Ok, sure.
How about you DON’T leave me out in the waiting room until 45 minutes AFTER my scheduled appointment?

I was taught to be on time for stuff. I know things happen that throw wrenches in schedules, but for the first appointment of the day?
And these schedule/wrench interactions can’t happen everyday, at every appointment time, can they?
And for every single doctor?

My gears are officially ground.

And God forbid you're a minute late

The urgent care near me is notorious about getting you checked in quickly then leaving your ass in an exam room for an hour or longer. Once I was like 1.5 hours and started walking around going "helllooooo...is there anybody in here?"

I think their "metrics" on getting people processed quickly are BS and they only count when you check in as a "success" on their end, then they leave you to sit for a long time.

The medical profession has changed for the worse and seemingly gets worse every year. Most doctors offices, the doctor has a contract with a Corporation and MBAs actually run the practice. In the name of efficiency, it's become a screw the patient model with the Doctor's time being valued and the patient's time being abused.

I recently did a televist for some labwork follow-up. Joined 15 minutes early, and he joined 55 minutes late. I like him, but I hate his front office.

Show up 15 minutes early to do paperwork, but the paperwork is brain dead and/or lazy:

some forms you do online prior to the appointment, but they're too lazy to have 2 other forms online.

you haven't been here in 2024 so our policy is we need to update your file. It'd cost money to have both a patient update form and a new patient form so they hand an existing patient a blank new patient form. I guaranfuckingtee 50% of the form cannot change, and the rest rarely changes. 2 weeks ago, the knee specialist decided that I needed to update my family health history so they hand me a blank form, but the flaw is I've only been a patient for 8 years and 4 of 4 grandparents have been dead for over a decade and 1 of 2 parents have been dead for 15 years.

Doc can see 10 patients an hour so we better schedule 12 patients an hour just in case somebody doesn't show up.

And of course, there's the Sigforum favorite. Do you have any guns in the house? They think it's a keep children safe question, but it's a flawed question unless there is a follow-up question (are they all secured so children can't get them?).

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Ego is the anesthesia that deadens the pain of stupidity

DISCLAIMER: These are the author's own personal views and do not represent the views of the author's employer.

This is why I try to schedule appts for the first time slot available, pretty much as they're unlocking the doors. And you still end up waiting a bit.

Especially with pediatricians

No metrics, no penalties, no reason to change. In my experience, there is no one in the office responsible for efficient operations. Only for superficially effective ops. They focus on inventory and ignore logistics.

I do give allowances for docs who perform surgeries; hard to balance surgery time with seeing other patients. And I understand when doctors allow for urgent, unscheduled patients between appointments. But the habitual tardiness of appointments is not acceptable.

I love the places that make you fill out the same paperwork every damn time you go.

I actually called one place out as I had just been there several months early and got some weak-ass excuse about them "updating their systems". Yeah, you're always "updating your systems", got it.

I guess I'm lucky. My Primary Care doc is great and his whole staff, including the front desk, are fantastic.

Check in, tell them "no changes for paperwork since last visit," and everything is done on schedule, on time.

On the other hand, I have fired two urology practices, one physiatrist (yes, that's the correct spelling), an ophthalmologist, and a dentist, all of whom thought it would be a really neat idea to keep me sitting on my ass in the waiting room for an hour or more past the appointment time. I walked out of the eye doc's waiting room and they sent me a bill for a missed appointment. They wanted thirty-five bucks. I responded with an invoice to them for one hour of waiting time, one hour of travel time, and travel mileage at the IRS approved rate, for a total of around $275.00. I never heard anything from them after that.

When this happens to me, I go up to the receptionist and say "I will come back when you are less busy" and hit the door. I will give them 20 minutes wait time, but anything later than that, its adios!

quote:

The medical profession has changed for the worse and seemingly gets worse every year. Most doctors offices, the doctor has a contract with a Corporation and MBAs actually run the practice. In the name of efficiency, it's become a screw the patient model with the Doctor's time being valued and the patient's time being abused.

^^^^^^^^^^
After Katrina the local hospital bought most of the practices. They run the show and own the practice. Policies and procedures and billing are done by the hospital. Lots of unhappy doctors.T They promised to keep their nose out of the clinic. That has not happened. Luckily there are independent docs who are taking patients.

