My relative who is a dermatologist sees patients every 5-10 minutes and runs on time. She works thru lunch and is very busy. She loves her job!
A dermatological emergency is not a joke. A recluse bite, a rash that turns out to be a severe infection, a mole that would not stop bleeding after the removal, etc. The person might be feeling fine at the moment, but could be in danger if nothing is done.
My understanding is standard OV is 12 minutes. Obviously, not possible over days and weeks and depending on the specialty and reason.
And docs who do sched that way are often popping between rooms- see you a minute, see the next room, come back to you, etc.
Lost a comment-- I’d think an emergency should get bumped up in priority. Though once I walked the halls in utter pain while waiting for a uro to get to me. His and his staff’s attitude was too democratic. I think the staff said the old, “Well others have appts, too.” Luckily, he left town. Once they made me wait a week…and gave me an alternative: an appt next month.
You can tell I have some good docs with well run practices. But not all.
I was 31 when diagnosed with CA. I was at the new oncologist’s office before 11:00 a.m. The snowstorm was getting worse, and I had cancelled my afternoon patients. I was the only person in waiting room. I heard the oncologist chatting with her staff about the snowstorm, where to order lunch, etc. I asked receptionist if I could be seen, since the MD was not busy. When told she’d be with me soon, so busy, I waited and left. It was an hour.
Unbeknown to her, I was an employee at one of the best Boston hospitals. The head of the hospital had heard of my diagnosis, called me, and said he was now my internist. He didn’t know me. He arranged that I had appointments with an oncologist and dermatologist in next 3 days. In 4 days, Xmas eve, I had surgery with the chief plastic surgeon. (Can you tell how lovingly impressed I still am?)
I had so much follow up,care with the 3 MDs over the next few years, and all treated me like a person, with respect and care.
Like PG’s husband, there are some wonderful MDs out there. One needs to shop, or be lucky, as I was.
I have a relative who is a PA. Frankly, given how late she is for every family function (like getting in the shower at the time you are supposed to be somewhere and having her spouse and kids drive separately) I’d be surprised if her patients ever get seen on time.
@momof3sons “What’s a dermatology emergency? Zits before the prom?”
Skin Cancer. Didn’t you see the Seinfeld episode when Jerry was dating a dermatologist?
While that may seem like an emergency to a high school student, wouldn’t a true dermatology emergency be something like [necrotizing fasciitis](http://www.cdc.gov/features/necrotizingfasciitis/) or a severe burn?
This seems like a pretty crass statement. The skin is the largest organ in your body. You can have emergencies on it just like any other organ.
I went to the ER a few weeks after Christmas this year because my skin had turned blue. You can bet there was a dermatologist called in to examine me.
I would wait no longer than an hour. I would ask for information from the front desk after 20 minutes.
@bookworm That story is wonderful. Wishing you continued good health.
My mom died in January at a NYC cardiac icu. Last month I got a card from a nurse telling me she thought of my mom and of us and hoped we were all doing okay. It’s one of the largest hospitals in the country and I was incredibly touched that she reached out.
@eyemamom I am sorry for your loss. This nurse must have thought very highly of your mother and you. What a sweet gesture!
What a lovely memory, @eyemamom.
My doctors generally do an excellent job of seeing me within a few minutes of the scheduled time. The pediatrician was another story. Wait and wait and wait. What I eventually realized was that their scheduling simply did not take into account emergencies – and in pediatrics, kids get sick all the time. Worst was Mondays, when docs on call over the weekend had told a number of parents to call the office first thing on Monday and come in that day. That simply doesn’t work when they scheduled Mondays the same as any other day. That practice had no ability or willingness to look at patterns. A pretty simple analysis would have shown them that they need to reserve a good chunk of emergency slots on Mondays and the day after holidays.
Closing the office during lunch doesn’t bother me at all.
