Seems like common sense to me, ucbalumnus. But, again, if you are employed by a corporate health system, you are at the mercy of what they tell you to do.
However, the solo or small practice offices that most of the stories in this thread are about should be able to clean up their scheduling on their own, right?
Yes, that’s what I’ve been saying, repeatedly. If they choose to, it’s in their power. They can run whatever hours they like.
Here’s a lunch hour story for you. I had a Moh’s procedure. I knew there would be waiting on pathology to determine how many layers would have to come off. I go back to the waiting room, gauze covering the hole in my forehead and held in place with a dead sexy headband. The nurse came to tell me my edges were clear (got all the cancer) and I was third in line for stitching up. At 11:50, person 1 was called back. Then, promptly at noon, the whole staff went to lunch! Person #2 and I sat in the waiting room, alone, for the lunch hour. No other patients in the waiting room, no staff at the desk, and drug reps wheeling back the lunch they brought for the office. Are you freaking kidding me? I really didn’t think I’d be alone in that room for an hour.
At 1:15, I went to tell the staff that I was going to lunch and they could stitch me up when I got back. Apparently, I couldn’t leave with an Un-closed wound. Again, are you freaking kidding me? I can sit for an hour, waiting while you eat, but I can’t leave. Was finally out at 2:15.
Oh, and this is a large specialty practice.
@ordinarylives THAT story is ridiculous. How unprofessional and rude.
That is completely unacceptable, ordinarylives. It’s the same mentality you find in the post office, when there is a line of people and they slam down the sign that the window is closed.
See, this is what I mean by lack of work ethic. In the business world, no one I know “takes a lunch break” when there is work to be done and a client is waiting. You can take it later.
There is a huge difference between “We will not make appointments or take non-urgent phone calls between 12 and 1” and “We are not going to finish up our morning appointments until after we eat our lunch”.
I’ve always assumed that the offices I go to that are closed for lunch are of the former.
(I’ve also always kind of assumed that the break was also partly to have a time to catch up if they were running behind in the morning so it wouldn’t flow into the afternoon.)
Wow, @ordinarylives. Completely unacceptable. There is a large medical monopoly in my area that owns most of the hospitals and medical practices. After any appointment, I receive a survey via email. Does the dermatology practice do anything similar?
One of the Murphy’s Laws is that the work expands to fit the time available. Thinking you can just stay open until 8, to catch the 5 pm appts is a bit nuts.
Doctors need to return calls to patients (or at least, discuss comments with the staff who will return a call,) or need to take a moment during the day to consult with or for other doctors, or read up (test results, consult notes and more.) So having breaks in the schedule day, every few hours, makes more sense. If the OV are running late, the doc can then use that buffer, as needed.
A little OT, but I had a bank once that prioritized lunch over clients. The line would be out the door at lunchtime and one or two tellers on duty.
Ha - I still have that bank – Wells Fargo. And one time there was a line for the tellers while one of the two drive-thru tellers had no customers and was clearly researching toys on her computer (this was in December). Most times if a drive-thru teller is not busy with a drive-thru customer, they help the tellers at the counter.
Part of the problem is there really isn’t much incentive for rationalized scheduling of doctor’s appointments, clients being dissatisfied don’t matter much to them. Why? Because it was kind of like quality and US cars before the 1970’s, if everyone is the same, then it isn’t a selling point. With doctor’s offices these days most practices are the same way, thanks to the insurance reimbursements being what they are, they schedule a lot of appointments, and if anything throws that off, an emergency call, a patient comes in who is in distress, etc, it throws the whole thing off because there is little to no wiggle room. If they schedule in break time, to allow call backs and such, the problem is that often what happens is those breaks make it more likely other appointments will run over, since it is known there is ‘wiggle room’.
Sure, you can try and find another doctor, but given that your insurance is what it is, you are likely going into doctors in the network, and they likely are under the same pressures the others are, and knowing that other doctors are likely no better, they don’t worry much about customer service. What also irritates me is many of the practices I have had to use, their answer to potential customer complaints are to find some of the nastiest, rudest people out there. When I talk about that, I get the same excuses I got with the old NJ department of Motor Vehicles, that it is a hard job, that people are difficult, yell at you, etc, which is basically a load of BS, what they really means is they don’t care (the owners of the practice) and are turning it around and blaming the customer.
