I send them a bill....after I walk out.

I have a patient that insisted she wanted a full half hour of my time. She has no serious medical problems, but I reserved a half hour slot for her. She shows up 20 minutes late with a fresh latte in her hand. (I guess she had time to stop at Starbucks). Any way, after 10 minutes with her I got up to leave. She said, "I told your office staff I wanted a 30 minute appointment!"

I told her we had a 30 minute appointment and that I was disappointed that she chose to spend the first 20 minutes somewhere else.

Hear ya loud and clear but consider this.

15 minutes per patient.

He had a 9:15 appt.

If the office opened at 9 then he was number 2.

I hear you too.

Most docs round in the hospital before going to work. There is no way to predict how many patients you will have or how long they take.

Docs want to run on time. We want to get lunch breaks (hardly happens). We want to go home on time too...

Patients needs are hard to shoe horn into 15 minutes...

Happens every day. Usually when a patient shows up late, they insist on being seen for just "1 quick thing." Thats secret lingo for "Once I get in the room I STILL want my 30 minutes..."

Its not the docs that are making you late. Its the patients before you...

Had a lady yesterday, called for a rash, so she got a 15 minute slot.

During the visit she wanted:
1) ALL her meds changed to generic
2) An ER followup she didn't mention
3) Discussion of er depression and divorce
4) Toe nail fungus treatment
5) Oh, her diabetic labs reviewed
6) Her cholesterol meds reviewed
7) Oh, and that rash on her back...

When I politely pointed out that she called for a rash, and we can reschedule the other issues, she was damant that she wasn't asking for a lot, and there is no reason I couldn't do it. Took me 45 minutes...I wasn't happy.

Rick, I want to give you some great advice. You heard the old saying "You get more bees with honey than...."

You NEVER EVER want to come across like a jerk in the doctor's office. Not on the phone, not to the staff, and not in the hallways. Docs are people too, and they hold grudges. Most docs will bend over backwards for patients they like... Patients that are liked get squeezed in to busy scheduled. Patients that are disliked, wait.

When you act poorly, the staff typically documents this. Then the doc sees it. Then they document it, etc. This ACT becomes part of your permanent record. And in the age of electronic records, everyone sees this. When you change docs, they will see this. WHen you go to the hospital, they will see it. And if you think that doesn't color the perception of the doc treating you...

Most docs are so busy, they will only see new patients after reviewing their chart. Any negative connotations, and they will decline you as a patient. This happens ALL OF THE TIME. Remember the Seinfeld epsiode that dealt with this?

We are so busy in our practice, that if a patient acts out, they immediately get terminated from the practice. If two docs terminate you, then the entire hospital system will no loner see you. Guess what. Happens all of the time...

I just want folks to know...

I have posted similar threads here myself...

And I appreciate that patients show up and waste your time (docs).

However this is a known quantity (time wasted)... when I worked installing air conditioning I could swap out a heater in 2 or 3 days. I always planed and bid for 5 days.

It just seems disrespectfully and bad business to schedule an appointment knowing in advance you client is going to have to wait 45 minute to an hour... or two...

I don't have to wait at the dentist or accountant... if they can do it don't see why a doctor can't.

But you don't know ahead of time... No one can predict what the patients will ask for that morning...or that day.

So, one may ask, why not just make the appointments longer? Why not make them all 30 minutes? Why not 45 minutes? For the same reason it doesn't work in other businesses...

Folks have very high expectations of their medical providers...unrealistic even...

Cable guy gets a 6 hour window to see you. And that for a totally unnecessary easily time demarcated service...

Hair dresser can run an hour behind, no problem...

Oil change place can make me wait for an hour...DMV can make me wait for 4 hours...

Contractor can stretch a 1 month project to 6 months...

I can wait on the phone to talk to the electric company for 2 hours...

Airplanes run behind an hour...routinely


But a doc, who has unpredictable patients and every varying diseases to deal with...should run like a precise swiss watch...


With the airconditioner analogy...

What if a third party were paying for the installation? And they would only pay for 1 days labor? Would you still alot 5 days, knowing it would take two?

Could be worse - my doc is apparently so busy that his office won't even call me back to schedule an appointment. Time for a new doctor.

I tend to run on time.

If he starts at 0900 and you were his 0915, he probably overslept or something. Around here, most of the family practice or internist guys don't see their own people at the hospital, full time hospitalists see them.

I have had to reschedule a bunch of people lately, because I just can't manage a full work load since that old codger ran that stop sign two weeks ago and wrecked my car. I get more of the, "I hope you are okay," or "Thank you for seeing me today, I understand you were in a car accident," than "What do you mean, reschedule?"

I am pretty old school though, will meet them on the 4th of July at the office if it sounds like I need to, visit them in the hospital when they are in for an unrelated problem, that sort of thing.

WRT a patient acting up. They can say anything they want to me, but if they are nasty to my staff, I have a one strike policy.

To me it's like going to a busy place for food, the empty usually arent any good.

Two wrongs don't make a right... "other people suck at time management so I should be allowed"

I sure as heck would not wait more the 15 minutes for a hair cut or an oil change.. that is just whack.

As far as airplanes... the plane and the pilot have to up to spec... if not another plane or pilot need to be arranged ed... not to mention they are at the mercy of weather conditions, I can understand that and would not want it any other way.

Exactly...

They ARE at the mercy of the weather...

Docs ARE at the mercy of the patients and their complaints. We aren't making widgets here...

Zactly, I understand all of our jobs are unpredictable to some degree... but some docs are better than others... like my dentist... never waited more than five minutes... when I show up there is rarely even anyone in the waiting room.

Hire an out-of-work guy to go for you for 20 bucks. He wins, you win.

God, you aren't happy if you don't have something to whine about are you?

your in 'public relations' and should know better..
if they like you//
they will buy ice on the North Pole.
had you had a relationship with your Dr & staff they would know..
R dont fly well needs AMBIEN..
and a simply call would have done everything..
.
BTDT..in out if ..
you treat me right..
to what do mean I not a pt...
''Sir you not in our system''
NEXT

Rika

Nonetheless, sometimes patients show up with urgent needs.

The other, and chronic problem, is that the system is geared to minimize the MD's time, and wastage of time. If a patient is a no-show, which is common, then the MD still has a nice stack of bodies there to examine (and bill for). They are also telling you an appt. time of X, when they expect most patients to show up at time X+20 or so (if at all).

Think about how a mechanic's shop operates. Very similar, except the cars wait dociley and most owners never know what is up. This is amplified by the lowering of payments for MDs by insurance companies, the ethical requirements (or non-mandated, but still an --- um -- impetus) to provide care w/o reimbursement, and other factors. One other factor is that the MDs time is worth big bucks -- your isn't. You are a worthless hunk of protoplasm -- got it? (ok, that has changed as has the hazing of residents, interns, yada yada -- but has it changed enough?).


I can guarantee you, no medical office is going to add slack time into their schedule to accommodate patients that run overtime, have some complications, etc. Not today, and definitely not in the foreseeable future.

Now, that said, I don't like it either. I've made my PCP aware of the problem (without staging a scene in the front office [BTW - you did not do that in the gym re the double parking thing...] and it has decreased -- at least for me). A friend of mine in Denver (who is a PhD chemist), just walks up there after 15 minutes, tells them in a calm, quiet voice the time of his appt., what his charge-out rate is, states that he will walk out in 5 more minutes, and then does so. It works for him.

You can expect this to get worse, over all - maybe not for you.

But if you went to that busy place with great food and it took 90 minutes to get your first course, I doubt you'd return.

Good one!