Medical appointment peeve

[John K Jordan]

[RANT ON] WHY, oh why, do medical organizations make appointments for me to come at a certain time, knowing this is not the whole story? I agree to the appointment, put it on my calendar and make arrangements for a driver if necessary, etc.

THEN a few days before the appointment I get texts or emails telling me to come earlier than agreed, typically 30 minutes, or as one that came today, 45 minutes early to "complete paperwork".

If you want me to come at 7:15am please make the appointment for 7:15, not 8am. Is that too much to ask? I will certainly be there at whatever time we have agreed on. I may not be able to come at a much earlier time. (I have llamas and horses and peacocks to feed and hatching birds to care for.)

Has this happened to anyone else or just to me? Am I the only one wishing this would change? Maybe I'm just getting grumpier in my elderly years, unsurprisingly coincident with increasing number of medical appointments. [RANT OFF]

I think I understand why they do that - to them the appointment is the time the procedure or doctor's visit is scheduled in their facility. To me, the appointment is the time I am to be there. (I always try to come a little early anyway in case of traffic delays, etc)

JKJ

PS: I should temper this rant by saying that I am SO grateful we have access to good doctors and specialists and increasingly effective medical technology AND the`means to take advantage of it. Many (most?) the world's people don't - either it doesn't exist where they live or they can't afford it. Insurance, what's that?

[glenn bradley]

Symptomatic of the outsourcing and diversity of responsibilities. Some do it well. Most do it terribly.

[Jim Tobias]

John,
I hear you about the frequency of appointments as we age! I try to make myself keep saying........"glad I'm here to go"!
My medical facility here (same one for 35 years - Wake Forest (now Atrium) Medical, has a website that allows me to go online and fill out all paperwork before I go to appointment. I have started using that on every visit and it makes the "in and out" part of the visit much easier, especially timewise.

Jim

[Bruce Page]

It happens to me too. Worse, I arrive on time and shortly afterwards a nice nurse leads me to the small Dr’s room and takes my vitals. Then I sit and wait 30-45 minutes for the doctor to show up..:mad:

[Jim Koepke]

My health care provider is very good about this. At the time an appointment is being made they always say to please show up ~15-20 minutes early for check in and any paperwork. Most blood draws and such are done on a walk in basis and there is hardly any waiting.

Sometimes they do get backed up and the wait to see the doctor can become extended. Usually this is a few earlier appointments delaying the process.

Since my first job I have always tried to show up for appointments early. Much better early than late.

jtk

[Jerome Stanek]

I guess I am bad about keeping the Dr in with me. I went 2 weeks ago and caught up on some stuff asked if he was still farming asked about his twins and oldest daughter that I worked with.

[Larry Frank]

There are some doctors who are very good about time and waiting is minimal and others are awful. I have some very good doctors who are typically on time.

Thank goodness for my phone as I read books with Kindle app, listen to a book, play a game or a lot of other things. This really helps with long wait times.

I do try to do all my paper work online. I hate filling out redundant paper work and refuse to do so.

[Aaron Rosenthal]

OK, I live in an area that does not have the same issues as you. Sometimes the Dr. (a personal friend) is 10 minutes late. No paperwork to complete; specialists, excepting for 1st visits, little paperwork.
My ophthalmologist (also a personal friend) read me the riot act when I was talking to a fellow patient in the waiting room about doctors keeping you waiting. Told off in no uncertain words that his office runs dead on time and NOBODY waits.
Still, I've had visits with some where I was waiting 30 or so minutes. I sent a doctor an invoice for my time, because at the time I was running a $3 million remodel. Naturally, I never got paid.

[Myk Rian]

I had an appointment at UM Ann Arbor a few weeks ago. They told me to be there a couple hours earlier. Turned out I was in and out, and on my way home before the appointment was scheduled for.

[Bruce Wrenn]

In our age group, it's important to CARRY a current list of meds. Recently, I've had two different doctors ask about a med which I quit taking back in January, as it causes and still does some major problems for me. I have seen both doctors since then. One of them is the one who took me off med. Actually, I took myself off med and then told them. It was a statin drug (Crestor,) which caused joint pain and muscle weakness. Even though I've been off this med for eight months, the lingering effects are most likely permanent. My knees hurt worse now than before I had bi-lateral knee replacement in 2013. Due to taking blood thinner, I can't take Ibuprofen. Acetaminophen does nothing for the pain or swelling.

