Can Doctor Offices Improve Appointment Punctuality?

Why not talk to the office?

"Can Doctor offices improve appointment punctuality?"

Sure; as soon as we (patients) improve our skills of diagnosis, so there are no surprises for the doctor at the visit or consultation.

Sure; when we (patients) stop pestering the doctor with broken bones, torn or burned flesh, heart attacks... things like that These distractions can disrupt doctor office scheduled visits.

I hate to wait, too.

But, the doctor never knows how long a patient visit will take.

I, for one, would rather have the Dr. take his time and do a thorough examination and give a quality assessment of my condition, instead of saying, we have to stop now, your time's up.

Sorry, I know that doesn't help.

I agree with you when you say that the doctor should take his own time, for our own good! However, WHEN the doctor spends time & how he does it to attempt to conclude helpfully the consultation is the main issue! A patient, most of the time is asked to do testing of different body systems by outside labs. etc. & the labs are asked to mail reports of what they find. The doctor never knows if his office received it & filed it till the patient arrives in appointed time! The office staff, then gives all records to the doctor who scans it for a while (1/2 hour or so) and figures out instantaneously how to advice the patient and what medicine to suggest from the TV ads that he/she has seen before! The patient is waiting all along when the doctor sees him/her and discusses for few minutes what he thinks, provides some pep talk and then guides the patient to a window where he copays and gets next appointment scheduled!!!!

The doctor, when sets up any appointment, must be required to prestudy the patient condition for at least an hour or so..he may charge the patient but the patient does not have to wait for the doctor to scan & plan !

So there are no female doctors? I believe that you should have written "..the Dr. take his/her time ..". After all it is 2010 and not the dark ages.

Agree with this comment strongly. The more patients you push through at your general rate, the less impact your overhead (student loan debt, building rent, fixed cost employees, etc.) has on your bottom line. Therefore the goal is to move through as many people as possible per day while maintaining enough of a level of service to keep you as a patient. Plus, the Dr.'s office is more of a catch-all in that he/she can't depend on "regular" visits unless you have a condition that requires constant monitoring. Therefore, they have to keep "overbooking" all the time to ensure the constant stream of patients.

It may be a business to the insurance company.

A person's health and well being and treating them with basic human respect requires services far beyond being just a business.

Hence my suggestion to break the doctor/insurance company link. The transaction should be between doctor and patient, then the business (doctor) will better respect his customer (patient). When doctors are being paid by insurance companies directly, they respect the insurance companies at the expense (figuratively and literally) of the patient.

No you are absolutely positively wrong. It is a buisness like any other business. Would you have the doctor work for free? Is that not slavery? How would you feel if the government decided without bothering to consult you, that you could not make more than X amount of money no matter how much work you did? what would you do? you would do no more than nessecarry. so what happens to all of those people lined up waiting to see a doctor? they WAIT. Maybe their conditions are amenable to waiting, maybe they aren't. In Mass. they implemented a "universal health care" program and you know what happened? waiting times to see a doctor rose from an average of less than a week to over 50 days. ALMOST TWO MONTHS!

Insurance coverage does not equate to treatment.

No, I would not have the doctor work for free.

If the government capped my income (perhaps they already have i.e. min wage), I am absolutely positive that I would find another "business".

I agree that insurance coverage does not equate to treatment.

What I would do is walk away from an appointment that the doctor's office cannot keep (10 minute rule). Appointment at 2pm..at 2:10, I walk out of the waiting room if I am still waiting.

If the government capped my income (perhaps they already have i.e. min wage)

Minimum wage is not a cap, it's a floor.

Do this and you never see the doctor. Some have waiting lists that are months long.

Medical care is not a business but Governments resposibilly & Human Right to which they are being deprived

I think that you are mixing the problem of Health Care Purchased by the people; as the governments in MUCH ADVANCED COUNTRIES HAVE PUT EVERY THING IN THEIR RESPONSIBILLITY TO BUSINESS.

