My psych often has people wait for their appointments. I’ll be scheduled for 800, there at 740, get seen at 840.
And you know what? That’s perfectly fine. I feel taken seriously, he listens, he asks, he quips, he shares his own experiences, he does all he can to make me comfortable telling him about the shit going on in my head. I’ll work up the courage to tell him something I find hard to phrase and unpleasant to talk about and he takes it with a relaxed professionalism, waiting patiently for me to finish, asks questions (usually very precise ones, both unpleasant in how close to home they hit and reassuring in the implications that I’m not the only one with these issues) and looks for the best way to help me.
So when I sit in that waiting room, watching the minutes tick by, I imagine he’s taking the same time with a different, far more difficult patient. Perhaps someone got slotted in for an emergency, perhaps someone needs blood drawn for a routine check and really, really hates needles, perhaps someone is having a breakdown… I don’t know and I don’t care what ails the other patients, but I know that I want them to receive the same quality of care as I do. To me, that’s worth waiting for.
There’s a movement inside of Healthcare to get the average Dr’s office humming like a dentist. Which, if you’re concerned with patient care at all, is impossible. You’ll see it with posters saying only one issue per visit, which also greatly imperils the patient as sometimes a diagnosis will change based off one symptom. You’ve got a good attitude about this. Please share it
This is the product of clinics being owned by corporations chasing a specific return, and not being owned by a local group of physicians who actually want to care for people.
Shop local applies.
We get the same issue in Ontario with family health teams. The structure of the corporation matters, but so does the funding model
Sometimes I wonder though if it’s because drs get to bill OHIP per visit as well so if you try to squeeze more than one complaint in in a visit then they only get to bill once.
That is what I meant by the funding model. What we’re talking about is fee for service. More service equals more money. There’s other funding models though.
It’s also a product of poor government funding models. We have universal healthcare in my country, and it works great for anything hospital-related. But GPs had the amount they get paid by the government frozen for nearly a decade as costs continued to rise, and once unfrozen, no effort was made to make up for the lost decade. So GPs are forced to either charge out the arse for private fees, or operate on a ruthless patient-unfriendly schedule to maximise throughput just to be able to make ends meet.
As far as I can tell, my psych is doing well enough to not worry about his living, not particularly keen on getting rich, deals with some super heavy things and curses at the stupid computer system he’s required to use, so he’s probably chronically low on fucks to give for seeing the maximum amount of patients per day.
But yeah, when you see him walk out of one room with a heavier-than-usual frown on his face, taking a deep breath to compose himself before walking into the next one, you start to wonder how many times he’s had to put on a stoic face before seeing you. And then he sits down, asks how you’re doing, whether you’ve done that thing you mentioned wanting to do last time and gives you full attention.
I have nothing but respect for that man. I’ve moved a good bit away from him now, but I’d still rather take the long trip to see him for my regular appointments than search for a new one.
If the appointments last longer…maybe he should schedule them properly
It’s hard to predict just how long an appointment will take. Some have been done in five minutes, just a brief check-in and new prescription, and scheduling half an hour for that would mean twiddling his thumbs for twenty minutes he could have spent helping someone that arrived rather punctual for their appointment. I think scheduling for the average appointment but allowing overtime for those who need it is the more patient-friendly approach.
You got downvotes for it but nah, it’s on the Dr if this is a regular occurrence. Once or twice or going over a min or two is fine, but regularly being 45 minutes late (hello my last Dr) is a sign you’ve lied to everyone scheduling an appointment about how long they are and when to even be there for one
Exactly, but if you the patient are late or a no show, then here’s a $50 fee for you.
You are to empathic for social media 😄
For sure. I’m too empathic for most things. I can’t watch embarrassment humour, I struggle with particularly heavy scenes in games or movies, I’ve put down books when I knew something tragic was about to happen because I couldn’t bear reading it and imagining the pain the protagonists must feel.
This comic is based on a true story. I’m certain, as father of a two year old.
I usually don’t get all that pissy about doctors running late. However, there was one time I was really irritated.
