Wednesday, May 25, 2011

Mary's desk, May 25, 2011

My 10:00 was a new patient today, a lady in her 60's. At 10:03 her daughter showed up, and had this conversation with Mary:

Mary: "Hi! Where's your mother?"

Mrs. Daughter: "Oh, she'll be here. She had a lot of errands to run, and won't get here until 10:30."

Mary: "Her appointment is now, not 10:30."

Mrs. Daughter: "I know that. It's why I came in on time. I'm holding the slot for her."

Mary: "Excuse me?"

Mrs. Daughter: "I'm here, since she can't be. I'm holding the slot, so you won't cancel it before she gets here. She'll be here at 10:30, I promise, and in the meantime I'll wait here in her place."

Mary: "But you're not the patient!"

Mrs. Daughter: "What does that have to do with it? I'm here on her behalf."

46 comments:

Headstrong said...

Um, yikes.

Packer said...

Common practice these days. When I go to the doctor for my scheduled appointment, I ask how far behind are you--the usual answer is an hour. Ok I say, I will be back in an hour. Not our problem if you overbook and cram them in. Medical profession is starting to reap what they have sown. I see more and more people doing this and similar.

a.generic doc said...

You could have told her you need to do a spinal tap to make the diagnosis and since she was there on her mother's behalf, you'd do the procedure on her.

Anonymous said...

Yes. From what I've seen, Dr. Grumpy seems to be the exception. He actually respects patients time and demands the same in return.

I don't think I've ever been called back at a doctor's office less than 45 minutes after the scheduled appointment time. Mr. Daughter has probably had a similar experience.

Anonymous said...

Hi dr Grumpy, somewhat off topic, but would love some opinions. Our fantastic Family doctor is leaving to specialise in Obstetrics, what parting gifts would u recommend?

Anonymous said...

My grandmother has waited 2-3 hours for an appointment for a 10min dressing change at her dermatologist. Last time I was there I told them they could call us 15 min before they could see her and we would return, but that my 89 year old grandmother was not going to sit here any more. Appalling. I personally pride myself on no more than a 15 min wait ever.

Snarky Scalpel said...

@Packer: has it ever occurred to you that Mrs Daughter and the likes might be a large part of the reason why doctors run late? If her mother showed up 30 minutes late, Dr. Grumpy has two choices. Either cut her visit 30 minutes short, or make everyone else wait those 30 minutes. The first makes Mrs Mother unhappy, the second makes everyone else unhappy, both make Dr. Grumpy unhappy. But cutting the visit 30 minutes short and rushing through the history and physical is also badbadbad medically speaking, so he chooses the other one. Two patients like this in a day and BAM, he's an hour late through absolutely zero fault of his own. And trust me, there's far more than two patients a day to arrive late, at least around here.

Grumpy, M.D. said...

"Candlesticks always make a nice gift."

Mary said...

I regularly see an orthopedic surgeon who runs 20 - 40 min late. However, when I arrive they tell me how late he is (I can go do an errand if I want) AND, most importantly he NEVER rushes me. He takes his time and thoroughly examines me/answers my questions. Worth waiting if the upside is you don't get rushed when it is your turn.

OldSquid said...

Specialists offices seem to always be running behind. Surgical especially. Wondering if specialists are moving towards more (if any same day) appointments? Most primary care offices do this and decreases no shows, which is the reason why many offices will over book. 25% no show rate and they’ll book one extra appointment per hour. Couple that with an emergency and they can get way behind because emergencies usually aren’t build into scheduling software.

Anonymous said...

So....what did you do? See the mother when she got there or make her reschedule?

BTW as a patient I appreciate the comments about waiting once you get there...a few weeks ago I needed a same-day Saturday appt. and was told to be there at 9:15. I asked if it could be a little later (my husband had to feed the cattle before he took me) and the reply was "No, on Saturday we book in order of your call." I'm sure you can guess that I wasn't seen til after 10:00--the appt. time I'd wanted originally.

Grumpy, M.D. said...

I made her reschedule. I will not inconvenience the other patients for the day because of one inconsiderate person.

Anonymous said...

So she thinks your office is a parking lot! Fun. Do you have valet service?

thatsit said...

Does that work?

Can I go fill in for my husband at his job today? I'm sure the Coast Guard wouldn't mind...

Ahahahaha

Mallory said...

Yay Dr Grumpy! I hate when clinics run late. The worst is when they don't tell you honestly how late they're running. One clinic I attended kept telling me I'd be seen in 20 minutes (or half an hour, or fifteen minutes).... for three and a half hours.
If they'd been up-front about it, I would have cancelled, and re-booked for another day. Instead I waited, in increasing pain, without my medication or anything to eat or drink. When I stood up to go in, I promptly fainted at the doctors feet. No doubt this caused the wait for those behind me in line to be even longer.

