unclemick
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
I think it may? have happened once or twice with a dentist since 1966 but not with any of the doctors that I remember.
heh heh heh -
heh heh heh -
It was a helpful post, thanks. As I noted at the outset, I can well understand being late on an exception basis, but not chronically late, especially for the first appt as in my case. Guess my doctors haven't heard of LEAN, interesting since we implemented ISO, Six Sigma, LEAN and 5S in manufacturing beginning in the mid 90's.
The volume of paper still in the medical profession is amusing too. Some (not all) of the old timers seem to be resisting technology with gusto. One of my friends is an accomplished 64 yo orthopedic surgeon, totally illiterate technology wise, email is a challenge to him...he just mastered texting recently, thinks it's pretty cool! But maybe he's not representative.
I am an ex-doctor myself, although I didn't have a clinic. But I did participate in projects to improve patient flow. Here are some of the reasons that doctors are notoriously late:
Somewhat tongue in cheek? At least where I am, many doctors seem to have consolidated practices and joined much larger health networks. And I thought that was happening nationwide. I would think these large/huge organizations would "know" what they don't know - and I know some have indeed implemented LEAN and other productivity tools. I thought the independent, small business practices were rapidly disappearing?Thanks Midpack. To put It in perspective, I'll bet that manufacturers wouldn't necessarily know enough about healthcare to be able to diagnose and treat the illnesses of their employees. They would delegate that responsibility by providing health insurance benefits......unless they were small businesses, in which case they might not have the resources to do that. Well, most physicians in private practice are running small businesses. And they often don't know what they don't know.
Midpack - your comment about larger organizations learning efficiency might have some merit. I've been a client of Kaiser Permanente for most of my life - and rarely have to wait for an appointment. The walk in nurses clinic is a whole different story - I had to wait 3 hours to get my tb test read earlier this year. KP seems to have put in scheduling processes that result in mostly on time (within 15 minutes) appointments. My dentist is a sole proprietor office - but he and his staff seem to have things down pretty well... the dentist moves between rooms, while the staff does all of the prep/cleanup/cleanings...
On an aside -- aren't you a retired doctor, not an ex-doctor? I mean I don't think I would ever see myself as an ex-lawyer... Even if I let my license go inactive I don't think I would see myself as an ex-lawyer.
Yes, and especially so when the providers are the primary partners. That does not mean they need to overbook or make people wait. I recall a weekly column by a physician in the WSJ, he discussed this topic a couple of times and shared his own experience. When his office reduced the number of scheduled appointments and programmed "open slots", wait times fell dramatically, satisfaction immediately improved, and the number of patients seen per day increased slightly.For profit organizations have a powerful incentive to be efficient.
Yes, and especially so when the providers are the primary partners. That does not mean they need to overbook or make people wait. I recall a weekly column by a physician in the WSJ, he discussed this topic a couple of times and shared his own experience. When his office reduced the number of scheduled appointments and programmed "open slots", wait times fell dramatically, satisfaction immediately improved, and the number of patients seen per day increased slightly. Contrast that to my mother's ophthalmologist. It is a family owned business, perhaps 40 physicians operating in 4 or 5 locations. The typical wait in the front waiting area is close to an hour, another 30 minutes in the back. Average total appointment time can easily hit 2 hours. My father used to call it "the factory". The last couple of times I went with her I sat back and studied the flow of patients and it occurred to me that they don't book individual appointment slots. Instead, they book groups of patients all for the same time, say 25 people at 1:00, another 25 at 2:00, etc, all for 4 or 5 physicians, and then just see them in the order they arrive. They are totally unconcerned with patient wait time. And the waiting room is always crowded.
What I've learned is we're bad at picking doctors (and dentists to a lesser extent). Some overbook/plan-manage time poorly (deliberately or not) while others are much better at it (being seen early, unheard of for us even though we show up early). There have been times that I came within an inch of leaving, but I thought if I reschedule odds are I will have to wait all over again. Again, I understand waiting sometimes, just not every time - especially on first appt of the day!
The average ophthalmologist sees 3.2 patients per hour or about 1 every 18 minutes according to the data. They are a high volume specialty. It's easy for me to see how they could fall a few hours behind seeing that many patients per day, especially if there are 5 doctors. The good news is that the per visit cost, by average, is only 118 dollars with insurance picking up most of the bill. Of course, many will pay a lot more per visit to cover those that pay little or none in order to get to the average of 118.
As a test of everyone's sincerity regarding docs
keeping to schedule.........
If you're with doc, in an appointment booked for the normally scheduled amount of time, and he/she finds an "issue," are you OK with the appointment cutting off promptly on schedule with instructions to book a follow-up to see what's going on? Or do you feel doc should blow off his/her schedule, spend an additional 15 mins with you?
If your doc could pretty much eliminate schedule slippage by seeing 10% fewer patients and allowing some "padding," would you be OK with your personal cost for the visit going up to compensate?
He's one of several, it's not just one. It's been pretty universal for DW and I...Is this the same doctor who dropped you for not seeing him/her for six years (when you were getting company physicals) http://www.early-retirement.org/forums/f38/doctor-gp-dropped-me-without-warning-63938.html ?