I'm certain that we all have our fair share of stories in dealing with medical care providers - doctors office, dentists, labs, hospitals. And to those who are in the field and to whom this story does not pertain, my apologies in advance. My personal issue with the medical establishment is not the level of care I receive, but with the utter lack of ability the vast majority (again in my personal experience) of physicians, dentist and lab/testing offices have for developing and operating a scheduling system that considers the patient's time as well as the doctor's.
Giving the benefit of the doubt to the physician/dentist, et al, I'm assuming the majority of these issues arise not due to the specific physician's lack of interest in the value of our time, but in the lack of structured process associated with scheduling appointments. But here's the issue. That appointment scheduled for 15 minutes is NEVER a 15 minute appointment. So, why does it exist. And how is that 15 minutes measured? A unit of time is a finite measure. It cannot be created. If I have the first appointment of the day at 8am and; lets assume I show up 2 minutes early; I have no forms to fill out in the waiting room; am a current patient and my name is called exactly at 8am, how is that 15 minutes consumed? By the time I walk down the hall from the waiting room to the exam room, put on the smock designed by someone with a twisted sense of humor, give a 'sample' and sit up on the exam table, at best, 6-7 minutes have elapsed. So, then lets say, again best case scenario, I only sit there for two minutes before the doctor comes in. That gives my physician and me 6-7 minutes to diagnose and treat whatever is ailing me. There goes the rest of the schedule. It snowballs from there and you know the rest of the story. The last patient of the day, who's appointment is at 5pm, and who shows the doctor the courtesy of arriving at 4:50, will be lucky to see his doctor by 6pm.
So, to my most recent personal experience. A couple of weeks ago I had my semi-annual routine dental visit at 9am on a Tuesday; my dentist's first appointment of the day. Having a two week old baby and a 2 year old toddler at home; well for those of you that have been, or are there, you know how smooth mornings are at your house. Fortunately, my dentist's office is less than 2 miles from my house. So, I headed out, climbed the stairs to the office and opened the door at 9:06. As I approached the reception desk, a finer reception I've never received. "Are you Dr. B's 9am??", she asked. Now, if I was going to change my name, "Dr. B's 9am" would not be my first choice, but ok, I played along. "Yes, sorry I'm a few minutes late" as I surveyed the deserted waiting room (never has something been so appropriately named). Her reply came in the form of rolled eyes and a glace at the clock. After an uncomfortable silence, I finally asked if there was a problem. "Do I need to reschedule? It's 9:07" Again, I got nothing in reply but a scowl. I turned. And as I took a step back towards the door, ready to leave, finally another assistant asked me to wait and went to find the dentist. After what was apparently very serious consideration for having me come back another time, I was told: "Ok, the doctor can still take you" OH HAIL! Thank you! How can I ever repay this kind gesture? I know. Next time, I'll show up at 8:45 so they can take me at 9:15. If I'm lucky.
Posts
We're Moving
14 years ago
3 comments:
Also take into account the rewards system. My previous dentist (whom I fired for a number of reasons) also spoke about how many cavities he needed to fill before he could buy a boat. My second to last visit with him was to fill a cavity - yet somehow he filled two? Kind of tough to question the facts, with a mouth full of instruments and a ever growing need to "spit".
Gotta love when your motivation lines up with a health care system that is more concerned about pushing paper.
I think we should fire dentists (and doctors) more often.
One of my other favorites...I saw my chiropractor for the first time and after an x-ray I was told "you are a perfect candidate for this." I really like the guy and I do feel better after my adjustments, but what were the chances he was going to say "you look great, you don't need me."
My orthopedic surgeon falls into the category of "your appointment is for 9:00, but will see you at 10:00." On the other hand, he takes his time to explain the situation in layman terms. He typically also takes his time to walk through the options and let the customer (or patient) be part of the decision process. He has operated on my wife twice (both knees) and has seen both of us for various injuries over the years. We trust him completely.
With a recent knee injury I was told "if you were 18 and had potential, we could go the surgery route." There are good ones out there!!
...good example of why the scheduling system and/or schedulers need to be more in synch with the care provider. If the doc typically takes 45 minutes for a route appointment, as in this case for very good reason, then don't schedule appointments every 30 minutes. It shows a disregard for the value of the patient's time (yes! yes! we are customers!). And, it may put pressure on the care giver in creating an environment where he starts to feel he needs to compromise his/her approach to patient care to keep up with the schedule. Part of the rub is this. Doctors have not had to make a choice. With the way our payer/provider system works. A doc gets paid the same amount for an office visit, whether it takes him 30 minutes to complete or 10. So, as a business model, the healthcare provider should need to make a decision. The 'per unit' price is the same. Volume and -rofitability are the issues. Do you want to spend more time with each patient and thus make less money; building a reputation and a loyal customer base. And driving profitability through lower customer acquisition costs. Or do you want to accomodate a higher volume of appointments to generate more dollars. You shouldn't get to have it both ways. Unfortunately, most people perceive the costs, in terms of time, confidence, etc associated with switching healthcare providers too high, and as a result providers have been having it both ways. Once more people start firing their doctors, consumer-drive competition would theoretically increase and these issues addressed.
Post a Comment