfore if I wait and hour, that is an hour of pay I could have got by staying at work the hour longer that he was behind. I do not mind waiting on occassion for an "emergency", but not every Dr's visit! That is the normal. Even if I have a morning appt, I'm waiting.
My Dr does not try to "fit" me in. If I am sick, go to the hospital if they have no available appointment time.
I can't get "free" advice from my dr, but I can my children's dr. My Dr's office says make an appt.
Please consider this: It costs this patient much more than the time sitting there:
1. My wage for the time period I have to wait.
2. I can cost child care costs in addition to the lost wages.
Most patients need more than 15 minutes. How can any Dr see a patient give them good service and take care of the proper paperwork and notes in that period of time. Yes, I realize you have an office staff, but they are not always in that room with you and are not capable of making your notes for you. It is next to impossible, unless it is a minor thing. Please schedule more time for patients. You know you are going to run late at the end of the day anyway, schedule appointments later.
By not being so rushed patients are happier, Dr's are happier, staff is happier. Giving more time will help lawsuits.
I am like another lady that wrote in. I do not want to call and tell the receptionist something personal. I mean she repeats it, and then says Mrs. Jones we can work you in at such and such time. Usually the receptionist is out in the open, so not only can the Dr's staff hear my issues so can anyone in the Dr's office! Everyone then knows what is personal and wrong with Mrs. Jones!
Has anone here ever thought to "bill" the doctor for the time spent beyond the old "college professor" rule? I did. I am a professional and I bill my time at (that point in time) at $100 per hour. When the Doctor's staff was unable to provide me with a good excuse, I told them that this was going to be billed from my firm. An hour and a half later, I saw the Doctor and advised him that he was being billed for the hour of my billable time that he had wasted. He laughed.
He didn't laugh when he got the bill. I don't know if he laughed when he paid it (which he did).
I am a doctors wife and run the front office because it is difficult to find staff to do a competent job- I have a masters degree in psychology and was in private practice for 12 years before leaving to help him run his practice of 18 years. People don't understand he works 24 hours a day 7 days a week- he spent 10-12 years going to school and is genuinely concerned about his patients-
Some days go very smoothly and everyone runs on time- but there are so many unknows--- everyone wants to complain about the drug reps but no one seems to find the free samples they get of very costly medications- the only way to get samples FOR THE PATIENT is to spend a few minutes with the drug rep- we try to keep people informed and give them choices- but everybody that calls needs to be seen today or this week- no one wants to wait 2-3 weeks for an appointment when they are sick.
one last thing, I don't know what other drs make- but for a 20 minute visit a dr averages reimbursement of about 55.00 before all of the expenses- like office space, supplies, staff, malpractice insurance, etc.... it is not what gets billed out, it is what actually gets reimbursed- there is a huge difference! not to mention all the phone calls and other services that aren't reimburseable.
I work front office and the reason pts are asked what the purpose of the visit is- is to know how much time to allow - we are part of the medical staff team- we are taught to ask questions that assess how critical the patient is- how quickly do they need to get it- beleive it or not some call reporting chest pain or extreme difficulty breathing and really need to go to the ER- not to the drs office- this may be a matter of life or death- other times the dr will want an xray or blood work done before a patients appt so when they do come into the office, we have the information he needs-
asking the reason for your visit is not to be nosey, to make you repeat yourself or to be annoying- every effort is made to protect your privacy- and the doctor wants us to do this- hope that info helps anyone who is willing to consider it
I work for a doctor's office also. We have two doctors. One is scheduled every 15 and the other is scheduled every 5 minutes. Each of them only works 2 days per week. The 15 minute doctor is elderly and is always behind, our record is 3 hours behind. We do not overbook him. He just wants to sit in the rooms with the patients and discuss the weather, the tomato plants in the garden, and whatnot. This throws the whole schedule off. We try to leave empty appointments so that he wont get so far behind, but our other doctor wants his patients rechecked on those days. This fills up the schedule even more, not to mention that we will see every workers comp case that needs seen. For some reason, it seems that our office is the one that gets all the ER and workers comp calls, even though there are 3 other specialists in this town. I do believe that the 5 minute appointments are rediculous and greedy, but as office staff, we have no control over that and it is frustrating when the patients yell at us for what the doctor tells us to do. I dont know how many times the patients have complained to the front office about being late, but the minute they see the doctor, they are happy and dont tell him how upset they were. I only do what my boss tells me to do. Thats what I get paid for, so you shouldnt take your complaints out on the staff.
for the most part I am happy with my doctor and try to be understanding that "things happen", yes I want to be seen by the doctor when I have an emergency. BUT, and you notice that's a bit BUT, I had to see one doctor and waited 2 hours to get into an examining room, then waited another hour before the doctor came in. This was ok the first time, I realize things happen, especially with this type of doc., but when it happened twice more, and my complaint went unheeded by both the staff and the doctor. I told my GP and the doc that I would not use a doctor that treated his patients like they were not important enough for him to adjust his schedule. As I said the first time ok, but every time? NO WAY!!!
