« Panel finds CU professor Ward Churchill committed serious academic misconduct | Main | Pentagon Video Postscript »

A question of etiquette

I have a pretty good doctor. I'm not overly fond of her, but she's been pretty good for me. In fact, if I listened to her more, I'd be in a hell of a lot better shape than I am. I have several conditions that need attention, one in particular that is likely to cripple and eventually kill me. Every time I see her, she reminds me of just what I can look forward to if I don't start treating myself better, and points out the damage it's already wreaked -- with my negligent help.

But one thing she's pretty lousy at is time management. I am convinced that her office overbooks patients. I once had to wait 90 minutes for my appointment and that's the lowest time. Last week, I had a 3:00 appointment. I called around noon, and was told I could safely show up at 4:00 without fear of missing things. By 6:00, I finally left and said I'd reschedule.

I have a followup this Thursday, at 9:00. I think I'm the 2nd or 3rd patient. At what point should I just leave again? And should I think about finding another doctor? As I said, she's been pretty good to me, but having to take that much time away from work is just too damned expensive.


Comments (35)

Folks who are repeatedly di... (Below threshold)
Old Coot:

Folks who are repeatedly disrespectful of others time are either simply rude and/or arrogant. I'd be very concerned about such a person acting in the mode of care-giver. Of course, doctors are subject to emergencies that completely screw-up appointments, but what you describe sounds more like just not caring.

i'm sure it doesn't surpris... (Below threshold)
GRY:

i'm sure it doesn't surprise you to know that what you describe is absolutely par for the course up here in quebec and virtually everywhere else in canada. it's far less of a headache to seek medical attention for my dogs than it is for my children....

I am a doctor (optometrist)... (Below threshold)
Eirik:

I am a doctor (optometrist) and I get pissed at myself if I'm running 30 minutes late. Regular MD's often run a bit later because of emergencies, but a well run office will build that into the schedual. Basically leaving empty slots here and there that only get filled in on the same day or day before.

I've only sat as long as you have once but my doctor had a good excuse, an emergency patient walked in right as I sat down in the exam room. The only real failing there was that his nurse didn't pop in to tell me the doctor would be late.

Personally, I'd find another doctor at this point, and let her know why. If you insist on staying, I wouldn't stick around more than 60 minutes, and that's being generous. *Maybe* longer if the staff tells you there's been some kind of emergency.

10am, Jay. Then I think a p... (Below threshold)
Peter F.:

10am, Jay. Then I think a polite talk or call (if you're forced to leave) with her about how long you had to wait will be enough impetus for her to a) talk to her staff about overbooking, b) consider not accepting new paitents or c.) change her patient approach. You have a job to get to as well and it's professional courtesy for her to see her patients in a timely manner.

My father-in-law has complained about the long waits back East, too. And guess what? He's a doctor!

Other than my cardiologist being late due to throwing out his back prior to my appointment or a long line at the lab for blood tests, it's rare that I wait for my GP.

I recently took my step dau... (Below threshold)
Starboard Attitude:

I recently took my step daughter in for an examination of her fractured pinky.

20 minutes in the waiting room, then 50 minutes in the examining room. No doctor.

As we were leaving, I told the receptionist to mark this as a no-show, and told her I would send my bill. She told me the doctor charges $90 if you cancel with less than 24 hours notice. I said "fine" and billed him $90 for his no-show.

That was about 45 days ago, so it's premature for serious collection action. This could be fun.

1. ask her out2. bil... (Below threshold)
McCain:

1. ask her out
2. bill her for your time
3. get another doctor. hello?
4. reassess what constitutes an interesting post before Kevin polipundits you.

Heh. McCain just came up w... (Below threshold)
a4g:

Heh. McCain just came up with a whole new verb.

To polipundit,. vt. Ban or prohibit in a sudden or unexpected manner.

I am an absolute fanatic ab... (Below threshold)
Charles Bannerman:

I am an absolute fanatic about being on time. I would rather arrive early and wait than to arrive late. I guess it comes from my upbringing: My Father impressed on me that keeping someone waiting is the highest form of insult.