Getting heavy taxes; sold their responsibillities to MERCHANDISE; and no control on them.

Doctor is also a public man & cannot be treated as a slave but public also can't be.

Lack of resources used in Health Care is the root cause of this. Sufficient number of Medical staff be employed to cater for as the other businesses do to run.

Inspite of heavy taxes & lot of flaws in procedure public is being deprived of their medical care in time.

It's not going to happen. This kind of falls into the same category as airlines over-booking flights, it's better to have to bump a couple of people, than to make a flight with empty seats.

It is inconvenient at times, but if you look at it from the doctors point of view, would you rather have patients waiting around, or be sitting there twiddling your thumbs, because you had two no-shows in a row?

If I was the doctor, particularly if I was in private practice, I would book appointments to insure that as little of my time was wasted as possible during the course of the day. Let the patients wait.

I have wondered if the number of patients a doctor takes on is a factor, as this secondary wait seems to take longer each time. This (the number of doctors) may have something to do with the laws involving malpractice for a particular state and the cost for insurance.

I try to occupy myself during the wait by extending those "chrome footrests?" attached to the exam table and taking a nap.

"I try to occupy myself during the wait by extending those "chrome footrests?" attached to the exam table and taking a nap."

I try to occupy my time by rooting through the drawers and cabinets and teasing my fiance with all the fancy instruments. Oh and grab all the pens you can because you never have too many pens.

There are several reasons why they run late (I'm sure there are others):

• In order to receive maximum $ from insurance companies (I believe this is where it comes from but I may be wrong) they are required to see a certain number of patients - this is why the appointment times are so tight
• Sick or injured people that call in with emergencies are "squeezed in" to non-existent spaces in the schedule
• Patients can be late too - and this throws off the whole schedule

The whole process is messed up - just like the health care system. And I don't see either one being fixed any time soon.

At one of the doctor's offices I go to routinely, I regularly wait at least 30-45 minutes to speak to the doctor for five. Then it's at least another 15 minute wait (on a good day) for blood tests. The only well run place is my dentist, because it's just him and his hygenists! The eye doctor is the worst because of all the machines - I plan on being there for three hours minimum.

Regards.

This is Social Security Business by Merchandise Not the Health Care.

"that gets my goat."

You take a goat to your Doctor appointment?

Figure of speech of course.

BUT now that you mention it, bringning a goat may speed up the process!

It can be done if you will pay for it. The insurance companies pay for about six minutes per patient visit. Tell them you want everyone to have five times that, but not to increase premiums. While we have a pay for service system it will not change. A pay for outcomes would work. I have been told that in ancient China the lord only paid his doctor while he was well.

Punctuality? No. Magazine subscriptions? I wish!

A doctor is not like a lawyer or an accountant, he can't show you the door when time is up regardless of whether he is done or not. And when emergency calls and cases show up, they have to be seen and it takes however long it takes. That said, there are some things YOU can do that will help get you in and out of his office quickly.

the biggest one is to schedule your visit as early in the day as possible. The later in the day you schedule your appointment, the more likely events will have pushed his schedule back. Most doctors don't have the luxury of scheduling breaks in the schedule as the day wears on to try to get their schedule back on track either. They just have to gut it out and keep up with the demands on their time as best as possible.

show up early in case there is any paperwork you need to take care of with the business office before you are seen, especially if it is a new doctor and you have to fill out medical history forms and get insurance issues squared away.

And there is another medical reason why the nurse gets your vitals before taking you back to the exam room. studies have shown that BP readings can be a full 10 points higher in the exam room than in a more relaxed setting due to many people's fear of doctors. it is called lab coat hypertension and it is quite real. Nurses, especially good looking ones, tend to be less threatening for most people. factor in your frustration from waiting and it could be much higher, leading to you being diagnosed with hypertension when it is actually unwarranted.

I have on more than a few occasions pondered this question as I waited to see numerous doctors, being their first appointment of the day. The only thing that kept popping up was, they like to play God and we will never know the time of the saviors second coming.