[Doug Garson]

For those who complain about having to wait for a doctor's appointment, what do you suggest is the solution? Would you like your doctor to set a timer when your appointment starts and push you out the door when the bell rings? My doctor doesn't rush me, he takes the time to answer all my questions and explain things with a little time for casual chat to make that important human connection, I'm sure everyone after me waits a few minutes longer because of the chat with me as I have waited longer for his chats with earlier patients. He could schedule longer times per appointment but that would just mean fewer appointments per day and longer waits for an appointment. I doubt he leaves on time from the office very often. Again what solution would you propose?

[Sam Force]

I value my time as much as anyone, waited numerous times in Dr offices. 1 particular day a teenager had a serious infection on his foot, the podiatrist office I was in was within a group of podiatrists. As they worked to save the young man's foot the waiting room was filling up with scheduled appointments, this was before HIPPA laws and they kept everyone informed of the extended delays. I finally got in for my appointment about 3 hours late. Was a little irritated but if it was my son I would have been thankful for the doctors care. You never know what any particular patient's concerns are but hopefully the Doctor covers everyone's concerns.

[Larry Frank]

What is my solution for waiting too long in a doctor's office. There are certain doctors who are always late and others who are mostly on time. If a doctor is always late he needs to look at his scheduling and office management. Maybe he needs to schedule slightly longer appointment times. There are some people who are late for everything and think nothing of making people wait for them. I have no patience for such people.

If a doctor has an emergency causing a long wait time, I understand. But those who are always late, they need to figure out how to do better.

[Stan Calow]

My doctor, like most of them in the area, works for a large corporate medical company. Most of the private practices have been bought out a long time ago. I was told by some staff that the corporation expects the doctor to spend no more than 15 minutes per patient visit actually with the patient. If they exceed that, they have to account for it to a supervisor. So if there is a patient that needs more time, then the next patient gets delayed. I dont know how any doctor can keep to a schedule under those conditions, without pissing someone off. My appointments are always rushed if they are routine.

[Jim Becker]

For those who complain about having to wait for a doctor's appointment, what do you suggest is the solution?

I don't think that the wait is the issue that John is bringing up. There should always be a certain expectation that a doctor/PA/NPA/Nurse is going to be somewhat flexible with time when they are with a patient when they are a patient focused resource. I actually expect that from them when I'm the patient. But I absolutely would be annoyed with what John describes if the expected time of arrival keeps changing because of "paperwork" or whatever. Tell me the time of my appointment and what time I need to physically be there up front and keep the "arrive early" expectation reasonable, too. Nobody's "paperwork" should take a long time and if there are more involved questionnaires, etc., required for the situation, provide them in advance...we live in a connected world.

[Bernie Kopfer]

My doctor, like most of them in the area, works for a large corporate medical company. Most of the private practices have been bought out a long time ago. I was told by some staff that the corporation expects the doctor to spend no more than 15 minutes per patient visit actually with the patient. If they exceed that, they have to account for it to a supervisor. So if there is a patient that needs more time, then the next patient gets delayed. I dont know how any doctor can keep to a schedule under those conditions, without pissing someone off. My appointments are always rushed if they are routine.

You hit the nail on the head! Physicians are not their own bosses anymore. They (particularly if they practice in a large system) are employees governed by whoever runs/owns the system.

[Alan Lightstone]

So happy to be retired from medicine. Times in the OR are "relative". Surgeons give fake shorter times for surgeries when they book them, so that they can schedule more cases in a day. OR staff knows this, and even have computer readouts of their actual times, but they don't dare confront the surgeons with this, as they don't want to lose the business. Ah, medicine in the 2020s.

I always felt bad for receptionists in surgeons offices. They are usually late for their appointments, and often have to cancel large numbers of appointments with the patients waiting for them in their waiting rooms. Must not be a fun job.

And, yeah, I get the e-mails asking me to be 15 minutes early, but giving me the web address for the portal to fill out all the forms. Which, I can assure you, with my background are completed fully and accurately. So that 15 minutes involves me saying hi to the receptionist and saying, no, my insurance hasn't changed.