In response to the doctor's wife who can't find competent staff for her husbands office. Sounds to me like you would rather work there than have him pay someone to do the work, who's the greedy one.
I have worked for the same doctor for 12 years. He is always running behind and our patients expect that. we schedule 3 patients an hour and he spends as much time answering questions and concerns as needed. We do not rush our patients. Our patients have also gotten into the habit of call about 30 minutes prior to their appt to find out if he is running late. If he is going to be extremely late I will call and give the option of rescheduling or having them come in later. We also have a sign in our waiting room that states "due to circumstances beyond our control, appointment times may run longer than scheduled, please check with the staff for approximate wait time. You have the option of waiting our rescheduling at another time." in closing please be patient with staff, it really is beyond their control.
I don't like the long wait in the waiting room, followed by a wait in the exam room, followed by a rushed visit where the doctor doesn't have time for my complex and chronic health issues to be adequately addressed!
With a previous doctor I had to wait 3 hours in the waiting room, 30 minutes in the exam room, and had only 5 minutes with the doctor.
Things are better with my new doctors, but still, if YOU make ME wait, give ME the time I need once I am meeting with you. I don't want to WAIT and then be RUSHED. And certainly don't punish me by cutting my time down because you are running late. And if you start my appointment late by a certain perioud of time, end it late by that amount of time, don't cut my appointment off at the planned for ending time if you started it late.
You wouldn't like me to short you on your bill, would you? Don't short me on my time, especially after I spend my time waiting for you, spend your time helping me not get worse, or better yet, get better. If I was healthier I wouldn't need so much of your time.
Very interesting readindg some of these comments! I tend to side with the patients -- the doctor has no one to blame but himself for his overbooking. It's called time management folks. I've switched doctors before because of poor service.
The doctors wife- actually I am not greedy at all- I think you miss understood the point- as a professional with a masters degree, I used to make my own schedule and only worked three days a week- my favorite stores are target and kohls'- your doctor is very lucky if you have been there for 12 years- most of the ma's and receptionist in the field seem to only stay about 1 year at each job before they move on and want to do something else- or decide not to come in for the day- We wanted pts to have the same friendly face at the desk everyday, someone who knows them and provides consistency- most staff don't care as much about your patients or your business as you do- at the end of the day they get to go home and forget about everything- We have a friend who is a RN and makes more money than we do- I gave up my job and my income to provide better service to our patients that the doctor has had for the past 15- 18 years- he also takes however much time is needed with each patient and if he gets behind the next patient knows they will also get the time and attention they deserve- I wish people could be in the doctors shoes for a week to see what most of them go thru- it isn't the affluent "greedy" lifestyle that so many people think it is- It is a lifestyle and a commitment to over 1,000 pts to be there for them 24/7- and god forbid a mistake is ever made, or anything might be overlooked- Yet despite what some people think- we are proud of the job we do- for the right reasons (to help people- certainly not for the money)- come sit in the doctors office for a day and see what it is like from the other side...
we are not talking about haircuts- or something that can be set on a time table- people think that it is a matter of time management have no idea the things that happen- someone comes in complaining of an infection in their finger- they haven't been in for a year- their skin is gray in color and they have unexplainedly lost 30 lbs that they failed to mention- all of the sudden an infected finger turns into having to get someone to the ER for blood transfusions and finding out they have cancer all over their body- or the person who is morbidly obese - doesn't exercise, non compliant with meds- but wants the doctor to "fix him" in a visit- with hyptension, coronary artery disease, diabetes, etc.... or the person who codes at the hospital- I have been on both ends- waiting three hours to see a doctor (and of course wasn't happy) and working at the doctors office and understanding why he is three hours behind- I guarantee you, it is because they were in surgery, at the hospital, had an emergency or crisis develop that simply can not be planned for.