I experienced my share of guilt last week with my derm. I see him every six months for mole checks since my dad and brother had melanoma. Anyway, when I saw him a few weeks ago, I asked him about a cyst I had on the back of my head - it had been growing bigger, and I thought, “Easier to get it removed now than when it gets even bigger.” So I asked him about it and he said I would need to schedule another appointment, which I was absolutely fine doing. Scheduled the appt. a few weeks out due to some travel on my part and went in last Friday. When the nurse took me to the exam room and asked me what I was there for, I told her, to remove a cyst on the back of my scalp. She looked at the notes and noted that the front office had not scheduled an appropriate time for an excision and suturing. Since that appointment a few weeks earlier, when I was traveling, one of the bags I’d been carrying through the airports rubbed a mole on my shoulder wrong and it was very irritated, so I said to her, “How about I reschedule the appointment for the excision, and just have him remove the mole on my shoulder today?” She seemed to be game for that, and frankly, I’d been having the heebie jeebies thinking about a needle going in my scalp to numb it, so I was open to a way out of the procedure. But the doctor walked in as we were talking and said, so what are we doing today. We started to explain to him that I initially had scheduled an appointment for a cyst removal, but the front desk did not schedule enough time, so we were negotiating my coming back another day. He took a look at the cyst and said, “No problem, I can do it now, along with the mole on the shoulder.” At that point, I realized if I said yes, I was going to make the rest of his patients wait that much longer… but in a flash of a moment, I got the courage to have the scalp cyst done and thought it would be best to go ahead with it instead of rescheduling and spending another week or two worrying about that needle in my head. So yea, I felt guilty for taking up more time than initially scheduled, but he really did work fast, and I’m guessing it only took an extra 5-10 minutes than was allowed for my appointment - the nurse did the numbing and removing of the shoulder mole. But a few of those 5-10 minute appointment extensions add up and impact patients coming in later.
But this is a great example of how easy it is for a doctor’s office to get backed up and I was complicit in it. I go back Friday to have the stitches removed, although the nurse did tell me if I had someone who could remove them for me, I didn’t need to come back. Yea, no… I have no one I would trust to do that, so back to the office I go.
It really can be a crapshoot sometimes and in this instance, it was the fault of the scheduler who did not set aside enough time for the procedure; I had no way of knowing that until the nurse took me back to the exam room. He decided to over ride it in order to save me another visit, which I did end up appreciating.
@teriwtt Don’t worry. I was probably right behind you and got the quick looksee to make sure my situation was static as I only needed a check to continue my prescription (God Bless Rosacea) . I also had the chance to catch up on who’s doing what with whom (or not) and what they were wearing in the latest issue of People. I only read that mag when I am at a doctor’s office or getting my hair cut. I didn’t mind waiting because I could finish up that story on I’m glad your mole and cyst are no longer troubling you.
(I won’t be there on Friday, but I bet you’ve got this and you’ll be fine.)
Scheduling can mess up things big time. Like my 2+ hour wait in an empty ER room when the scheduling forgot to click on a window to complete my check-in. I was sent to that ER by the urgent care doc who though I had appendicitis. I cannot imagine what I would have done to them if I really had appendicitis and if it had ruptured!
It’s just tough when appointments have to be so tightly scheduled because of economics. If patients are scheduled for 5 or 10 minute appointments, it doesn’t take much for them to run over, and all of that to add up. When I’ve gone to appointments out of state, they are generally set for at least an hour, so the background can be covered as well as what has happened since the last visit. With complicated patients, I really don’t see how visits can be done in 5-10 minutes.
I am one of those emergencies that caused my PCP to be even later than usual. My H and I were on the way to the hospital complex for him to get a blood test and me to see the dr. about a lingering cough. On the way we got rear-ended and my head bounced off the headrest pretty hard. I called the office to say I was going to be late and the office manager said to come; she would shift me to a later slot. I arrived 45 minutes late and the dr. did a few simple tests (visual, walking etc) that extended the time of my regular appointment. I was extremely grateful the next day when I had a major vertigo episode that I had been seen by the dr. and he could refer me to a physical therapist without having to go in for another visit.
"It’s just tough when appointments have to be so tightly scheduled because of economics. If patients are scheduled for 5 or 10 minute appointments, it doesn’t take much for them to run over, and all of that to add up. "
Such is the risk of going to a large, corporately owned practice where the doctors have quotas to meet and are graded / compensated on meeting those quotas. Doctors in privately owned practices can set their schedules how they like and are not beholden to anyone. Of course, some will still overstuff the calendar nonetheless, but that’s their choice.
My children’s pediatrician, who just retired this summer, had a great system for seeing patients in his original office building. All the exam rooms had both inner and outer doors. When you walked up to the building, you would look to see if the outside light was on or off. If off, then you just opened the door, walked in, locked the door, and switched on the light. That would both turn on the light outside the door, and also turn on a light at the nurse’s station to show that the room was occupied. There was also a waiting room, but I rarely had to use it. I loved not having to sit with my kids and lots of other sick kids. I’m so glad he waited to retire until my youngest started college! He was a fantastic doctor.
Our ped had a door note saying, if your child is very sick, don’t bring him in.
I know they meant a critical emergency. Sure, you should take him to the hospital. But they could have worded it better.
I think it’s common to like to gripe, but most times, for most of us with private docs, a wait is just a wait.