Clinic Practices: Joining the Fray
Have you been following the unholy fracas taking place over at Rod Moser's WebMD blog All Ears? Scroll down to the posting dated January 20. He wrote a candid and contentious tome regarding clinic booking practices and the many reasons why patients are left waiting.
I encourage you to visit and add your two cents.
The response was overwhelming!
= Overwhelmingly hostile
= Overwhelmingly sarcastic
= Overwhelmingly judgmental
= Overwhelmingly passionate
Everybody hates to wait. There, I've said it!
Everybody wants more time with their provider. There, I've said it again!
It makes no difference how busy or how (in)efficient my individual clinic may be. I was surprised that so many respondents blamed the waiting on GREED. If that were the case only private practice clinics would have problems with overbooking. University-based clinics, institutional, military, and missionary charitable health care facilities would hum along. Ha! Ha! Ha! In Honduras they wait for DAYS in order to be seen by the visiting eye doctors and no money changes hands.
About time management. Is it possible that all clinic administrators are idiots? They usually prepare the schedules. Many have MBA degrees. The core struggle is the provider's inability to dehumanize the practice of medicine: listening, thinking, educating, comforting, balancing so many conflicting priorities while trying to compress 16 hours of compassion into 8 hours of clinic.
For example, a walk-in patient with a new corneal ulcer (serious threat to eye!) will unmercifully consume at least one hour of my clinic. One hour, POOF! What happens to the four waiting patients?
In 25 years' practice the following gesture has never failed me. When things get backed-up I walk into the waiting room and ask for everybody's attention. Without violating HIPAA I inform the group that the schedule has been sabotaged. I give my promise that patients who are willing to wait will receive the same care and attention. Those who cannot wait are invited to rebook. My final word is that I will not leave the clinic until every patient is seen and satisfied. Usually there is some soft laughter and a little applause. It really decompresses things.
Congratulations to Rod Moser for giving all of us a change to express our perceptions and our attitudes about outpatient health care delivery. Now, Rod, when are you going to tackle serious issues like hospital food?
I encourage you to visit and add your two cents.
The response was overwhelming!
= Overwhelmingly hostile
= Overwhelmingly sarcastic
= Overwhelmingly judgmental
= Overwhelmingly passionate
Everybody hates to wait. There, I've said it!
Everybody wants more time with their provider. There, I've said it again!
It makes no difference how busy or how (in)efficient my individual clinic may be. I was surprised that so many respondents blamed the waiting on GREED. If that were the case only private practice clinics would have problems with overbooking. University-based clinics, institutional, military, and missionary charitable health care facilities would hum along. Ha! Ha! Ha! In Honduras they wait for DAYS in order to be seen by the visiting eye doctors and no money changes hands.
About time management. Is it possible that all clinic administrators are idiots? They usually prepare the schedules. Many have MBA degrees. The core struggle is the provider's inability to dehumanize the practice of medicine: listening, thinking, educating, comforting, balancing so many conflicting priorities while trying to compress 16 hours of compassion into 8 hours of clinic.
For example, a walk-in patient with a new corneal ulcer (serious threat to eye!) will unmercifully consume at least one hour of my clinic. One hour, POOF! What happens to the four waiting patients?
In 25 years' practice the following gesture has never failed me. When things get backed-up I walk into the waiting room and ask for everybody's attention. Without violating HIPAA I inform the group that the schedule has been sabotaged. I give my promise that patients who are willing to wait will receive the same care and attention. Those who cannot wait are invited to rebook. My final word is that I will not leave the clinic until every patient is seen and satisfied. Usually there is some soft laughter and a little applause. It really decompresses things.
Congratulations to Rod Moser for giving all of us a change to express our perceptions and our attitudes about outpatient health care delivery. Now, Rod, when are you going to tackle serious issues like hospital food?
1 Comments:
A large part of the problem of overbooking is out of the doctors hands. That said, THEY should be the driving force to correct it. Many practices, especially at large institutions, have 'farmed-out' the front office task to outside staffing agencies. These people are not eceptionally medically literate, and in some case, not to literate at all! THe commonality of double and tripple-booking time slots is testament to a bottom-line driven activity.
Another thorn in the side of efficiency is that hospitals, in particular, have very poorly-designed computer applications that require the doctor to spend more time as a data-entry clerk than a Health Care Provider! Slow server response time can slow-down patient flow worse than any thing else.
Lastly, the issue of Insurance providers dictating to docs how many patients to see in order to be able to accept that provider's particular insurance. They almost mandate short, and more frequent bookings.
It is about money, bottom line. Money for the doc, money for the insurance co, and money for the hospital. More for the office staff that can keep every minute booked, and squeeze more through if possible.
I wait 30 minutes, max, then leave.
"M.D." does NOT stand for "Medical Diety", either!
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