I would Fed EX a letter to her and explain that I resent being kept waiting. If that doesn't do it, get a new doctor.
Chuck

Don't waste your time givin... (Below threshold)

Don't waste your time giving her feedback. If she doesn't understand her problem by now, she never will. There are plenty of "okay" doctors out there. You're a masochist for sticking with her this long. (Is she a psychiatrist?)

LOLMy answer depen... (Below threshold)

LOL

My answer depends upon how hard it will be to find a convenient new doctor, considering insurance requirements, distance, etc.

If it is going to be easy, then switch now and let them know why after you have a copy of your medical records. [I recommend to get a copy of any reports, notes, etc each visit so you have a complete and up to date copy of your med records at all times, and if you have already been doing that, you are onestep ahead. Requests for copies of your med record go to the bottom of the pile of things to be done in most offices, and may take weeks, possibly delaying medical care at a new doctor].

Docs run behind for many reasons besides emergencies: they may just spend more time with each patient than they schedule (and if you like them then this might be a mitigating factor), they have lousy time management skills/set up, support staff are disorganized, or they really don't care about your time and just want to see as many patients as possible at their convenience rather than yours [good reason to switch]. If they share office and exam rooms with other practitioners, there may be delays due to competition for exam rooms.

You owe it to the other patients if no one else to voice your complaint. Eventually they will either get the message or wonder why their waiting room is getting emptier and emptier.

If the doc is solo private practice, but you are part of a PPO or similar insurance scheme, if you get no satisfaction from talking to the doc, then call the PPO. If the doc is part of a group, make sure the group executive officer gets a written complaint from you. If they are an employee, write to the boss [hospital, clinic, etc.]

Now if its going to be real hard to get a new doc, then you need to start schmoozing the front office and the nurse [bring food, flowers, smiles, etc. each visit and thank them profusely even if they don't seem to deserve it]. Maybe they'll start squeezing you in first and you won't have to wait so long.

You should change doctors a... (Below threshold)
bobdog:

You should change doctors and choose one that is willing to respect your time. If she doesn't care what she does to her patients' schedules, how can you expect her to care about your health?

I walked out of a doctor's office after a two hour wait. My wife has used this doctor for years, and I knew this was a routine event. The reception room was completely filled for the entire time. My issue wasn't serious, so without making a fuss and without being rude, I told the receptionist to cancel the appointment and that I would find another doctor with better time management skills. The receptionist almost fell over backward in shock. Just couldn't believe it.

As the old joke goes, the difference between doctors and God is that God doesn't think she's a doctor.

Vote with your feet.

I've never had to wait long... (Below threshold)
pst314:

I've never had to wait longer than 10 minutes, and usually no more than 5. But that's my internist. With specialists I've usually had to wait between 15 and 30 minutes.

As a RN that used to work a... (Below threshold)

As a RN that used to work at a MD's office I know how difficult docs are when it comes to time management. Still - you are the employer. She is your employee. You pay her for a service. If it was a hair salon, would you be okay with waiting for longer than 1 hour? There are a lot of docs out there and some actually are sticklers for time. Good Luck!

You should go to Doctortree... (Below threshold)
RICH:

You should go to Doctortree.com where doctors compete for your ailments.


Rich

"By 6:00, I finally left an... (Below threshold)

"By 6:00, I finally left and said I'd reschedule"..."she's been pretty good to me."

er...now.

My doctor's office always r... (Below threshold)
Palmateer:

My doctor's office always runs late (afternoon appointments), so I just call ahead on the same day and ask how late they think I should arrive.

Don't be hard on them. You ... (Below threshold)
drjohn:

Don't be hard on them. You have no idea what it's like to deal with PPO's and insurance organizations. You also have no idea what it's like to schedule patient appointments- half the time they fail to show. That really kills your day. So they overbook to compensate.
Then for a reward the third party carriers slive off 30% of your fee about every three years or so. Then there are the emergencies. It's brutal being a doc.