I find it ironic that you bash patients for being on the cell phone when you walk into an exam room but acknowledge that doctors run late.
I love when I am "abandoned" with the pink paper robe with a 5 year old germy Golf digest magazine for 45 minutes. I don't own a cell phone but if I did, I'd be doing something to pass the time.
Shame on you for complaining about the few "ackward seconds" that it takes to say, "The doctor is here, I'm hanging up now."
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DJ MichaelAngelo said...
Very interesting readindg some of these comments! I tend to side with the patients -- the doctor has no one to blame but himself for his overbooking. It's called time management folks. I've switched doctors before because of poor service.
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Same here. That wasn't the main reason why I switched doctors/practices/primary care provider/ob/gyn both of them were in the same practice/to a family care practioner. Now, as I look at it now that was also reason as well. Do like my new doctor, only have seen her 2 times, but don't like somethings about her/practice, but rather with stay her/practice because its worth it.
Thank you.
Sorry for my grammar.
To those who complain of overbooking and money-hungry doctors who have "never filed for bankruptcy". I think you may be confusing yesterday's doctors with today's doctors or confusing specialists with general practitioners. I am a Pediatrician who left practice after many years. Why? You literally have to see patients every 10-12 minutes without breaks for 8 hours a day just to pay the bills. No, I wasn't broke, but I didn't make close to 6 figures. Then factor in student loans ($1700/month with NO TAX DEDUCTIONS) and malpractice insurance, and there wasn't much left. Then add in the while all expenses have been increasing the past 7-8 years, the amount insurance companies reimburse us for a visit is stagnant or declining!! That means a very severe squeeze on the bottom line.
Now take all of that background and throw in some very unpleasant patients, the constant influx of telephone calls from patients that are trying to speak with me to avoid a visit, hospital rounds at 6:30 in the morning before the office, night calls (yes, parents call you at 2:00 am to inquire if it is OK to give Tylenol for a fever), and a general public that has no sympathy for any of this, and the burnout rate is really increasing, especially in pediatrics, family practice and internal medicine.
I didn't create this system and I don't like it.
And please, please, when the doctor comes in the room, TURN OFF THE CELLPHONE AND USE SOME COMMON COURTESY!!!
I totally understand the waiting for these type of problems. However, this seems to be the norm and I am always in a waiting room with 3 other people who have an appt. to see my doctor at the same time? Now if these things are happening on a regular basis, why schedule 4 people for the same time to see the same doctor?
I always appreciate an apology for waiting endlessly for the doctor or pa. The patient's time is equally valuable too. If someone shows me a SMALL amount of courtesy, I always return it and am very grateful. But it does seem ridiculous to have to wait for a PA. Why can't the dr. hire more PAs or NPs? Their salaries, while very substantial, aren't as high as an m.d.'s and the m.d.'s should consider them a bargain.
For dealing with the long waiting times, I will do deep breathing exercises, bring my own reading materials (which beats the old, disease carrying magazines in the doctors offices), and a notebook to write in. I have often thought about getting some sleep in, but I don't like to awakened suddenly. Sometimes a 20 or 30 minute nap will do wonders, maybe I SHOULD bring in a pillow and sleeping bag next time!!!
Seriously, I have a cousin who is an RN who works with oncologists. Her hubby is an engineer and she claims that the doctors don't work as hard or as long as the engineers. But I really think that the ER doctors, nurses etc really have it harder than anybody. I would imagine cardiologists would have extremely stressful workdays too. I am not too sure about the other fields.
It was interesting that someone should mention those pharmaceutical reps.
They really ought to bring some of the same treats/freebies for the suffering and waiting patients as they do for the extremely well paid medical staff. Some doctors/pa's get free lunches/ dinners, travel, etc from these pharmaceutical reps. How can a doctor not resist these freebies? Does that bias their judgment in prescribing certain medications?
Just wondering.
if a doctor hires a pa or np- he still ultimately is assuming care for the patient as he must oversee the work of the pa or np- the doctor would be the one held liable in a lawsuit if something was missed as the pa and np don't have the years of education or experience the doctor has-
and as for the "extremely well paid medical staff?" I don't know where this misconception came from- most office staff make between $11.00- $15.00 per hour- most waitresses I know make more than that-
one final thought about all the "freebies" frome the drug reps- at our office we get paper, pens, calendars and a bunch of useless stuff noone would want- the drug company offers a dinner while the doctor after a 12-14 hour day finishes at the office and the hospital to try to come get them to listen to "an expert" talk about the new medication that has come out- I don't know about other doc's- but ours makes up his own mind and poses questions to the drug reps about studies, results and this is the first line of feedback the drug companies have re problems patients may be experiencing on the new meds-
It is tough on both sides... "Can't we all just get along?"
