The Waiting Room

On 18 Mar 2006 09:08:09 -0800, "Crispee"
wrote:

Anyway, don't you think if people just *left* when they were kept
waiting for more than 10 minutes, doctor's offices (and other
businesses) would stop taking advantage of people like that?

I think a 10 minute wait is *short*!
I don't mind waiting to see our doctors. They never rush us through
so they can get to that next patient, taking the time with us, that we
need.

Nan

Crispee wrote:

I honestly don't care *why*
he/she is late--that's not my problem. Same thing if I were unable to
pay my bill. I am sure they would not care *why*---that's my problem.

Hm. For me, whenever someone is late, I presume that they have a reason
-- even if it's a reason I wouldn't label as 'great' -- and it's not
just a behavior calculated to upset me. (I'm a bit compulsive about
being on time, as much as possible.) Sure, I have friends whose watch
is basically a calendar -- and I plan accordingly. But for professional
services, I'm fine with waiting -- I've been 'squeezed in' enough times
for emergencies that I'm just happy I'm not the person/family having
the emergency (or the unduly long and depressing conversation with the
physician).

Likewise, in my experience shadowing financial counselors, physicians'
offices actually did care *why* someone couldn't pay their bill,
offering either to enroll for free care, Medicaid, to directly contact
insurers, to reduce charges, to set up no/low interest payment plans,
etc.

Anyway, don't you think if people just *left* when they were kept
waiting for more than 10 minutes, doctor's offices (and other
businesses) would stop taking advantage of people like that?

I'm sure in some cases people are scheming that they're going to take
advantage of me, but in general, I really don't believe it's the case.

Practice scheduling is a bear, due to 'standardized' times per CPT --
if you get a wide variety of patients, let alone a wide variety of
insurances, or a need for a translator, et cetera -- things are going
to run late.

Caledonia

Caledonia wrote:

Practice scheduling is a bear, due to 'standardized' times per CPT --
if you get a wide variety of patients, let alone a wide variety of
insurances, or a need for a translator, et cetera -- things are going
to run late.


Why do some manage and others don't then? Interestingly, the practice I
left, because waits of 1 hr + with no explanation of emergencies, was a
very high end place. Situated in the most expensive part of town,
elaborate building, etc. Those appts rarely lasted more than 10 mins,
and the OB never asked "so how is everything going with you?" or any of
those other questions people argue 'take time." OTOH, the practice I
moved to has a mix of insured clients and uninsured, is located in a
poorer part of town, dealing with a very wide assorted of clients and
more variety of needs. I never had to wait more than 10-15 mins without
an explanation (I think that amount is acceptable on both ends). And
the OB took quite a long time with me each time, asking all sorts of
questions and offering to answer any questions. Somehow, they manage to
attend to a wide variety of clients and needs and still be reasonable
on timing. Incidentally, they're also excellent about disease reporting
whereas the other is not (part of my job involves receiving such
reports, so I know this ;-))

I'm willing to bet a lot of this has to do with insurance companies'
expectations of how many patients should be seen, and just like
airlines, the offices double book so they can meet those expectations.
Unfortunately, it all boils down to money.

It is harder when you go to the OBGYN because we all know that babies
come when they come and emergencies do arise. I tend to be very
patient there (or at miswives) bc I know/hope that when I have an
emergency some other woman will give me the time. However I fully
agree, they need to tell you why you are waitting or give you the
option to reschedule.

Kath

"Crispee" wrote in message
ups.com...
I had a rather important appointment to meet someone yesterday at 10 am
(not a doctor's appt). It was 10:10 am and she still wasn't there.
She didn't call and have the secretary tell me she was running late.
Nothing. So I left. Simple. She didn't keep the appointment, so I
left. And I won't be making any appointments with her again. Aside
from being insulted, my reasoning was that if she would be
inconsiderate in that way, then she would certainly be inconsiderate in
other ways in the future.

My question is, why do we (the general public) put up with that
nonsense at doctor's offices? If someone does not meet me within 10
minutes of an appointment, or at least very politely explain the delay
and offer immediate apologies, I assume he/she is not interested in
keeping the appointment and then I leave. I honestly don't care *why*
he/she is late--that's not my problem. Same thing if I were unable to
pay my bill. I am sure they would not care *why*---that's my problem.

Anyway, don't you think if people just *left* when they were kept
waiting for more than 10 minutes, doctor's offices (and other
businesses) would stop taking advantage of people like that?

Crispee


i guess you didnt want to see the person badly enough, b/c most of us would
wait more than 10 minutes, even though we'd be mightily ****ed off at their
attitude. Often it is the receptionsit that has the attitude, not the doctor

chris

"Crispee" wrote in message
ups.com...
Anyway, don't you think if people just *left* when they were kept
waiting for more than 10 minutes, doctor's offices (and other
businesses) would stop taking advantage of people like that?

I agree or submit a bill at yourhourly rate and deduct it from the doctor's
bill.!

Carl

"Kath" wrote in message
oups.com...
It is harder when you go to the OBGYN because we all know that babies
come when they come and emergencies do arise. I tend to be very
patient there (or at miswives) bc I know/hope that when I have an
emergency some other woman will give me the time. However I fully
agree, they need to tell you why you are waitting or give you the
option to reschedule.

Kath

At my OB, they do tell you as soon as you walk in IF the doctor is out doing
a delivery. I know with my doctor, she's very quick with deliveries, and
she's usually only out of the office for 15-30 minutes (the hospital is
right across the street) and yes, emergencies to happen where they can get
tied up. I know for my first, DS was an emergency C-section, and it had
taken up a bit of her time, I'm sure, given she had to have me rushed into
surgery. It seems that every time a doc is out doing a delivery or
something, patients are informed, but if they're just running late, no one's
really given an explanation. It sometimes could be because of a delivery or
something that came up earlier in the day, but yes, it's nice to know why
they are running late, and if possible, about how late they are running or
when they are expected to be back - an approximate time, anyways - and I
know for me, I'd be greatful if someone was patient if they had to wait
because of me

"xkatx" wrote in message
news:jqqTf.3113$J43.1062@edtnps90...