Regards.

Insurance should be responsible to provide you the Health Care needed on spot; Not with their Schedule.

Sickness does not come with a SCHEDULE & does not give you a time to plan in advance.

Regards.

A little true joke of my life:

I visted a senior doctor's home to check his TV.

Diagnosed one component & asked him to bring from the shop.

By chance its price just matched the Consultatin Fees he had been charging from patients.

" Oh tech! you are charging as much as a Specialist Doctor" he uttered.

" Oh no Doc! it is the cost which a patient spend on your prescription-chit, not my fees"

" it will only be if the TV is fixed", I replied.

"And that will not be like yours; No MATTER THE PATIENT IS CURED OR DIE; it will be only after the cure of the TV"

Have a nice day!

You so right, everytime i go to a doctor i get annoyed, you wait for so long!!! What i have suggested doctors is to increase the time (interval) between appointments, why not 1h30 or 2 hours, that should give enough time, and not only 30 min or even less.

aguy

"If A is a success in life, then A equals x plus y plus z. Work is x; y is play; and z is keeping your mouth shut. Albert Einstein

Guys,

With Doctors you will always have waiting issues. The patient in front of you will always have a problem that takes time.

The only solution is to anticipate problems and prepare - I always take a book or two to any place where there is likely to be a wait.

That way the wait can be profitable, dependent upon the book topic.

Sleepy

I'm kind of on the fence about this issue. On one hand, as already mentioned, the doctor is not in complete control of his/her schedule (i.e. emergencies pop up, people come in for something they described as simple yet ends up being very complicated, etc.) and they (doctor's offices) are businesses where they are striving to maximize their profits (more patients = higher profits); on the other hand shouldn't doctors be concerned about their customers (patients) and what their customers experience is?

Also as mentioned, there are things we patients can do:

• bring something to occupy our waiting time
• express dissatisfaction with the office staff (it may not make a difference right away, but if a number of patients express the same sentiment something may be done about it)
• find another doctor - this should be done after expressing dissatisfaction, so many times service providers (doctors, restaurants, etc) loose customers but have no idea why. If an office has a lot of patients leaving for the same reason they are more apt to make a change. Also, tell the new doctor (and office staff) why you left your previous doctor so they will be aware that punctuality is not trivial.

I think the profit=patient equation has been distorted by insurance companies in that doctors are working more to keep the insurance companies happy than the patient. So the equation is more likely profit=customers where customers=0.8*(insurance company) + 0.2*patient. This is not how it should be IMHO.

My take on healthcare reform (in the US) is that the problem stems from too many entities involved in the transaction and how they are linked/intertwined. There are as many as 5 - the patient, the doctor, the insurance company, the employer (although not in all cases) and the government.

Currently, most employers provide healthcare as a benefit by subsidizing the insurance premiums. To keep the premiums low they make deals with the insurance companies to get group benefits. While that may keep the group average rate down, it doesn't necessarily optimize the coverage for any one individual (i.e. my insurance costs include coverage for child delivery benefits which I no longer need). What the doctor charges for some procedure is highly inflated because of insurance companies.

For instance, when I get a statement of benefits from the insurance company it shows the charge from the doctor (lets say $1000) and then a negotiated amount ($250) that the insurance company pays the doctor and then my copay ($30). So the doctor was willing to accept $280 for his services yet started out by billing $1000....hmmmm.

I strongly believe if the doctor/insurance company/employer link was severed and each was linked only to the patient medical costs would drastically go down and individuals would get much better care. Employers could still offer health care benefits, but only to be paid to the insurance company on the employees behalf, where the insurance company is chosen by the employee. The doctor and patient should work handle their transaction independent of the insurance company. The patient should be reimbursed by the insurance company for covered medical expenses forcing insurance companies to deal directly with the patients as the patient would be their customers (not employers). Patients should deal directly with doctor forcing the doctors to deal directly with patient's priorities in mind as the patient would be their customers, not insurance companies. Finally get the federal government out of the transaction....it distorts the tax code to subsidize corporate sponsored health benefits (via flexible spending accounts) and restrict insurance from being sold across state boundaries. All of these would then allows consumers (patients) to maximize their health care vs. their own priorities (most likely their own cost).