I am a chiropractor and have been in practice for years, and I can assure you that on only very rare occasions do patients wait more than 5 minutes in my waiting room. Perhaps I have nearly perfected the art of time management, or my healthy patients don't require as much of my time. Whatever the reason, I like most, hate to wait on my MD more than 15 minutes past my scheduled appointment time.
When I moved to the city I am living in now (Madison, WI)I found the very best medical care I have ever received. My doctors are generally on time, professional, friendly, and actually know my name. The importance of having a personal relationship with my doctor is as important as his/her diagnosing some jungle fever I may have picked up. I love PA's and NP's because they often know more, and are more apt to reveal more to me. I have had some stinkers, but once I let them know I know what I am talking about, e.g. frequently finishing their sentences for them, and applying some self diagnosis considerations they figure out that this woman isn't someone to mess with. I like to think of myself as being polite, yet assertive, and have no problem letting my doctors know that I am the most important person in their world, at that moment.
After waiting over an hour in the exam room,I took a length of that paper that is on exam table, wrote "you've wasted my time, I'll let you discuss with my PCP whether or not I need to see you, then YOU can CALL ME to reschedule." I e-mailed tn'the department chair and changed to someone else.
I believe that most doctors don't seem to understand that by knowing your name, before they walk into the exam room, a smile, a bit of brief banter, and even a handshake or a pat on the shoulder would do a lot to decrease malpractice charges.
As far as the clerical staff goes, I believe that they realize they are at the bottom of the food chain and will never rise any higher, so they get their gratification by being impertinent.
If you let the doctor know that s/he works for you, and you in the process are polite while being adversarial the relationship can become magical.
I am seldom left waiting, at least not for long.
I hate to tell you folks...in our office, if we are running behind, more often than not, it is the PATIENT'S fault. People that don't show up on time, people that say "oh by the way," people that say "look at this other child's ear", etc ,etc. So, do what you do for your hair appointments and show up 15 minutes early. It will at least help things move more smoothly.
To the woman who was complaining that there were no toys in the pediatricians office:
The reason there aren't activities/toys in the room (I'm only speaking for our office) is that at one time there were, and the patients (kids) destroyed them. And the parents let them. We get books and the parents take them home, or the kids rip them up. Thus, empty exam rooms. We don't have the money to replace things every week.
I am an FP who has been in different practice settings for 16 years and as much as I try, I often fall behind for the reasons mentioned -patients with more going on than they were scheduled for; the "Oh, by the way" as I'm going out the door - etc. Occasionally it's for a reason anyone might run late - traffic, can't find my keys, overslept etc. I ALWAYS apologize for running late and my patients know I will spend an equal amount of time with them. While there may be some doctors who are in it for the money (and I can guarantee you none of the medical students these days are going into medicine "for the money" - there are a mulititude of other careers that take less time to train for and where you can make tons more money without all the debt)and feel their time is more valuable than their patients (these tend to be specialists) I can tell you every doctor I have ever worked with feels terrible when they fall behind and often try multiple ways of adjusting their schedule and their staff to try to overcome this.
But you can't plan for a lot of things in medicine - a routine prenatal visit where you can't find the heart tones on the baby or mom says she's leaking fluid since yesterday; a kid with a sore throat who really has lymphoma; a patient with a stomach ache who, you find out, her mother just died last week; patient's who show up show up at exactly their stated appt. time and by the time they fill out the papers, verify their insurance (which has to be done at every visit because of how frequently insurances change or to verify their Medicaid eligibility this month)get in the room with vitals and change - it's now 15 minutes past their appt. time. We've also tried telling people to come 15 mins. before their appt. time for this reason - so now if they come AT their appt. time, do you say they're late? If a pt. shows up late, how late is too late to be seen? 10 mins.? 15 mins.? If a patient shows up 30 mins. late for their appt. for a "cold" but they are 75, gasping for air and turning blue, do you tell them,"sorry, you're late"? Even if you just call 911 that's going to take time out of your schedule. People may think these are extreme stories, but it would be a rare day not to have one event like this. The staff may not know that we're running late or at what point we're going to get behind - when should they call you? When I'm 15min behind? 20? There are now entire medical journals devoted to these issues - so the profession knows its an issue and are honestly trying to improve it. And these journals recommend apologizing - which apparently not everyone has learned to do..