It is not surprising that the only doctors I have seen where appointments are efficient tend to be the ones who either are not part of a network but will fill out the insurance forms, or those who don’t bother with insurance and leave it up to the client, because in the first case they aren’t beholden to the insurance company in network payments and can pick up the difference from the patient and in the second case the patient is doing all the work with insurance, and those kind of places do compete on customer service, get treated rudely at a place you are paying extra for to go to and you likely would say I might as well go in network…and for cash businesses, like plastic surgery, they are competing for clients and how they treat people is part of the picture.
I didn’t find it any better at an urgent care clinic, I recently had a bad case of poison ivy that was getting worse, went to an urgent care center at like 7:30 at night here in NYC, there was no one in the place, and I waited an hour, and I didn’t see too many people leaving during that hour.
The ERs are one of the toughest places. I have been told if you want priority, it’s best to arrive by ambulance and have chest pain or breathing problems. Folks without insurance tend to use it as their urgent care or their check up place to get “a tune up” and/or Rx refills. The crowds there rarely seem to move much.
My dad caught the ambulance three blocks a few years ago, so he could have priority at the ER when he was in his 80s with chest pain. He wanted to walk but his internist insisted he use the ambulance.
My doctors office doesn’t replace patient concerns with insurance concerns. It’s a large-ish practice, established enough that they can take this position. It’s part of a larger umbrella group, to streamline purchasing, billing, digital improvements, communications, etc. But very patient oriented.
It’s true that insurance, in some areas, can dictate. It’s true some doc have large med school loans to pay off. Or just want to be wealthy.
About the double ER charge. There’s a poster (not on this thread) who, in past discussions, has advocated almost haunting the billing folks. Get them to account for the double visit (which was their problem) and reduce your charges.
The other way to get ER attention is to have your doc call ahead. My primary practice will and even when I had kidney stones, the on-call at the uro did this for me.
I have been very impressed with my one visit to urgent care. I was in agony and it turned out I had a broken fibula. They had a wheelchair that D borrowed to get me from car to the clinic. The MD was excellent–she was a younger internist and liked the autonomy. She took and read my X-ray and had it re-read by a radiologist. She gave me the option of a short soft boot or plaster cast–I chose the removable boot and crutches.
The next day, I went to an ortho urgent care and they said the ankle boot was too short to support the fibula and gave me a taller one that ended just below the knee. They never charged me for it, as I was already having to pay for the wrong shorter one I got at urgent care. They referred me to an orthopedic surgeon, at my request for follow up.
Wait times were reasonable for all of these visits as well as for the ortho.
The worst for waiting is when you are freezing in a paper gown and not given any idea how long the delay or why. After it happened once to me at GYN, I told them to let me know 5 minutes before the GYN was ready and if put on the paper gown then. They apologized and obliged.
I hate to say this because life will bite me in the butt, but I don’t think I have ever been to an ER nor had to take my kids there. The one exception was a time when premie D decided not to breathe, but H took her and I stayed with her twin.
Paper gown made me think of something. H doesn’t use paper gowns for patients. They have soft cloths - you drape one over the top and one over the bottom and thus during the exam he uncovers only the part he is examining. Patients seem to love this.
Typically, ERs have a triage nurse who prioritizes patients based on the urgency. Chest pains and head trauma and suspected appendicitis get urgent attention for very apparent reasons. Sprains, fevers, etc. that can wait get to wait. Even if the doc calls ahead, ER will still triage you. More urgent patients will be brought in ahead of you.
We live almost equal distance from 2 large hospitals. If we have a health emergency, I go to the hospital in the wealthier part of the area, not because I assume that they have better standard of care, but because I know the wait there would be much shorter - for the reason mentioned by HIMom.
I have been through a lot of exam rooms lately, and in every single one I was offered a warm blanket to keep me from freezing! I almost fell asleep in the MRI magnet. Lol.
My primary also has a great collection of magazines. Most of the rest of the practices, labs or test centers focus on men’s sports, those generic health mags you find everywhere, and I hate the tv blaring. Or the health info videos that run so short you’re hearing the same thing over and over.
Proper draping is part of med school training today, did you know? Like washing hands and introducing yourself.
Most of the MD offices I’ve been to lately have stopped offering cloth and several ANY gowns and just pull up your shirt or offer you paper gowns. I figure it must be the cost and time of laundering them. It seems more awkward, but whatever works. I just can’t stand prolonged waits in AC wearing paper “clothing.” I won’t tolerate them any more.