I took my wife to the doctor for an appointment. She got the first appointment of the day. We were there 45 minutes early. We waited more than 30 minutes past when the appointment was supposed to start. While we were waiting there, the doctor came in through the waiting room.
It’s one thing to be running late because of the normal day to day delays that happen in a medical practice, but if you’re actually just running late getting to work, you should call and have your staff let the patients know.
I had an appointment booked at my GO. Get there 10 mins early. Everything’s normal, one other person in the waiting room.
Other person gets called in. Still normal.
Receptionist walks through the waiting room, locks the front door, then shuts the shutter to the reception desk. “Uh what”
20mins pass, haven’t seen another soul. Not tooo unusual to wait 20mins.
40mins, sunk cost fallacy sets in. Can’t leave anyway as the front door is locked.
50 mins later, receptionist comes in “the doctor will see you now, sorry for the wait we had our weekly staff meeting”
You fucking what. You booked me in at the time you have your fucking weekly staff meeting?!
Holy shit that’s bad!
I’m willing to bet this is more common than we all think, probably a self fulfilling prophecy.
Some doctors may get complacent thinking, oh I’ll be late by the end of the day anyway.
At least, this has happened to me on a handful of occasions too.
But really, the problem is that the practices are booking too many appointments.
Yeah. My wife was an eye doctor in private practice, and she was positively militant about never getting behind schedule.
She very rarely ran behind. It would require a cascade of emergencies.
Props to her, must have been a hectic job
It was hectic. She loved being an eye doctor, but she hated running the practice. Unfortunately, she got sick and was not able to keep working.
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None of that precludes notifying patients in the waiting room that the doctor is running late.
My first day at my duty station I was 10 min early to work and a staff sergeant told me if I wasn’t 15 min early I’m already 5 min late…good words to live by
You gonna pay me for those 15 minutes?
Exactly. My meetings I time to the T to be there exactly on time. I don’t want to sit around and waste my time small talking with people before the meeting.
Funny, I intentionally join my meetings a minute or two late to avoid the small talk.
In what world should anyone be criticized for not being early enough? I agree if you’re not early, you’re late.
But for fucks sake, five minutes, ten minutes, fifteen minutes, whatever… dude sounds like an asshole.
The military. It’s ingrained in you from like day one that if you’re not 15 minutes early to everything, you’re late. It’s also why you’ll hear folks from the military talking about standing in formation waiting for 3 hours before the Colonel/Captain even shows up. By the time the order gets from the Colonel to the Private, everyone in between has padded the arrival time by an extra 15 minutes.
You don’t clock in and out in the military, so sure, fine. And for job interviews, it looks good to employers. But beyond that, I’m in the “if you want me here early, you need to pay me for that time” club.
It’s a common saying and it’s usually meant as something you should hold yourself to, rather than others.
Staff Sargent - Military. Typically military peeps are held to a higher standard.
I haven’t been in the army for, um, Holy cow! that many years!, but I still operate on ‘15 minutes before a parade’.
Man critized for being 10 min early and then down voted for being 15 min early…I’m always early/on time is all I gotta say
This did not happen.
Nothingeverhappens
Nothingnevereverhappens
Is this a Smiths song?
Idk toddlers be like that
Why not? Toddlers do things like point out clocks all the time. The “passive agressive” part is the parent’s interpretation. The actual action that is described is so very normal.
Yeah, that’s absolutely something a toddler would do
Thank you for your wisdom omniscient Chef Boyardee
My 4th favorite Chef Boyardee.
“Nurse, can you bring me the big needles?”
I would have pulled shit like that if I hadn’t been non-verbal haha
Unless that doctor is performing emergency surgery there really is no reason they need to keep people waiting that long. it’s so disrespectful, doesn’t matter they are a doctor.
It’s awesome being a doctor because you get to try your best to help people all day, get held up by patients talking about 6 different issues they didn’t even book their appointment for, held up by admin demanding you finish your notes between patients, held up by arguing on the phone with insurance that won’t authorize clearly necessary treatments, held up by nursing staff (understandably) needing your input on things between patients, and then read people bitching online like you were just spending that time drinking coffee and flirting with the nurses when you have a caffeineh eadache because you haven’t even had enough time to stop and drink coffee at all AND admin is bitching at you because you aren’t seeing enough patients every day.