The main reason we schedule patients every 15 minutes is NOT to make more money (that has been shown NOT to increase your revenues)it's because if we didn't then patients would have to wait weeks and months for their next appointment! I would LOVE to schedule patients for longer appointments, but then I wouldn't have any available appointments for new patients or for follow-ups or for acute/emergent appointments (for which I already have to "squeeze" people in).
My patients are very dedicated to me and already I'm "booked" a month in advance!
And whoever thinks that it is very RARE for a woman to tell you all her troubles at her pap smear appointment is obviously IGNORANT of what goes on at those appointments - even if you're a woman who would never dream of doing something like that, I can tell you there are a lot more patients who do. This may be the only time all year a woman sees her doctor, so there's a lot to cover during that appointment and I schedule them for 30 minutes for that very reason.
I'm not saying it's OK to consistently run behind and if it's consistently 1hr or more, then you probably should find someone else (although depending on where you are, there may not be anyone else in a specialty in your network, which is probably why that person is so busy). And by the way, many offices don't accept drug reps visits anymore - but with that comes the loss of free samples.
But it irritates me to no end when people assume that, across the board, running late occurs because of callous, money-hungry doctors. There are doctors like me out there who run a little behind because I take time to listen to my patients and because of that they are willing to wait for me because they know I will give them time too. And these patients have followed me over 16 years, through several moves.
Very well put.
Okay, fine. Doctors get behind due to emergencies. I understand and accept this. But how do you explain this? Several weeks ago, I called my daughter's new pediatrician to schedule a wart removal. I specifically told them I wanted it burned off with the liquid nitrogen. The front office checked, and said that if I didn't mind seeing the NP, I could have an appointment the next day.
I rushed to get there early, because being new to the practice, I knew I was going to have to fill out paperwork. Got that all completed prior to the appointment and waited to be called back to the exam room. And then waited some more. Several sick babies came in, and they were seen before us. Okay, sick babies. I can deal with that. 45 minutes after our scheduled appointment, we are finally called back. We then proceed to wait for another 1/2 hour. When the NP finally shows up (with out an apology for a more than 1 hour wait) she takes a look at my daughter's hand and says "Yep, that's a wart all right," and then proceeds to tell me to use Compound W.
When I asked why she wouldn't burn it off, she glibly told me that they didn't have the liquid nitrogen at this office - only at the old office. Also, she wanted to look at it just to make sure. And when I asked where I could get it done, she said that since I was on an HMO, she would have to write a referral to a dermatologist, but she wouldn't actually do that!
I walked out of there feeling well and truly used...like the only reason she had scheduled the appointment was to get my copay.
I don't think we will be going back.
Hmmm. Last time I checked, going to the doctor's office wasn't the same as going through the mcdonald's drive-through.
I'd like an order of antibiotics please! Give me what I want!
Someone who works in an office said "If he is going to be extremely late I will call and give the option of rescheduling or having them come in later."
WHY DOOESN'T EVERY DOCTOR DO THIS?
1) quick
2) cheap; can be done by non-medically trained people
3) allows you to reschedule those patients who can't move their assigned time
Unless you're an idiot, you can manage your time for constantly recurring events.
That means that if you're late by an hour every day by lunch, then guess what? You need to stop scheduling so many patients.
That means if you only see your 4:30 appointments before 5:00 PM. 5% of the time, then guess what? You need to stop telling people to get there at 4:30.
That means if you average 2 critical call-ins every day you're a fool if you don't save at least one slot, every day, all the time.
And saying "it's not about money" is bullshit. Why? Because the only reason that doctors DON'T schedule like this is... they don't want to lose money if they have a no show, or an 'unused' spot. Which is to say, they don't want to lose money for THEMSELVES, as everyone who waits loses money by the minute.