"Kath" wrote in message
oups.com...
It is harder when you go to the OBGYN because we all know that babies
come when they come and emergencies do arise. I tend to be very
patient there (or at miswives) bc I know/hope that when I have an
emergency some other woman will give me the time. However I fully
agree, they need to tell you why you are waitting or give you the
option to reschedule.

Kath

At my OB, they do tell you as soon as you walk in IF the doctor is out
doing a delivery. I know with my doctor, she's very quick with
deliveries, and she's usually only out of the office for 15-30 minutes
(the hospital is right across the street) and yes, emergencies to happen
where they can get tied up.


snip


I find that strange that you know your doctor is "quick with deliveries"...
When I gave birth, the doctor spent a full 2,5 hours with me... I don't
think it's the doctor who can be "quick", but rather the patient... I was a
slow pusher, I suppose, and the doctor stayed with me the whole time, and
then at least one hour with me and the baby after. Not sure I would want a
doctor who's there 15 to 30 minutes and then good-bye.

Isabelle

Kmom wrote:
My answer? I don't. The only exception being physicians I *know* are
running late because they are spending needed time with patients. I had
an ENT who would come in at 6:30 and 7AM to see patients before they
needed to be at work, he would also fit in all emergency cases that
day. His office would be very up front when you arrived for your appt
that Dr. P was running behind and gave the choice to wait or
reschedule. I didn't mind because I knew that if *I* was the patient in
need he was available for me.

Now I had (note the past tense) a GP who had prominently displayed a
paper at the front desk that if you were 15 minutes late for an appt
the appt was automatically canceled and you had to reschedule. Fine.
Except when I had the first appt of the day the doctor was 1 hr late.
Nothing said to me from her secretary. No opportunity for ME to
reschedule. She comes in and flippantly says her child had an ear
infection. Nifty, next time MY child has an ear infection and I'm an
hour late for my appt will you wait for me?
Total and complete lack of consideration for MY time but I'm supposed
to respect hers? Don't think so.

My philosophy is that if someone turns up late but apologetic, I'll see
them. These things happen. If they turn up late and don't seem to care
- well, depends how busy I am that day. Late with apologies counts as
respectful of my time, IMO. Unapologetically late does not.

Similarly, I will always apologise when I'm running late. (It's no
doubt a depressing commentary on the state of medical care that this is
so frequent that when I'm running on time I have to remind myself that
"Sosorrytokeepyouwaiting" is not actually part of the routine greeting,
even though it feels that way.)

As to letting people know while they wait that I'm running late, I'm not
totally sure how to do that. I don't actually know whether the
receptionists let people know or not. One practical problem is that
appointment times are _so_ unpredictable that I might make up a lot of
time later in the surgery - unusual, but has happened. So, I can't
really get the receptionist to tell people that I'm such-and-such an
amount late and they should go away and come back later, because I might
have actually caught up by now.

Oh, I just thought of something - When I know that there is a specific
reason why I'm going to be exceptionally late (such as getting called
out on an emergency visit) then I tell the receptionists to warn
patients of this. Sometimes they do, sometimes they don't. (I have
found that patients are extremely understanding about this.)


All the best,

Sarah


--
http://www.goodenoughmummy.typepad.com

But how do we _know_ that no-one ever said on their deathbed that they
wished they’d spent more time at the office?

cjra wrote:
Caledonia wrote:

Practice scheduling is a bear, due to 'standardized' times per CPT --
if you get a wide variety of patients, let alone a wide variety of
insurances, or a need for a translator, et cetera -- things are going
to run late.


Why do some manage and others don't then? Interestingly, the practice I
left, because waits of 1 hr + with no explanation of emergencies, was a
very high end place. Situated in the most expensive part of town,
elaborate building, etc. Those appts rarely lasted more than 10 mins,
and the OB never asked "so how is everything going with you?" or any of
those other questions people argue 'take time." OTOH, the practice I
moved to has a mix of insured clients and uninsured, is located in a
poorer part of town, dealing with a very wide assorted of clients and
more variety of needs. I never had to wait more than 10-15 mins without
an explanation (I think that amount is acceptable on both ends). And
the OB took quite a long time with me each time, asking all sorts of
questions and offering to answer any questions. Somehow, they manage to
attend to a wide variety of clients and needs and still be reasonable
on timing. Incidentally, they're also excellent about disease reporting
whereas the other is not (part of my job involves receiving such
reports, so I know this ;-))

I'll hazard a guess that practice A has a higher overhead that they
need to cover, and hence MDs are encouraged to have a higher patient
volume -- regardless of whether the MDs themselves really even wanted
this overhead.

Again, just guessing that practice B is an enhanced prenatal place
(w/r/t Medicaid) and can get reimbursed at a higher rate for the array
of Medicaid-eligible prenatal services, and they have a lower caseload
and lower overhead. But this is just guessing.

I'm willing to bet a lot of this has to do with insurance companies'
expectations of how many patients should be seen, and just like
airlines, the offices double book so they can meet those expectations.
Unfortunately, it all boils down to money.

I'm unfamiliar with insurance companies setting expectations of patient
volume, with the exception of insurers/providers like Kaiser (where
they're both). Within managed care, I think insurers (and physicians,
in some cases) would be more inclined to *reduce* volume (and reduce
claims expenses), not increase it -- except for visits that are viewed
as quality-indicators (e.g., mammograms, smoking cessation) pmpm.

Caledonia