I don’t think people mean it’s the doctors fault or that they’re sitting around doing Jack. The frustration is that doctors time is so packed full that they don’t have time for all those things, which is an administration problem.
Clinic/hospital admins want to pack the doctors schedule full of 15min increment appointments, where they’re expected to see the patient, diagnose/treat, and complete notes/charts within an incredibly short amount of time.
Worst part is that most of the time this is not done because the clinic is having trouble making money, but because they want MORE profit from every person walking into their doors.
It’s the culmination of decades of cost cutting measures in the medical field as small practices get eaten up by large companies.
I used to get mad at the doctors who worked for those big companies, now you are lucky if you can avoid them.
A doctor tha expects those things to happen should schedule based on that knowledge.
If the admin has unrealistic expectations, then those expectations need to be addressed.
Unfortunately the doctors usually aren’t the ones managing the schedule. The admin / secretaries are.
And good ones, that understand that a new patient with no file, that doesn’t speak the language, that has a history of complications with her previous pregnancies, etc is not gonna be a normal half hour consultation are extremely rare.
Even kind ones that see that you are swamped day in day out just seem to assume that these are teething difficulties, adapting to the position, etc (even after almost two years).And so that’s how my wife ends up doing a ten hour workday. Nonstop. With no break for lunch because hey, too bad, she finished the morning shift two hours late and now her first afternoon appointment has been waiting for half an hour…
But of course if you tell patients there is no time for them because the few doctors that are here are already overworked…
(to be clear, I’ve been saying the same thing as you to my wife for two years now. But apparently the message is not getting across)
And you haven’t even gotten to the medical billing phase that’s been strangling American healthcare systems for decades!
Thankfully we are in France and everybody is fighting tooth and nails to not become that. So far so good.
everybody!?
what an overstatement!
I want to believe that the vast majority of people in the medical profession are indeed fighting to keep capitalism away from the system. And so far that’s been my experience. But you’re right, of course. That’s an optimistic take.
Idk if my boss gives me a schedule with unreasonable timelines and deliverables, I tell him, and we talk about it, and we get it fixed. If it keeps happening, I’ve found new work.
Maybe the medical industry has systematic issues that can’t be resolved, but everyone should have some autonomy
The problem is that doctors and more broadly care workers have a hard time walking away from their job because, you know, they care for people that they would leave in a worse situation if they left.
It’s not an industry, it’s a public service (I’m in France). Also they’re saving lives.
If she walks away, that’s one fewer ob/gyn in a region where they have almost none left in the private sector (the last one in town retired this year). Women and children will quite literally die and she knows it.On the other hand that means she’s more valuable and surely she should negotiate her salary from a position of strength, right?
But the set of people who become doctors and who negotiate with “would be too bad if something happened to women and children” is, as far as I know, empty.
If any exist, I don’t think they’d last the twenty odd years of studying and training before they start making bank. Much simpler and faster to become a gangster.
Unfortunately the doctors usually aren’t the ones managing the schedule.
A doctor can address the scheduling issue with whoever does the scheduling. Addressing does not mean the doctor gets their way, but that they discussed it and attempted change.
If they can’t have that discussion, why are they atill working there and what is their plan when changes are made that make scheduling even worse?
Why can’t your wife adjust her schedule? She’s the one with the medical degree. She can ask for anything she wants, within reason.
Tell her to say that she needs more time between patients to avoid a lawsuit. She doesn’t want to miss anything. They’ll listen to that.
Yeeep. We are on the same wavelength. I literally opened my argument with the same idea, last time we had the convo : she’s the one with the doctorates, plural. She should be the one telling them what she can and can’t handle. Feck, her head doctor is on the same page too. Unfortunately that sort of power seems to come with age and even at 40 she still doesn’t have that kind of attitude. One could attribute this to her gender, I suppose, but having seen my dad do exactly the same thing throughout his career until he reached near retirement age, and having seen all my dad’s colleagues do the same thing, hopefully you get the idea.