JTI hope you find ... (Below threshold)
Imhotep:

JT

I hope you find the time and self respect to listen to the advice your physician is providing, you are making a choice by not heeding her advice.

It is only an opinion you are obtaining from your physician,and if you feel you are not being seen in a timely fashion you should, by all means, leave her practice (fire her).

I have over a hundred attorneys in my practice; by and large I like them, they tend not to lie about their health and are more than willing to heed my advice when I ask them to obtain a second opinion.

I always call if I'm late or even anticipate being late to the office. I have a schedule that starts every morning at 7am, usually by 7:01 a change or delay has occurred, thus resulting in plan B, or C, D, E etc.. Rest assured that your physician is not on the golf course or loafing; chances are he or she is spending more time with a more critically ill individual than you; and be blessed that you are not critically ill!


Starboard,

I'd like to know what kind of physician you are seeing for you stepdaughter's pinky? A hand surgeon, perhaps?
Quite possibly he was sewing a severed hand back on for someone's mother/ sister/ brother, but I know he should have had the respect for your daughter sprained pinky to cancel that operation and see you on time.

I also tend to question the... (Below threshold)
Imhotep:

I also tend to question the quality of care I get from a Physician who is always on time and has a Spa for an office. Especially, if no one else is in the waiting room and I'm not part of a Boutique Medicine practice.

Drop her like Michael Jacks... (Below threshold)

Drop her like Michael Jackson almost dropped that baby.

I used to just grin and bea... (Below threshold)
will:

I used to just grin and bear it, but recently after a long wait, I told a doctor that I had a schedule to keep, and they needed to honor their appointments. I left.

Since then, I haven't had a problem with that office. Whether my reaction had any effect, I don't know, but it's important to give feedback. Doctors don't have an inherent right to fall behind schedule. Now, if I have to wait more than, say 15 minutes, well, there are plenty of other providers out there.

Medical practices are more ... (Below threshold)
Dave in W-S:

Medical practices are more than the doctor. The doctor is the technician that works on your bod. The technical staff supports him/her, and the front office runs the public interface part - scheduling appointments, billing, check-in, etc. If the practice is a fairly large one, the individual doctor may not have much control over how the business end of the practice is handled. They are too busy bouncing from exam room to exam room, trying to keep up with the schedule that is imposed on them by the practice.

It can be very difficult to find a doctor and a medical practice that you are happy with, in fact it can take years. I imagine that doctors can also experience discontent with the practice they have joined. What looks efficient and clinical when you first see it can be a frustrating cycle of hurried visits and less than thorough diagnoses when you are in it day to day.

My doctor recently left a group practice and started her own office, mainly because of the way the business end was handled. I get there on time, check in, and within 5 minutes am on the way back. She takes her time and does what needs to be done, because there is enough room in the schedule to accomodate a decent clinical visit.

In answer to Imhotep, of course there are emergencies, but what Jay is talking about is habitual abuse of patients. No one should resent being bumped for an emergency. But being consistently jerked around is not conducive to happiness.

I have also learned that, even in a large practice, their are ways to effectively voice your complaints. A large practice will have a doctor who is the medical director (or suitable term). There may also be a business manager or an administrative nurse. If you can find out who manages the practice, especially if they are on the medical side, you stand a better chance of complaining to someone who a) might just listen, because you are talking professional standards and money leaving their pockets, and b) might be able to do something about it, if they are willing.

Having said that, I know practices that habitually double and triple book appointments. Even once you manage to get face to face with the doctor in the exam room, you've only got 1/3 of his attention, because he has 2 other patients he's working down the hall. Talk fast, before he slips out, "for just a moment".

If it's a small practice or an independent, it boils down to a choice between a bad office manager or a doctor who likes doing business that way.

If you live in an area that... (Below threshold)
Brian:

If you live in an area that Drs are leaving, then there is probably no reason to change. Even if you find a new Dr that is not overworked/overbooked, it will only be a matter of time before you are in the same situation again. Otherwise, I would look for another Dr who is not already overly busy. Because of emergencies, delays can be unavoidable, but they should be the exception.