Anonymous said...

i am with you, grumpy. that patient must reschedule. the waiting room is not a queue.

gena said...

"So you'll be having the lobotomy on her behalf?" Jeezley crow. Some people's children.

The Evil Receptionist said...

And keep in mind---the nurse/medical assistants are usually the ones that call up to the front and let the reception people know there is a backup. We then let the patient know. If the nurse gives me the wrong behind time, or the doc gets even further behind for some reason (high number of direct admits, for example) I'm the last one to know, but the first one blamed.

I'm glad you didnt see her, Dr G.

Anonymous said...

So 'a few errands' outweigh a visit to a specialist? Yeow! What an attitude.

clairesmum said...

I can see both sides on this one, but overall the customer/consumer/client/patient is wrong, i think. Certainly to assume the doc would be behind when it was her first visit to the practice is not ok.
But, I've come close to leaving one of my specialist docs - I like him and he spends enuf time with me - but waiting up to 3 hours for a less than 10 minute routine followup is not ok. This practice routinely double books at a mimimum - twice i have been checking in and had the person in the next line say they are here for the same time with the same doc. You don't sit in the front waiting area, you sit in the hallway outback, so you are almost knee to knee with the folks on the other side of the hallway, and no way to avoid the blaring TV. I have spoken up enough to him that he now has the tech squeeze me in ahead of other folks - I don't think that's great either, but I don't complain. My time is worth something too, and the occasional running behind is understandable, but this office relies on volume. Lots of the folks are either elderly or kids, so it really doesn't seem fair. Front desk can't ever give you an estimate of wait time, either, and they usually get you back to the waiting halls within 10 minutes of your scheduled appt. So then you are trapped - and can't use a cellphone or laptop to get work done while you wait, either.

Anonymous said...

People anymore are so used to endless waits for any kind of appointment that they treat a doctor visit like calling "customer service" at Microsoft.
Sounds like you've still got a grip on scheduling. Too bad I don't need a Neurologist.

Amanda in AK said...

If you absolutely can't wait for a Doctor that has been delayed, why not make your appointment that is available when the door opens in the am?

I've had long waits before - but have never minded due to the courteousness and professionalism of the staff backing up the Physician. The family practice we frequent is in a rural community and isolated - if my neighbor needs stitches, an x-ray, etc. before I go in - then so be it.

Watercolor said...

I always arrive early having learned most docs take you in order of arrival, no matter the appointment time. Best friend is a doc and she says usually that's right. Most of my docs, a 15 - 30 minute wait is normal. One specialist I see is a 1 - 3 hour wait depending on how many hospital admissions she has throughout the day. I don't ask to reschedule because it would be 4 - 6 months until her next open appointment... And the wait would be the same. Plus I love her. She's awesome. So I don't mind.

ERP said...

Christ. Probably from Boston where everyone puts crap into their parking spots to hold them for later.

emjay said...

Umm please don't post these things I have marys job in an eye drs office don't give my pts any ideas!

The Merry said...

One doctor (not a specialist) that I used to see would always make me wait at least 20 minutes in the waiting room and then 90-120 minutes in the examining room itself. It's true that once he was there, he took all the time the patient needed. But even if I was the very first patient of the day I'd have to wait over 2 hours to see him.
Once, I arrived 20 minutes late and the receptionist chided me. When I replied that I'd never had a wait time less than 2 hours, lo! the doctor turned up after I'd only waited an hour in the exam room.
Other than that particular doctor, yes, being on time is a good idea.

C said...

I hate it when I have to wait because I have to take time off from work -sick time- which is counted by the hour. That said, I have had my dentist see me on an emergency basis by "squeezing me in"- I assume because some one did not show up or they canceled. I guess you could have told Daughter/Mother to camp out if there was any possibility of a no show, with no guarantee that they would be seen. Probably you should warn people (if you do not do so already) that they need to be punctual because you run on time.

Cal said...

All my doctors run on time, specialists or otherwise. Honestly I have never waited more than 10 minutes, normally less.
I did have to wait two months to see the neurologist, but not only was she on time, but I had three doctors/nurses all to myself once in the exam room!

jacquie said...

I often have a long wait for my Dr and wondered why consistently he is so late. Now I know (after watching in the waiting room for four hours) He arrived 90mins late TO WORK, when asked the secretary stated "oh he always comes at this time". If you book appointments for 90mins before the Dr arrives, he is gonna be late all day! and then I discover she is also double booking.... GRRRR me thinks it is time to find another practice.

Sparkly Jules said...

Are people really that dense? My goodness. Try that with your hair stylist or manicurist, lady, and watch them freak out.

I once waited to see my doctor from 9am to 2:00pm. My husband and I were trying to figure out the best way for me to get home (taxi?) because he had to go to work.