I am a Medical Assistant in a very busy Internal Medicine practice which is owned by a big hospital. The docs are paid a salary, have their malpractice paid for by the hospital and receive a bonus every quater if they exceed the minimum patient contact. While they do work hard, the staff is also being overworked (and underpaid) hence the high turnover of staff. They do not "practice what they preach". They are aware of what a high stress environment day in and day out will do to the human body but it all comes down to the bottom line-money. While they can afford 3+ children each and wives that can stay at home and huge homes and brand new vechiles, I cannot. My husband and I cannot afford a child. We own a modest home and have very used vechiles. I cannot afford to continue my education because I have to work full time. I can make more money doing something else and put in less than my usual 50 plus hours a week.
Our staff doesour best to keep our patients happy and healthy because we genuinely do like and care about people but sometimes you just can't please everyone. As much as I am intrigued by and love medicine and people I am looking to leave the whole thing. It has turned into a money making business and I cannot in good faith practice in this way. Blame the politicians, lawyers, insurance companies and the big executives running the medical industry and those doctors who allow themselves to be governed by their rules. And why-all for the MONEY.
There is no law that says you need to see patients every 10 or 15 minutes. What would happened if it were every 20 minutes? Hmmm patients might get better care and might have lower blood pressure from getting angry waiting forever.
I agree with the fellow that said that if a Dr. consistently runs 1 hour behind by noon its not rocket science to figure out that you need to lighten the load or at least tell the 11:30 patient that 11:30 really means 12:30. Its not that hard to do yet they fail to do it. Stop reaching into the bottomless bag of excuses.
What the hell, who was that dumb doc. that said seeing more patients per hour does not make more money? huh. Hmmm ok using your logic (must have been an English major) you should see 1 patient per day to make the most money.
I know some docs that make a free empty 15 min slot every 2 hours so they do not run behind. They make plenty of money and keep the patients happy at the same time.
Its not that hard to do, Docs try to refrain from the excuses and give it a try.
Who ever said that Drs only collect insurance money from 50% of the patients is wrong too. Ever heard of checking for eligibility? You can call and check to see if they are covered and if they have a co pay etc.
Student loans can be put off for a long time, you don't need to pay 1700 per month if you do not want to. Switch your loan over to a goverment loan which is forgiven after 25 years even if you have 100k left on it.
All of the preceding comments hit home. I work in a veterinary hospital and the previous posts could just as easily apply. We switched from 15 min slots to 20 min slots. We ask for the nature of the visit so that we CAN schedule enough time. We call the day before to confirm the appt. As a patient perhaps you can tell us what to do when a patient doesn't show up for his/her 40min blocked off time and didnt call and I have a waiting list of patients that could have come in instead of feeling bad that we couldn't see them that day. As a patient can you tell me how to take care of the client who makes a 20min recheck for 1 pet and then brings an extra pet along because IT WILL ONLY TAKE A SECOND TO TAKE CARE OF HIS ABSCESS AND I KNEW THE DOCTOR WOULDN'T MIND. We try very hard to make it so that our patients have a minimal wait but when the pet goes to our treatment area for x-rays to be taken then the doctor needs to spend time reviewing the films and then time with the client discussing the findings. I assure you that when the client makes the appointment to check a small lump on the side doesn't tell us that the doctor will want an x-ray of the chest which automatically means additional time with the client and will most likely result in the doctor falling behind. There are also times when we are running ahead of schedule. We understand your time is valuable and we try to book accordingly. We note on the chart your appt time and the time you arrived so that when the doctor enters the room he/she knows how long you've been waiting because often they don't know you've been waiting. Someone is not likely to apologize for something they didn't know happened. For every doctor you think is out money-grubbing there are more who are trying to do their best for you. Think about that the next time you're sitting eating supper and your doctor or nurse is callling you while they're still at the office where they've been since 7 or 8 AM and you didn't get a bill in the mail for that time they're spending.
There is only one long run solution to greater patient through-put -- each MD ACTUALLY spending LESS time with patients (e.g. intra-office specialization, delegation, self-service, productivity technology, etc.)
Merely setting artificially fast schedule does nothing to accomplish this. Such scheduling only gives the illusion of productivity, because your patient appointments are going to last whatever time they actually last.
The amount by which your ACTUAL average speed is slower than your "standard" is nothing more than a created inventory of frustrated patients sitting out in the lobby.
You cope with this artificially fast scheduling several ways:
1. You try to "work ahead" or "catch up" on this lobby inventory by working longer, off-schedule hours (before/after "normal" hours; during skipped meals. Of course, this extra time simply lengthens the too-fast "standard" time to a more realistic average time.