Guess I have been lucky with my local VA clinic.. They request arrival 15 minutes prior to appointment time and I have have arrived 15-30 minutes prior and several times have actually seen the doctor and be walking out the front door before my appointment time with a smile on my face..... Am lucky we have a great VA clinic that both myself and wife(she is a Army vet also) have received great medical care. ..... drill sgt. PS>>>that 15 minute time spread could account for traffic hold ups for you that normally would not be a problem makeing you truly late..

This message has been edited. Last edited by: drill sgt,

quote:

Originally posted by PASig:
I love the places that make you fill out the same paperwork every damn time you go.

I actually called one place out as I had just been there several months early and got some weak-ass excuse about them "updating their systems". Yeah, you're always "updating your systems", got it.

Lately , my Doctors have been pretty good about not trying to pull that bullshit . One time I flat out refused to do it . " Same wife , same address , same employer , same insurance . I'm not filling out any forms . " If looks could kill I was a dead man .
My best experience was when I fractured my wrist . Went to an after hours place and they put a temp cast on it . When I showed up at the Ortho Doctor the lady gave me a clipboard with a bunch of forms on it . Nope , I'm left handed , Want to guess which hand I write with ? They had to get somebody to come out and do the paperwork for me . Sweet revenge ..

My (soon to be dumped) dentist starts early with texts to confirm appointments up to a month and a half ahead. I've had four texts in the last few days for an appointment Tuesday.

I've been in the medical environment for 20+ years now and I currenly manage multiple specialty medical offices for a large hospital system. Let me give you my perspective of why some of the things are the way they are (maybe it'll help, maybe not)

The "arrive 15 minutes early" thing seems mainly to be a holdover from when forms, etc. were all paper. Most places have gone to online forms you can complete well before your visit. However, we still have the reminder to "arrive 15 minutes early" as many patients arrive either right at their appointment time or a few minutes after. If they plan to arrive early then it's more likely they will arrive on time. Yes, even if you arrive early there is the possibility that you won't be seen at your appointment time.

A "routine" visit can turn into something more complex very easily which puts the provider behind schedule. I mean, if during a visit the doctor encounters another problem or (more likely) the patient brings up something else that they're not at the appointment to be seen for, it's not like the doctor is going to tell a patient "sorry, your time is up. We'll address your concerns/issues/etc. at your next appointment." Yes, I don't agree with some of the industry standards that are the benchmarks for length of visits. A "routine" follow-up appointment is usually scheduled for 10-15 minutes, but as stated it can often be much more than "routine. Some specilties allow for longer appointments. Appointments for new patients takes more time than an established patients usually. Still, even with new patient appointments being alloted 60 minutes for some medical specilties they can and do run longer than scheduled. There is a balancing act of balancing patient demand to be seen with available time. It doesn't always balance out.

The reason they ask for updated information annually is because many people's insurance changes coinside with the new calendar year. Could they ask you "has anything changed since last visit?" Yes, but almost always people say "no changes" when they in fact have a completely new insurance plan/carrier. Wrong insurance means that the provider isn't getting paid timely and, if not resolved, it ultimentely means a bill for the patient. In order to try to prevent these problems it's best to get updated info annually from patient up front. Is it a pain? Yes - for you and for the staff. Think they want to put in or review that info with you. They don't. They'd rather be able to trust that the patients knows what they are talking about or is being factual, but the fact is the patients often don't or aren't.

I agree, you'd think that the first appoinment(s) of the day would be on time. They usually are in my experience, but depending on your doctor's specialty (and also on the provider themselves) they can be late to their first appointment. Things like rounding on patients in the hosptial before clinic, performing a surgery before clinic that goes longer than planned, etc. can put a provider behind before they even start. But sometimes its just poor time management of the provider and they arrive late and tell the staff to give some excuse, usually something like "the doctor was called away for an emergency" or some other lie. My recommendation is that if you don't appreciate your doctor running late or seeing you later than your scheduled appointment then tell them that in the visit. Ultimately there is only 1 person who controls the doctors schedule and that is the doctor themselves.