[Doug Garson]

I don't think that the wait is the issue that John is bringing up. There should always be a certain expectation that a doctor/PA/NPA/Nurse is going to be somewhat flexible with time when they are with a patient when they are a patient focused resource. I actually expect that from them when I'm the patient. But I absolutely would be annoyed with what John describes if the expected time of arrival keeps changing because of "paperwork" or whatever. Tell me the time of my appointment and what time I need to physically be there up front and keep the "arrive early" expectation reasonable, too. Nobody's "paperwork" should take a long time and if there are more involved questionnaires, etc., required for the situation, provide them in advance...we live in a connected world.
Good point, I haven't had that experience of changing appointment times to do paperwork. I have had the annoying experience of filling out forms online before the appointment only to be given a different form to fill out while I'm waiting asking many of the same questions.

[Mike Henderson]

When I make an appointment with a new physician, I ask them to send me the paperwork by email so I can fill it out before I go there. Many of the docs here have the "paperwork" on a web site and you fill it out there. This is a big advantage to them, now that they have to do electronic records. Your electronic submission goes right into your record. If you do it by paper, someone has to enter all that data (which usually is not done).

If I go to a doctor for a non crtitical appointment (where if I don't see the doctor, I'll won't die), if I'm kept waiting too long, I go to the desk and tell them I can't wait any longer and I need to reschedule the appointment. Most of the time, that gets me in right away. If that keeps happening, I go to a different doctor.

I don't accept the excuse that the doctor has to spend more time with a patient. That just pushes everyone else back, or the doctor has to "short" some of the later patients, which is unfair to all the patients later in the day. The doctor needs to schedule that patient for a follow-up appointment rather than punishing everyone else on the schedule.

If it's a real emergency, I understand. But doctors often overschedule because they expect a few people will call and cancel. And most doctors hate to have a dead time in their day - they don't make any money if they don't see anyone. They would rather inconvenience you than lose the money for a time slot.

Mike

[John K Jordan]

I don’t mind waiting at all. I know my dr takes as much time with me as I need. If i’m waiting a long time I simply assume he is doing the same for other patients. He’s a fantastic doctor.

Now once I had to wait almost 3 hrs at another doctor's. I used some of the time to calculate the square root of 15 in my head, to 10 significant figures. That was decades ago and I still can’t forget it; it’s taking up space, wasting valuable memory cells. 3.872983346

Another time I waited for hours to get a cast cut off my young son’s arm. This was about 35 years ago when he was small. I finally took him up to the receptionist and told them we’d been waiting there WAY too long, just forget it, I was taking him home now and I would cut off the cast myself. They had the cast off and we were on our way in less than two minutes.

[Alan Rutherford]

I have an appointment at 8 tomorrow morning for dental surgery. They want me there at 7:30. No excuse about paperwork or anything. They just want my body inside their door at 7:30.

[Steve Demuth]

Speaking as the former CTO for a hospital / clinic that saw over 1M patients per year, and who spent a LOT of time trying to measure and improve the patient experience, and simultaneously as the spouse of a person with medical conditions that require medical appointments in aggregate more frequently than once a month - I feel your pain from both sides of the equation.

First, most clinics are primarily scheduling the doctor's time, and using that to inform the patient of the appointment. That is, the primary record, and purpose, of their record of te appointment is as you say, to note when the patient is expected to see the doctor. Their Electronic Heath Records system are wired that way as well, by design. Any clinic that thinks about and tries to optimized patient experience, though, will make an effort at the time of scheduling, and in all subsequent notifications to be clear when they expect you to arrive and begin interaction with the clinic overall.

Patients, however, don't make this easy. If we told patients their "appointment" was at 9:00AM, when in fact we didn't expect the doctor to see them until 9:30, but needed them their early for registration, paperwork and rooming, we were dinged for the doctor being late. If we told them their appointment was at 9:30, but we needed them at registration by 9:00, we heard complaints such as yours. And, often, we'd have to change things a bit in the notifications. If the doctor decided that a pre-visit test was needed, after the initial scheduling, we'd have to notify the patient, as in your case, that we needed to see them even earlier.

I know, of course, that the patient experience team mostly saw the complaints, and heard very little from anyone who was happy with how scheduling went. Still, it was frustrating trying to align to a system that reduced disappointment. We found it particularly hard, because the actual variance in timing, and need for "padding" varied widely from primary care to routine followup in speciality care, to a wide variance between specialties in first-line specialty care.

