How Long is Too Long? Doctors please chime in

Parent Cafe
81

Here’s my most impressive story. My d had chronic stomach issues, after her pediatric gastroenterologist died we were transferred to the head of the department at a major medical university. We checked in, didn’t even sit down for a minute when we were brought back to the exam room. The dr and her assistant were in the room, with all her tests and files up on computers and were completely up to speed on her history when we walked through the door.

She performed an endoscopy on her a few weeks later and things ran like clockwork, with the nicest, most confident competent staff I have experienced to date. It’s too bad she’s a specialty we don’t often use, it was a pleasure.

82

This type of thing can also be observed with other things like airline flight delays.

83

I had a doctor (a specialist I no longer need) who made you feel like you were her most important patient. But it did come at a cost of long waits.

The first time I went to see her I must have waited over an hour. We were the last appointment of the day but she spent an hour and a half going over everything with my H and me about my condition, the different courses of action, books I could read, etc. It ran long, not because we kept her there, but because she had so much material she wanted us to understand. When we walked out of there, there was no one left in the place. Her staff had all gone home.

One time I called her office to ask a question, completely expecting to leave a message and wait for her return call. However, she came to the phone within a couple minutes! Another time I called and got a satisfactory answer from the staff, I did not need to speak to her directly. But my phone rang 15 minutes later. It was the doctor making sure I had all my questions answered!

Obviously, with all that personal attention she fell behind in her appointments. I learned that if I didn’t want a long wait for her, to make that first appointment in the morning (and I did!). But I’m pretty sure all her patients (and a did meet a couple others) felt she was worth the wait.

84

Wouldn’t it be easier and more honest if she just offered realistic appointment times reflecting the amount of time spent with each patient?

85

My mom told me that when I was little, I was so frightened of the pediatrician’s office that I would vomit as soon as I got into the waiting room. After this happened for a few appointments in a row, we never waited again. I was always seen immediately.

86

Sadly, most of my local docs have patients scheduled a lot more frequently than the Stanford and UCSF and National Jewish Health docs in Denver. For my appointments away from HI, visits are generally scheduled for an hour or longer (sometimes 90-120 minutes). They tend to be pretty prompt and do have a sign to let the receptionist know if you’ve been waiting more than 15 minutes.

Locally, visits are scheduled for much shorter appointments and can have long waits to even get an appointment. I’ve had MDs who chronically run late, so I call before driving over and ask how far behind they’re running and HOPE to get an accurate ballpark. If the provider is otherwise excellent, I will wait. Some have a sign to let the receptionist know if you’ve been waiting more than 15 minutes, but it doesn’t really do anything.

I suspect teaching and research grants may help subsidize salaries and allow for more manageable patient loads, but I am just guessing. I bring a printed list of questions when I see my docs, as well as a printed update from my most recent visit. If I know my visit will take a lot of time, I plan accordingly and warn the scheduler and ask to be last for the day. I’m always fine about returning to have further discussions as needed, unless it’s an emergency as well.

87

http://www.huffingtonpost.com/2015/06/18/cut-wait-time-doctors-office-_n_7597902.html

88

I’ve switched OBGYN offices over the wait/cancellation thing. I found that practices with several doctors worked best . And cut down on the surprise waits and cancellations. Pediatricians generally ran late. When kids were younger the practice was managed differently. We learned that appointments in the day saw a lot of time slippage. So we made sure we prepped the kids and kept busy items. The derm people are spot on for appointment. Never waited there.

As a kid, I remember our family doctor had a wonderful fish tank. And his home office was next to a farm so there was usually a horse or cow around. (while waiting for all my siblings to go through their visit).

When my father was alive, I took him to the VA for most of his care. I can honestly say that not one appointment was ever on time. It was a 50/50 if the appointment would even take place (we’d get a call the day before cancelling the appointment). The people were great. But the system was terrible. My then 3yo D had to come with us. It was a day long ordeal. Each and every time. She remembers the long days there but loved the cafeteria. It’s been 15 years and I don’t miss those days one bit. If the VA model is our future, we’re doomed.

89

@ucbalumnus -Good point. I think that would have taken care of most of the issue. I’m guessing she probably tried to fit in anyone who needed her.

Since I learned quickly to schedule early morning appointments I don’t know how consistently (or how long on average) she ran late.

90

It strikes me that it is a difficult logistical problem to figure out how to schedule medical appointments. There are at least two competing impulses–one, to see as many patients as possible during a reasonable work day, and two, to give each patient the time necessary. If you don’t see enough patients, you’ll lose money, and some of your patients may not be able to get an appointment until far in the future. There are also the issues of no-shows, as well as patients who need to be worked in because of urgent issues. I suspect that what doctors try to do is set an appointment schedule that will allow all the scheduled patients to be seen at a reasonable time on average. That will mean that on some days, there will be waits, and on other days, there may be some unfilled time. If there are always lengthy waits, it means that this balance hasn’t been set properly. If there is never a wait, then it probably means that your doctor isn’t fully booked. (I rarely have a wait at my doctor’s office, because he has gone to the “concierge” approach where I pay a substantial fee just to stay on as a patient, and he has fewer patients. He spends more time with me, as well. It’s a market response to the problem.)

91

Our dentist calls us if a opening occurs in their schedule, to see if we may be willing to take it. If we can, we try to, to help them out because we are generally pretty flexible. They are busy but generally quite prompt. Visits are mostly teeth cleaning and run about an hour.

I agree that if an office is always WAY behind, a thorough re-eval is needed.