Two experiences, opposite e... (Below threshold)
Borg Queen:

Two experiences, opposite ends of the spectrum, sort of:

A few years ago, my sister-in-law had reached the point you're at now with the kids' pediatrician. When she tried to address the issue with the doctor, she was told that she'd obviously be happier at another office and the doctor told her to be sure to let his staff know where to forward the charts.

On a better note, I recently took my daughter to a specialist for root canals. We waited 35 minutes past her scheduled appointment till she was seen. When we left, the office manager handed us two tickets for a local movie theatre since we'd been inconvenienced! I've never heard of anything like this before in the medical community....unless you want to count the stickers the kids get.

Type up a contract that you... (Below threshold)
Headzero:

Type up a contract that you will charge X amount per hour that you have to wait past your scheduled time - have the receptionist sign it when you walk in, if they ask what it is, explain and have them go present it to the care giver for their signature. You called, scheduled an appointment, took time out of your day to see and PAY them, they should see you when you are scheduled. If they see you within the first hour of waiting, your fee to them waved, otherwise they can deduct the cost of your time, waiting for them to see you to be able to pay them for their time.

Quid Pro Quo.

I've had similar experience... (Below threshold)
Pothus:

I've had similar experiences with a former doctor of mine. I would schedule an appointment early in the morning, so I would be one of the first, but this still entailed anywhere from 45mins to an hour wait. The next time I had to see the doctor, I made sure to get the earliest appointment I could, 7:30am. I arrived at 7, waited in the waiting room and listened to the doctor and nursed talk about what they would have for breakfast. It wasn't until 8:30 that I was ushered into the exame room, where I sat for another 20mins. I had an important meeting at 10, and knew there was no way I was going to make. I sat and calculated how much money I was losing on my wait in the doctors office. When the doctor finally came in, which was 9:15, I gave him my bill. I told him I expect it paid for my lost wages, and if he didn't agree, I was sure that my lawyer would happily get involved. (He was a patient of the doctors as well). Within five business days I had a check from the doctor. By this time I changed doctors, who kept a better office schedule. Try it. I couldn't hurt.

Perhaps you should just man... (Below threshold)
Pete:

Perhaps you should just man up, stop your whining and do everything you can to ensure your visits to the doctor, any doctor, decrease. That will save you more time than blathering on about a particular office's time management skills.

Another trend is instead of... (Below threshold)
Steve:

Another trend is instead of the doctor coming in to see you, the intern or nurse sees you then leaves to talk to the doctor. After another wait, they come back to tell you what the doctor said.

And they even had the gall to charge the same as if you actually saw the doctor. I could have done the whole thing on the phone!

I used to have a female doc... (Below threshold)

I used to have a female doctor like that and I found almost without exception early appointments were almost always right on time and late appointments were, without exception, running quite late. She had a heavy load of older patients with chronic problems and had a reputation of hearing her patients out to see what they really were saying and a reputation for thorough patient teaching. I learned to request the earliest possible appointment. Five years ago she got tired of trying to reconcile what she thought she should be doing for her patients with the time her practice allowed her to do it in. She now teaches at the medical school. I miss her. My new doctor keeps real well to his schedule but you better only have one issue for him per appointment.

Imhotep:He was a q... (Below threshold)
Starboard Attitude:

Imhotep:

He was a quack of an orthopod who specialized in worker's comp evaluations. My step daughter was refered to him by her primary physician in a bad HMO.

We walked out and went to a good hand surgeon I know, and he treated her right away. Then we switched her mother to a good PPO.

PS: The first guy was a baaaad quack. About 4 years earlier, he was seeing a kid for workers comp tx and eval of hip pain. Eventually, as the kid's pain and disability grew worse, the doc accused him of faking. Three months later, the hip spontaneously broke, because the pelvis and part of the femur were consumed by osteosarcoma. Five weeks later, he died at age 20 in the Long Beach VA hospital.