From the patient's point of view - my (obviously informed) expectation is that I be told at the time of scheduling when I am expected to arrive, AND when I should expect the actual doctor appointment to commence, and that this set of facts be clear in any followup notifications. For primary and routine secondary care, any good scheduler should know these things, and the system should accomodate and communicate them. But I know from experience that many EHR system do not make this easy, stuck as they are on scheduling doctors, not patients. We spent millions refactoring the out of the box scheduling system from our EHR to accomodate our sprawling practice and create a focus on patient experience and scheduling. We may have been better at it than any comparably sized institution. 10-15% of our patients were still unhappy. C'est la vie.

[Alan Rutherford]

I have an appointment at 8 tomorrow morning for dental surgery. They want me there at 7:30. No excuse about paperwork or anything. They just want my body inside their door at 7:30.

Arrived at 7:26. Spent about 2-3 minutes at the desk and 2-3 minutes in the waiting room. Dental assistant did the preliminaries and anesthetist stuck something in my arm and I don't remember anything until about 10. So I can't really say when my "appointment" was but if I was kept waiting too long, I slept through it.

[Ron Citerone]

I think a good secretary/scheduler could eliminate a lot of the confusion and upset patients.

[Bill George]

Ok paper work, I am a computer person. Years ago perhaps 25 I typed up in Word my current and its updated as needed, medical history and on another sheet my RX's. Now I print out those and also have a DOC file on my smartphone that I can send in a email attachment. When asked to fill out this and that I hand them the print outs and ask if they need electronic files I can send if needed. End of discussion, but we need you to fill out OUR paper work.... honey its right there, just scan it in!

[Alan Rutherford]

I'm a computer person too and that wouldn't fly around here. It would be nice, but it wouldn't work. The RX, sometimes, not the rest.

[Doug Garson]

I think a good secretary/scheduler could eliminate a lot of the confusion and upset patients.
I doubt it, if the first appointment is scheduled for 10 min and takes 25, the whole day's schedule is off until/unless several appointments take less than the allotted time to get back on track. Not sure what the best secretary/scheduler can do about that other than advise patients as they arrive how far behind the doctor is. Up here there are many more patients than doctors so doctor's time is more critical so overestimating appointment length would lead to idle doctors and patients waiting an extra day or more to get an appointment. The real solution is more doctors.

[Doug Garson]

Ok paper work, I am a computer person. Years ago perhaps 25 I typed up in Word my current and its updated as needed, medical history and on another sheet my RX's. Now I print out those and also have a DOC file on my smartphone that I can send in a email attachment. When asked to fill out this and that I hand them the print outs and ask if they need electronic files I can send if needed. End of discussion, but we need you to fill out OUR paper work.... honey its right there, just scan it in!
Agree with Alan, imagine the extra time required to review patients history and potential errors if every patient had their medical history in a different format.

[Alan Lightstone]

I do the same thing with the same result. I have to type everything in again.

[Bill George]

I do the same thing with the same result. I have to type everything in again.

Never ever had an issue, I just say here it is and just scan it in. Handwritten Why? They never have an answer. BTW it all has to be entered into the system anyway, what magic is there in handwritten on their form? Zero and there is zero interest by the doctor he never looks at it, just looks at you and asks what's wrong?

Oh my medical history is in chorological order, what could be an issue?

[Brian Elfert]

In our age group, it's important to CARRY a current list of meds. Recently, I've had two different doctors ask about a med which I quit taking back in January, as it causes and still does some major problems for me. I have seen both doctors since then. One of them is the one who took me off med. Actually, I took myself off med and then told them. It was a statin drug (Crestor,) which caused joint pain and muscle weakness. Even though I've been off this med for eight months, the lingering effects are most likely permanent. My knees hurt worse now than before I had bi-lateral knee replacement in 2013. Due to taking blood thinner, I can't take Ibuprofen. Acetaminophen does nothing for the pain or swelling.

Interesting. I just completed a six month clinical trial for over the counter Crestor at half the prescription dose. I have had some additional pain in my knees that I attributed to hitting age 50 and weight gain. I was also having muscle pain in my right arm. They specifically asked at the end of the trial if I was having severe muscle pain. I talked to them about it and decided it was not severe. My muscle pain seems to be better after two weeks off the drug.