2. You try to cap the growing lobby inventory by leaving unscheduled blocks of time in the daily schedule to "catch up" (which, when added to the scheduled times, again simply lengthens the too-fast "standard" to a more realistic average time).
3. You can let the lobby inventory reduce itself by doing nothing and counting on a certain number of frustrated or inconvenienced either reschedule or walk out. And, again, these cancellations simply reduce the scheduled number of too tightly booked appointments to a more realistic average.
There are plenty of expensive, high tech scheduling systems out there. But the underlying problem is still the same -- match the scheduling standard with ACTUAL productivity.
How?
A. Calculate the total # of hours each MD in the practice sees patients over a typical period of time (e.g. several weeks up to a couple of months).
B. Calculate the total number of patients each MD sees during that same period of time.
C. Divide A by B for each MD to determine his/her ACTUAL average.
D. Adjust the scheduling of each MD's appointment times to 80-90% of his/her ACTUAL time average (to allow for late arrivals, cancellations, and no shows).
E. Calculate the total number of walk-ins (included in B) each MD sees during that same period of time and the typical arrival times of these walk ins.
F. Calculate (B-E)/B and multiply it times D to determine the number of schedule slots to actually pre-schedule.
G. Book the pre-scheduled appointments (F) away from the typical arrival times of walk-ins to create room for walk-ins.
At any given level of productivity, you will still see as many patients as you're going to see, but without completely unnecessarily creating a large inventory of annoyed, inconvenienced lobby-parked patients.
The personal benefit is that whatever hours you need to work to handle the desired schedule load will be known more accurately known and can be better staffed or conveniently scheduled.
As an office RN AND a patient of several different physician practices, I can see and appreciate both sides of the coin. YES, physicians do overbook! YES, it's done mostly out of greed. YES, better time management would be beneficial to all parties involved. HOWEVER, if patients would learn to take more responsibility for their own actions, it'd be a smoother process all together. When you develop symptoms of bacterial vaginosis on Monday a.m., but wait until Friday at 4:00 to call and demand to be seen b/c the itching and fishy odor are killing you", then I say GET IN LINE. I can't tell you how many times as a phone triage/advice nurse I have heard crap like that. Despite what you think, this world does NOT revolve around you. Frankly, I don't care that you've been away at college all week and couldn't get away until now, that's NOT our problem. There are urgent care facilites ALL around. Find one! And yes, a patient waiting on a routine pap smear most definitely WILL want to discuss her bastard of a husband and how bad her last hair cut was. Everyone (me included) at some point in their lives will suffer from "it's all about me syndrome", and most everyone will prove that when they come to the doctor. Trust me, I've seen it all!
I used to be an office nurse and have seen this problem on a daily basis. It isn't the "once in awhile problem" that patients seem to think it is. It is a DAILY occurance to have one child scheduled for a time slot only to have the parent bring the other 2 sick siblings. They basically get a free visit fior the other two siblings. Even when you do make good money, I don't know anyone who consistantly wants to work for free!As for the comments pertaining to MDs working 4 days a week, that is in the office. People forget MDs must also do call at the hospitals so Mds often leave there 8-10hr office day ( yes, just because office hours are over doesn't mean they've left) only to spend multiple hours rounding on their hospitalized patients. It's a hard and consuming lifestyle that patients don't always get a "behind-the-scenes-tour" of.
By the way, the person that complained about no toys in the pediatric office, needs a little education. The office sees SICK kids. It is a sanitary issue as viruses and infections can be spread by these toys. It isn't to annoy you, it's responsibility and concern for your child's health!!
All the people who want to complain about greedy doctors: you try to get in medical school, spend 4 to 5 years in undergraduate school, 4 years in medical school, 3 to 5 years in residency, and a 1 to 2 years in a fellowship, all at a huge personal, social, and finacial cost, take out huge loans to pay for years of medical school, then have to pay huge amounts in malpractice insurance, work 60 - 80 hours a week (nights & weekends).
this is fascinating to me, i've never been on this site. i'm an er nurse of many years, and the one thing that rings true here is no o0ne wants to take responsibilty for their own actions. health care providers- manage your time and set some limits instead of complaing about people wanting freebies. health care recipients-don't smoke, stuff yourself into obesity, drink to excess. Do Sleep, manage stress, exercise regularly, and have some prductive purpose in your life instead of glutting DR's offices and ERs with frequently unneccessary visits. that wou7ld cut your waits and health care costs hugely.
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