Say what you want about Bil... (Below threshold)
"Candy":

Say what you want about Bill O'Reilly - but after reading "The No Spin Zone" several years back, I decided to create my own no spin zone - I am always on time, and refuse to wait more than 15 min for a doctor. My time is valuable. I personally think that if an office knows they are running behind, they should have the courtesy to call the later appts and tell them what kind of wait they are facting - perhaps come in a bit later.

Yes, I realize there are emergencies to deal with - but it's okay to shop around for a doctor who does not overbook to excess. Bravo to the reader above who billed the doc for $90 - I love it!

Starboard,I'd get ... (Below threshold)
Imhotep:

Starboard,

I'd get out of that HMO. You are in a position to know who is a quack and who is not, so use it to your advantage. Not everyone has that kind of knowledge.

Also, I'd like to add that the most on time Physician that I knew was also the worst. Made a misdiagnosis on my daughter and before we could get out of that practice and into another one, he did it again. To add insult to injury, he had a horrible beside manner and treated me unkind, too.

This particular physician also had/has a policy of billing the patient if they are late to the appointment time and cancelling the appointment. It happened to a friend of mine who was 5 minutes late, they took her copay and promptly cancelled her appointment and sent her the bill.

Amazing.

They double, triple and qua... (Below threshold)
beth:

They double, triple and quadruple overbook so when someone doesn't show up for an appt they aren't sitting there waiting.

Better you wait than them have to wait.

I have a doctor that does the same thing. I know when I get there I'm in for a 2 -3 hour wait - so I go sign in and then leave to run errands. I try to be the first to sign in for that time period. I've figured out the pattern (they schedule every couple of hours) so I try to get either a 9 am or 1 pm - first in the morning or first after lunch. Then I try to make sure I get there early enough to be the first to sign in.

ps. I also always think abo... (Below threshold)
beth:

ps. I also always think about the fact that they do take care of emergencies. I had a miscarriage in a docs office years ago and whoever was in the waiting room had to wait. They took good care of me and the doctor didn't leave to see other patients till I was stable. I think about that when I'm waiting and it makes it a little less irritating.

I've worked in doctors' off... (Below threshold)

I've worked in doctors' offices for over 30 years so I've heard it all. Our docs run more or less on time because the front desk does not overbook and will not let the docs try to push them into it. I remember a story I heard once about a doctor who would not come out of his office and start his morning until he had 10 patients waiting for him in his 10 rooms. That made him feel important, or something. Mweh. Who needs it?




Advertisements









rightads.gif

beltwaybloggers.gif

insiderslogo.jpg

mba_blue.gif

Follow Wizbang

Follow Wizbang on FacebookFollow Wizbang on TwitterSubscribe to Wizbang feedWizbang Mobile

Contact

Send e-mail tips to us:

[email protected]

Fresh Links

Credits

Section Editor: Maggie Whitton

Editors: Jay Tea, Lorie Byrd, Kim Priestap, DJ Drummond, Michael Laprarie, Baron Von Ottomatic, Shawn Mallow, Rick, Dan Karipides, Michael Avitablile, Charlie Quidnunc, Steve Schippert

Emeritus: Paul, Mary Katherine Ham, Jim Addison, Alexander K. McClure, Cassy Fiano, Bill Jempty, John Stansbury, Rob Port

In Memorium: HughS

All original content copyright © 2003-2010 by Wizbang®, LLC. All rights reserved. Wizbang® is a registered service mark.

Powered by Movable Type Pro 4.361

Hosting by ServInt

Ratings on this site are powered by the Ajax Ratings Pro plugin for Movable Type.

Search on this site is powered by the FastSearch plugin for Movable Type.

Blogrolls on this site are powered by the MT-Blogroll.

Temporary site design is based on Cutline and Cutline for MT. Graphics by Apothegm Designs.

Author Login



Terms Of Service

DCMA Compliance Notice

Privacy Policy