Thursday, April 8, 2010

The last patient of the day

Following a whine session yesterday with Mary and Annie, I now present our list of issues that always seem to plague the last patient seen each day (especially when on a Friday).

The last patient of the day:

1. Shows up late, and wants to tell you the 10 minute story of why they're late. And/or wants to spend 10 minutes in the bathroom before the appointment starts.

2. Wants to read the required HIPAA privacy form word-for-word and ask questions, even though it's identical to the one every other doctor and hospital in the country use.

3. Has a new insurance card. And forgot to bring it.

4. Forgot to bring the insurance authorization for the visit, and the doctor who issued it closed earlier in the day.

5. Left their (MRI reports/lab reports/small child) in the car, and and has to go back to get them, and has no fucking idea where they parked.

6. Doesn't want to start the appointment until their spouse/child/parent arrives, and has no idea where they are. Or what their cell phone number is.

7. Has a new address, and needs to fill out the forms for it.

8. Needs a shitload of tests ordered.

9. Needs a bunch of prescriptions written, with both 30-day (local pharmacy) and 90-day (mail-in) scripts written for every damn drug.

10. Makes all who have contact with them want to strangle them.


Texas Pharmacy Chica said...

From the pharmacy perspective, I wish you would act on #10, because their next stop will be the pharmacy where it will repeat itself all over again:

New insurance, no card

Lost the 30-day prescription between car and door to pharmacy. And ask us to call the doctor for a 30-day prescription even though it is 8:35 PM. And then get upset when we refuse.

Forgot wallet.

Don't understand their co-pays yet insist on arguing they are wrong

Will be back in 1 hr, and, when told we close in 25 minutes, sigh loudly and whip out a cell phone to complain about our service to brother/preacher/imaginary friend.

Yep. #10.

Amanda said...

It's not always the patient ;-)

I was the last patient of the day 4:30 for my dentist a few weeks ago. My file says that I take SEVERAL shots to get numb. He was running late. I got there early. When, at 5:30, the doc was still trying to numb me, he said "It's always the 5:30 patients that are the hardest to numb" and I said "actually I was a 4:30 patient and I was here early". He felt bad.

Of course he was probably running late because of some other idiot but I was glad that I wasn't the cause of him missing dinner!

Grumpy, M.D. said...

Good point, Amanda.

I hate the patients who show up late earlier in the day, and screw up the schedule for everyone else.

I usually move them to the back of the line when possible, so I don't punish the ones like you who were on time.

Anonymous said...

This remind me that I have an appt. to see my cardiologist in clinic at 9:30 and another to see the pacemaker tech at 10:00 (the same day).
That's gonna work, :)

Helen said...

I always seem to have people ahead of me at the receptionist's desk who, when asked why they're there, say "I don't know."

If it drives me crazy, I can only imagine what it's like for you and the poor receptionist!

Brandy said...

We had a policy on Thursday and Friday that the last 2 patients were rechecks ONLY.
Not new patients and not new illness issues.

It meant we all got out on time and had dinner!

ERP said...

Good thing for me is that the last patient visit of the shift is over when my shift ends!

Dr. Tonya said...

I agree with Amanda - it is not always the patient.

My sleep doc (who is a neuro) has a sign posted where you check-in - huge, bold letters saying that if you are more than 10 min late for your appointment, you will have to reschedule. He has another sign next to it saying that if you are a no-show and/or do not cancel 48 hours in advance you will be charged $150. No joke.

That being said, I always bust my tush getting down there on time if not early - just to freakin wait. I have had 4 appointments with him and he has always been 45-90 min late for every appointment. What is worse is that the nurse will take you back to the exam room right away - so you think you may actually be seen on time - but then you just wait. There are no magazines or TV or anything. Once I thought he forgot about me and opened the door to make sure someone knew I was still waiting - waiting 90 min in an exam room is not exactly my idea of fun.

He's a good guy and is highly respected in the field of sleep medicine but I'd be lying if I didn't say that his lack of time management irk me to no end. I asked his staff if he is late to his first appt and they all shook their heads yes. Makes it hard when you are trying to schedule it around work. *sigh*

Anonymous said...

no patients after 1600. no friday afternoon clinic. make every effort to stay on or ahead of time. patient satisfaction 91%. staff satisfaction 100%

Anonymous said...

Every last patient, upon seeing that they are the last for they day, always feels the compulsion to ask for advice for numerous medical (and personal) problems, none of which related to the reason why they came. If given prescriptions they'd refuse politely, 'No thank you it's not that bad!'

I'm not a doctor btw. I'm just the girl who waits for her parents(they work together in one practice) to come home for dinner.

Anonymous said...

The last patient of the day scheduled tomorrow (on Friday) is a new patient with "headache for three years" and two other chronic painful conditions and whose intake form cites "allergic to Tylenol." And yet, mysteriously, Percocet is tolerated. And is on four other meds that all will require prior auth from her Medicare-D carrier, at least one of which will not go through, I can tell from just looking at it, because I spent much of last week dealing with them.
In the words of the great Dave Barry, I am not making this up.
I believe that the front desk has started deliberately scheduling this way so that I will spontaneously offer to buy a LOT of drinks for the staff at the end of the day on Friday.
It's working, too!

stargirl65 said...

The last patient is often the one with vague but significant symptoms (abdominal pain) that require urgent evaluation with stat labs and xrays that are hard to get at 500pm, especially on Friday. You end up getting called hours later at home with the results. Then they need an urgent referral to a specialist but end up getting sent to the ER since none are to be found.

Anonymous said...

this is possibly a person who craves attention - runs around in a daze and makes everyone accommodate her. she's a classic pain the the butt, however, neglecting the need for attention, doesn't have a worry in the world.

i would have kicked her out by number 2.

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