My cholesterol did drop significantly during the six months I was on the drug.

[Brian Elfert]

My sleep doctor almost always spends more time per patient than is allocated. He was already 20 minutes behind by 8:20 in the morning for my last appointment. His next appointment was supposed to have started at 8 am! Mine was like 7:40 am or something.

[Roger Feeley]

My horror story involved a urologist. I had an appt at 1:30. His receptionist/wife (a horrible person) told me to start calling every half hour starting at 2:30. At 3:30, she told me to come in. I sat and sat. As time went by, anger and frustration gave way to curiosity. How long would this go on? As much as two hours would go by without anyone being summoned from the waiting room. I was seen at 9:30pm.

I got to know other patients. One guy used the time to study Masonic stuff and had advanced in the organization because of time spent in the waiting room. Another had his wife drop him off. Then she would go to a movie. After the movie she would call him. If he hadn’t been seen she would go to another movie.

Time spent in that waiting room was sort of a slow torture. The chairs were these old maple captains chairs with no padding. Just imagine all these men, most (like me) with enlarged or inflamed prostates squirming to try to get comfortable.

So I told my regular doctor about the problem and he was aghast. He referred me to another doctor. The first indication that this guy would be better was the soft upholstered chairs. The second was their apology that I had to wait all of 15 minutes.

[Ken Combs]

I always felt bad for receptionists in surgeons offices. They are usually late for their appointments, and often have to cancel large numbers of appointments with the patients waiting for them in their

And, yeah, I get the e-mails asking me to be 15 minutes early, but giving me the web address for the portal to fill out all the forms. Which, I can assure you, with my background are completed fully and accurately. So that 15 minutes involves me saying hi to the receptionist and saying, no, my insurance hasn't changed.

My Dr.s medical group now offers the web checkin too. It's part of an app named MyChart which seems to be in use by several. I really like it, checkin, messaging, prescription requests, access to lab results, visit recap, Doc notes etc. I can see labs before getting word from the physician or assistant.

[Clifford McGuire]

Speaking as the former CTO for a hospital / clinic that saw over 1M patients per year, and who spent a LOT of time trying to measure and improve the patient experience, and simultaneously as the spouse of a person with medical conditions that require medical appointments in aggregate more frequently than once a month - I feel your pain from both sides of the equation.
<Snip>



Thanks for that explination Steve. We don't see that side of the issue.

It's never simple, is it????

[Dave Lehnert]

I hate when the doctors office gives me an appointment, A time they picked, not me. call a few days before saying they need to reschedule. Im sure its not because it is a Friday afternoon before a holiday weekend.:rolleyes: Last time it happened I had to wait another 4 months for a new appointment.

Another one I get a lot is if my appointment is in the late afternoon (I make them for after work) They will most always call on that day and ask if i will come in sooner. I always respond. "No, I dont want to inconvenience my customers because I want to leave early" :D

[Keith Pitman]

It’s not just medical appointments, this was part of the appointment email I received for windshield repair:









https://image.t.safelite.com/lib/fe90137277610d7977/m/1/Clock_icon86x85.png












Please arrive at least 10 minutes before your appointment to check-in.

[Doug Garson]

It’s not just medical appointments, this was part of the appointment email I received for windshield repair:









https://image.t.safelite.com/lib/fe90137277610d7977/m/1/Clock_icon86x85.png












Please arrive at least 10 minutes before your appointment to check-in.










What time was the appointment? The clock only has 8 segments and no indication of AM or PM.

[David Powell]

I don’t mind waiting at all. I know my dr takes as much time with me as I need. If i’m waiting a long time I simply assume he is doing the same for other patients. He’s a fantastic doctor.

Now once I had to wait almost 3 hrs at another doctor's. I used some of the time to calculate the square root of 15 in my head, to 10 significant figures. That was decades ago and I still can’t forget it; it’s taking up space, wasting valuable memory cells. 3.872983346

Another time I waited for hours to get a cast cut off my young son’s arm. This was about 35 years ago when he was small. I finally took him up to the receptionist and told them we’d been waiting there WAY too long, just forget it, I was taking him home now and I would cut off the cast myself. They had the cast off and we were on our way in less than two minutes.

Thanks John. I now can't get the method for calculating square roots out of my head.

Dave