92

@pizzagirl:
You are talking something that is obviously critical, like a new mother who is struggling and could be in distress, or someone who is suicidal, and I wasn’t talking about that. However, a lot of people, if my friends who are doctors are any indication, get people who come in for something like a bad case of poison ivy, then go on about what is wrong with their spouse, aunt suzy, or go on about the various aches and pains they have. This seems to be especially true with older people, who may simply want someone to listen to them from what I have heard of.

Something like the young mother in crisis, the guy who may be suicidal, should be exceptions, not the rule, and given the delays I have experienced routinely and others, it means appointments don’t mean all that much, they are simply a placeholder. If a doctor has that many demands on them during the day, if they routinely are answering calls during the middle of the day that ‘have to be returned immediately’ and the like, then it means they are overscheduled, which is the truth in most practices, they want to cram as many people in a given day, and they don’t take into account the varioujs distractions a doctor has in a typical day, they book assuming no distractions, when the reality is you can expect some. It is no different than for example, when people estimate how long something will take at work, the mythical man days, they often base that as if their time is 100%, when in reality most people spend time doing other things.

I kind of resent when clients complain about this and them being treated as if they are being ungrateful or being unreasonable, given that office visits usually are scheduled during the day, that means people likely have taken time to schedule that appointment when they did, with a reasonable expectation that they will be finished with it in a reasonable time after the appointment. Some take time from work, some schedule it around other things in their life. Yes, medicine is a very labor intensive thing, yes, there are going to be things that throw schedules out of whack, but the reality I have experienced and others seem to is that the practices basically are like “take it or leave it”, despite all the signs around saying that their patients matter, that they want the experience to be good, etc. I hear a lot of excuses about why appointments are routinely so late, and usually it boils down to it is the patients duty to grin and bear it because the people in the office have such hectic lives, it totally leaves out the reality of patient’s lives that theirs are often just as hectic, they have to schedule around their own individual chaos to be there for the appointment, then they are the ones who will have to work around when it takes 2 or 3 hours to get through the visit.

93

We fill out a form at the GYN listing everything we want to discuss. If it’s not on the list, it can’t be discussed. I’ve never had to wait more than five minutes after my appointment time.

I USED to have my GYN exam through a family practitioner that I eventually left. One morning I was in the office, undressed and on the table, when the nurse said “the doc will be here soon; she’s driving her children to school today”. Not acceptable. At least let me stay dressed til she was in the building! We ditched her when they actually closed down the office one afternoon while we were still sitting in an exam room - fortunately the doc went to sign off on a chart and realized she hadn’t seen my daughter.

On the other hand, my kid now works in an urgent care center. There was a mom there recently with five kids, one of whom was supposed to be seen for a minor issue. The kids were running around like crazy until they could finally be sent to an exam room. My kid was outside the room reading the nursing notes when she heard one say “are we being naughty enough? You said if we were bad they’d see us sooner”. I think there is still steam coming out of my kid’s ears over that one!

Said kid did have a full hour scheduled for lunch when working family practice, but there was a doctor who had a different lunch hour so there was always a medical provider at work if there was an urgent walk-in.

94

Wow! :open_mouth:

95

My mil had rheumatoid arthritis and saw a specialist at a teaching hospital 1.5 hours from her home, who she absolutely loved. She routinely waited more than an hour to see him. Never complained–he helped her with her disease and she thought he walked on water. When she passed away a few years ago, he sent a condolence card to the family. Never heard of a doctor doing that–so maybe there was a reason she was willing to sit in a waiting room.

96

I have never had to wait more than 15 minutes at my dentists’ office, which I find amazing - it’s a big practice, very busy, and yet the waiting times are very short. I don’t know how they do it!

My H goes to the same dental practice. Once he had to wait 20 minutes, and he was given a gift card to a local movie theater as part of the apology from the staff! He was told that it’s the policy of the office that if anyone waits more than 15 minutes for their appointment he/she receives a gift card as a way to say “we’re sorry.”

97

Several docs (urologist and Pulmonologist)?I know keep a stash of condolence cards and and them out when they learn patients have died. Our support group also sends out condolence cards after members die. The palliative care doc even attended my aunt’s funeral.

I honestly am fine waiting for docs, as long as I feel they are worth it. I do try to get an estimate as to how long the wait is likely to be, but have waited as needed. My favorite allergist has finally gotten better at sticking closer to appt times. She has a new office mgr (her D) and staff will come in and ask her what she needs when she is running long and getting behind. She also tries to schedule the longer appts for the end of the day. My kids and I have waited hours to see her.

98

I have a friend who had a doctor that always kept her waiting. One day she (my friend) happened to be 5 or 10 minutes late to an appointment. The receptionist told her she would have to reschedule the appointment because she was late. Friend made a stink and pointed out that the doctor always kept her waiting and the doctor wasn’t even ready to see her so how could she really be considered late. She got in.

99

My old obgyn used to allow me to call her office to see how far behind she was running. (It was a 45 minute drive to get there.) Generally, she ran 2 hours behind, but it didn’t bother me because I always knew that and compensated for it. Also, I really liked her.

I left my previous PCP because the office staff was rude and incompetent. I can’t believe that DH still puts up with that practice. I have to say that my current PCP runs very much on time as did our pediatrician. My current OBGYN, not so much, but she always apologizes and we’ve become sort of friends now.

Several years back, one of my kids had an appointment with the dermatologist. We had a very long wait and when I inquired as to what was going on, I was told there was an emergency. What’s a dermatology emergency? Zits before the prom?

100

I ditched my long time OB/GYN after multiple appts made well in advance were cancelled at he last minute. The weather was good and he wanted to sail.

My primary’s practice has had a “sick clinic” for several years. Call, get a callback to see what’s up, then they can set an appt M-F til 9pm, full Sat, half Sun. You see whoever’s on duty, but the entire practice is super.