As to walking out/changing doctors that is certainly an option. The impact of such actions on the practice really depends on the demographics and location. In my city there are literally dozens of other patients waiting to get in so if a patient says screw you and goes to find another doctor they won't be missed. I do not say this to be a smart ass. It's simply the fact that the demand (to be seen) is higher than the supply (of available appointments).

For those saying there are no metrics, no penalties, no reason to change - I can't speak for every place but for us we have very high metrics to attain and failure to do so impacts everyone - financially mainly but continued failure can ultimaetly cost your job (yes, even doctors).


If you find a doctor you like, my recommendation is stick with them. That's who you're there to see. If the staff don't perform well, tell the doctor. Most (but not all) will let the manager/administrator know and staff who are repeat offenders or those who can't perform up to standards should be terminated. That's how it works in my offices anyway.

quote:

Originally posted by P250UA5:
This is why I try to schedule appts for the first time slot available, pretty much as they're unlocking the doors. And you still end up waiting a bit.

I do this too. It's pretty obvious why I'm waiting if I sit in the waiting room where I can view the staff entrance. Half of them walk in 15 or 20 minutes after my appointment time. So either they're all slacking or the MBAs decided to have patients show up before they start paying their staff.

quote:

Originally posted by V-Tail:
I guess I'm lucky. My Primary Care doc is great and his whole staff, including the front desk, are fantastic.

Check in, tell them "no changes for paperwork since last visit," and everything is done on schedule, on time.

On the other hand, I have fired two urology practices, one physiatrist (yes, that's the correct spelling), an ophthalmologist, and a dentist, all of whom thought it would be a really neat idea to keep me sitting on my ass in the waiting room for an hour or more past the appointment time. I walked out of the eye doc's waiting room and they sent me a bill for a missed appointment. They wanted thirty-five bucks. I responded with an invoice to them for one hour of waiting time, one hour of travel time, and travel mileage at the IRS approved rate, for a total of around $275.00. I never heard anything from them after that.

I remember a story I heard many years ago when I still lived in New Jersey.

A business owner had waited well over an hour past his appointment time to see his Doctor. He told the Doctor he was sending a bill for the time he waited past his appointment time. The Doctor said to go ahead and send it, so he did.

The practice sent the business owner a check for the amount he billed.

Apparently the people who scheduled appointments for the practice over scheduled them all the time. The Doctors in the practice were not happy about this but they did it anyway.

quote:

Originally posted by tatortodd:
Half of them walk in 15 or 20 minutes after my appointment time. So either they're all slacking or the MBAs decided to have patients show up before they start paying their staff.

Or....maybe they have their staff on a staggered schedule where some show up later than the clinic start time so they can work later and take care of patients/issues that run beyond the normal closing time.

You seem to have a hitch in your giddyup about MBAs. Why is that?

quote:

Originally posted by mojojojo:

quote:

Originally posted by tatortodd:
Half of them walk in 15 or 20 minutes after my appointment time. So either they're all slacking or the MBAs decided to have patients show up before they start paying their staff.

Or....maybe they have their staff on a staggered schedule where some show up later than the clinic start time so they can work later and take care of patients/issues that run beyond the normal closing time.

You seem to have a hitch in your giddyup about MBAs. Why is that?

I liked it better when doctors offices were run by doctors.

quote:

Originally posted by mojojojo:...

A "routine" visit can turn into something more complex very easily which puts the provider behind schedule. I mean, if during a visit the doctor encounters another problem or (more likely) the patient brings up something else that they're not at the appointment to be seen for, it's not like the doctor is going to tell a patient "sorry, your time is up. We'll address your concerns/issues/etc. at your next appointment." ...

Unscheduled maintenance can FUBAR the best Ops...

I bet you interview went something like this:
"So, I see from your resume, that you flew a fixed wing without depending on airflow and lived. Your perfect for the position. Start after lunch?"

Seems to me the easiest explanation for the long waits is simply the practice overbooks appointments. Say the place can reasonably handle 40 visits in one day but they are packing in 100 per day.

quote:

Originally posted by tatortodd:
I liked it better when doctors offices were run by doctors.

Me too. Unfortunately most doctors have no clue about business. You'd be surprised how few doctors have any idea how even the simplest items of the business work.