There just isn’t enough time and too many patients for not enough doctors. Always. And most doctors want to help their patients, so they just don’t count the hours, until the work is done.
Doctors don’t do the scheduling. The idea of telling admin to change their expectations is laughable.
What a defeatist attitude.
The doctor is a professional and can address things, no matter who does the actual work. If they can’t even address issues with an admin on acheduling, what are they going to do when the admin stops ensuring they have all the supplies they need?
Ok but like, there was a little sip and flirt on the way wasn’t there? ;)
I kid. Keep on keeping on.
All of that for 6€/h after taxes!
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Doctors don’t do the scheduling. I also explicitly mention the part about admin bitching about not seeing enough patients. I don’t give a fuck about money, I make enough. I would love to only see 3 patients a day and give them all the attention they need. But I would be out of a job, and then I’m helping no one. I highly suggest that you don’t comment on subjects you are completely uninformed about.
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Doctors don’t hire fucking anyone unless they are in private practice. If it IS private practice you have to keep your business afloat for yourself and employees. Holy shit, just stop fucking talking. The enemy here is not doctors, it’s the hospital and insurance system.
then read people bitching online like you were just spending that time drinking coffee and flirting with the nurses
I don’t think anyone actually took that route (none of the comments I read).
I honesty kind of blame the patient for talking about 6 different issues while here I am trying to go by the rules and only use 5 mins of my doctor’s time.
I have never unappreciated doctors, but that doesn’t mean things can’t improve.
You sound so disrespectful…
Then book fewer patients per day (assuming it’s your own practice). It’s one thing to have a bad day where you fall behind. It’s another thing when you fall an hour behind every day.
So what happens if a patient lies about their concern and a 15 minute checkup is all of a sudden a 45 minute spiel. You can’t just leave a patient you’re treating, they try to allow for some leeway, but they’re a business too after all, can’t be sitting around either.
they’re a business too
Without meaning to go completely off the rails, maybe this is part of the problem? I mean we can’t sink our entire GDP into toenail fungus, but there ought to be some middle ground somewhere.
I don’t think “they’re a business” properly captures the concern. It’s probably more accurate to say that they have a desire to operate efficiently and not waste resources, but it has to be balanced against the need to treat patients effectively and fairly.
So long as demand exceeds capacity, we will wait.
Even in public health care, family doctors who don’t work in government hospitals or clinics, operate their own “store front” have their own bills and employees and can only bill the government certain amounts for certain visits. So if they can’t bill the government for sitting around, it’s cash out of their pocket for their expenses.
Right and that is getting off the rails. I know providing healthcare isn’t free so consuming it isn’t free either. But when a public need becomes a profit-seeking venture, I start getting skeptical that this is the best way to ensure efficient use of resources.
Profit
can only bill government certain amount for certain visits.
How are they making a profit seeking business when they can only bill insurance, WCB, or the the public health care system a certain amount for each visit. There is some uninsured things, but they don’t charge unreasonable amounts, people would go elsewhere. It keeps everyone honest in that regard. And they only charge since they can’t bill anyone else and it costs them time and money.
You called it a business. Which I read as “profit-seeking endeavor”. Perhaps you intended it differently.
Not for profits are also businesses… your assumptions are your bias… and ignorance.
Edit Actually, which definition are you even using here…?
No definition has “profit” in it that I can see
My intention is the definition of the word, what is YOUR intention here dude?
That toddler’s name: Albert Einstein
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Jeez dude, it probably isn’t like the doctor was slacking off and just waiting to keep you waiting. Most likely there were more people who needed help that day and they ran long. Most likely everyone is working as hard as they can to offer everybody the assistance they need. Making a stink about that is just selfish and a dick move to the people that work hard to help you.
That’s all well and good, until one of us has other things that run late and they charge us a $200 fee. Everybody has busy days and meetings that run late, including their patients. And some doctors offices are great at adjusting. Its the double standard that’s the issue.
Professionals need to hone their processes and understand how to hit their commitments. If they can’t hit their commitments, they need to commit to different things. If you are always seeing people an hour late you need to change the way you schedule.
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