My apologies for the verbosity of this post. I just had to get it off my chest.

I read an article recently about 'group' appointments... the patients would sign an agreement to participate in such sessions (privacy issues are addressed).. a P.A. or doctor would make general inquiries within the group before addressing particulars in a more private setting. Folks trying this seem to think it is working to alleviate wait times. Carlos

I think doctors should be replaced by robots with amazing life-like resemblance, excellent bedside manner characteristics, and heated "fingers" (Turn your head and cough<beep>).

Patients should be equipped with diagnostic ports which will not only download your system status, but your bank account as well.

Once I had an appointment with a doctor at around 6.30pm but he arrived around 8pm.Around 10pm when I was inside the room with the doctor,the nurse assisting the doctor said "there was an old woman who wants to see the doctor soon" because she was already late and if she waits till her number was called she will miss the bus to go home.The doctor said "no way" if she insists he will close the clinic and go home.Some poor souls are afraid to complain to the hospital authorities due to fear of repurcussions,who will help them?.

I understand doctors are busy, and don't know how long it will take per patient.

I called the doctor's office for an appointment. They said be there at 0930, I was on time, signed in and took a seat. There was a room full of people waiting. I had to wait until they were all served, before it was my 'turn'. Did they have a 0930 appointment, too? Or were they 'walk-ins'? Why should I have to wait for a 'walk-in' when I had an appointment?

When it was finally my turn, I asked the doctor if all these people had an appointment, and he was real embarassed, and told the staff to take appointments first. It's only fair, or why even give appointments? When I tell a customer I will be somewhere at a certain time, I'm there, or my reputation is lost.

P.S. I was in serious back pain, and not appreciating having to sit up and wait.

I summarize responses thus far into 3 categories;

1) Patient must grin and bear it

-improve our skills of diagnosis

-Make the best of the wait time
extending those "chrome footrests?" attached to the exam table and taking a nap

-by rooting through the drawers and cabinets and teasing my fiance with all the fancy instruments. Oh and grab all the pens you can

-read a book

2) Not the doctor's fault/just a business
"Doctor never knows how long a patient visit will take"

-A visit to the doctor's office (health care facility) is a business just like any other business

-falls into the same category as airlines over-booking flights

-Zero appointments, ever. First come, first served

-The insurance companies pay for about six minutes per patient visit

3) Answers to the question (not excuses why improvement can't be made)
-doctors should be replaced by robots
-improve Magazine subscriptions

Perhaps the question should be rephrased from

"Can Doctor offices improve appointment punctuality?"
to

"What can the medical service profession do to respect the patients time?"

Do what I have learned to do - that is - to always show up 30 minutes to 45 minutes later than the appointed (annointed) time, and when you do finally arrive, then give the receptionist a "valid?" excuse for doing so - (stuck in traffic, had to take care of an emergency at work, had to rush to the school to pick up the kids), whatever it takes - (phone ahead if need be), and I have found that in most cases, the receptionist will accept my "excuses" for showing up a little late, and the wait time is less than 15 or so minutes - regardless, this is a lot less waiting time than if I had shown up on or before the agreed to scheduled appt. It just seems to be the way things work around my Dr.'s office, at least.

Medical practice should not be treated as a money making trade or business.It is like clergy or nursing or teaching which are considered sacred although they charge for their survival.If a doctor cannot come to hospital in time he should give the option for the hospital to arrange another doctor without keeping the patients waiting two or three hrs. Human rights groups,hospital authorities and patients welfare organisations should jointly take action and if doctors do not cooperate they should report to the medical council and state organisations which give licence to doctors. There should be a feedback system for hospitals to get doctor's performance from patients.