When the doctor came in, we said, "Oh, there you are, we were just trying to figure out if we should stay or go...."

His response, "I've got real sick people here, and that's not my problem."

I reported him to my insurance company and immediately changed. That's crazy.

Jules

Julie said...

Worse was when we waited for 3hrs to be told the specialist wasn't in and we'ld need to reschedule ...

oh the joys of nationalised medicine ...

Pissed Off Patient said...

This has never been the battle I wanted to fight as a patient.

I just pack some books, something to drink and a snack and enjoy the wait.

My last pulmonologist was always a 2-3 hour wait, but that was because she was marvelous.

My current pulmo is up 'til the wee hours of the morning on a routine basis working the floors and comes in late as a result. I don't begrudge them the sleep. (They run about 30-60 min behind and I try to make sure I'm the first appt of the day.)

However, now that I have a kid, I do sometimes have to leave without being seen and reschedule. Childcare waits for no one!

M

Anonymous said...

I work the front desk in primary care and we got rid of appointments years ago - and everything has been just fine. Granted, there are days when we are very busy and days when we are not so busy, but it all evens out at the end.

Don't want to wait to see the doctor? Then don't come in during lunch hour; instead be there first thing in the morning.

And as for that lady? If the patient isn't here, that's called tough. We don't hold places in line.

Frankly, I'm surprised that more primary care physicians haven't stopped using appointments. Not sure if it would work for specialists though...

CholeraJoe said...

One of our local Ortho practices posts waiting times on their website. Another does like restaurants and gives their patients a pager and says, "It'll be about 20 minutes. We'll page you. In the meantime, feel free to browse the Barnes and Noble next door."

Anonymous said...

Anon 8:21
No appointments? How un-American!
How will people know how important their personal trainers are? How will the lawyers bill by the microsecond?
And after we've spent 12 years of primary schooling to teach proper subservience to future generations.
Oh, the shame..

Anonymous said...

Her mother did the same thing for her on her wedding night.

Anonymous said...

I like it when the office 'works' with you. I try to attend my doctors appointments on time, and with some of the specialists out of town, if there's been road construction or other inconvenience on the way in, I can usually tell how late we'll be and give them a call half an hour to find out if I should turn around and go home or they'll still see us.

For my local doctors, it's usually best that I show up on time, and if they have a reputation for usually running late, then I try to work it out schedule-wise with the office staff, explaining any dilemma.

The dentist and doctor's offices are very accommodating. A couple weeks ago, my doctor had an emergency at home come up and had the office call all her patients to inform of that and to reschedule.

If the woman was going to be there at 10:30, she should have phoned Mary to let her know, and at least Dr. G could've scheduled tea time or something else instead of 'holding a slot open'!

Anonymous said...

If you have a patient that is late, and demands that the entire schedule for the rest of the day be shifted because of them, tell them you can do so, but you will be giving their home phone number to all of the angry patients that have to wait due to their tardiness, and instructing them to vent their frustrations whenever they feel like it.

If the doctor's staff isn't responsible for the delay, they shouldn't have to deal with the abuse.

WV: normocup
Patients are such normocups!

oceankisses said...

OMG! What an "artisnal" way of thinking!

Kim said...

Once when my son was sick and throwing up and not eating or drinking I brought him to the doctor. I was told it was going to be a long wait...they were very busy. After we had been waiting about 5 minutes my son threw up all over everything. We were seen right away. Hehehehe.

Anonymous said...

Too bad you couldn't bill the idiot daughter for wasting your time. I would've been tempted to make a physiologically impossible suggestion to her....

Anonymous said...

I can't stand it when patients have disregard for an office's schedule. They think that being 20 minutes late is no big deal but they need to realize that a lot goes in to an appointment. When they are 20 minutes late, they have put the front desk/registration person 20 minutes behind, the nurse 20 minutes behind and the doctor 20 minutes behind. So in effect they have practically caused about an hour's worth of delay! But heaven forbid if THEY have to wait an hour on us! geez

The Bus Driver said...

I've always made an effort to be on time for doctors appointments. If I am going to be late, I always at least call the office to make sure I can still be seen, and to notify them of my possible lateness.

There is only one doctor that I don't mind waiting to see and that is my foot doctor.. his office routinely runs about an hour to 2 behind, but he is GOOD at his job, so i dont mind the wait.

jamiegirl said...

I am convinced that something somewhere in the universe has snapped and there is an entire planet of people who are convinced the universe revolves only around them. More proof in your office Dr. G. Yikes.

The Nerdy Nurse said...

at least she had the courtesy to send a squatter, most wouldn't. Really, I kind of admire that.
More respect than most would give!

cliffintokyo said...

Time waits for no man.
But for women......

Misogynist of the Year 2010, 2009, 2008, 2007, 2006, 2005.....

 
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