this post was submitted on 11 Jul 2024
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[–] [email protected] 180 points 8 months ago (4 children)

My psych often has people wait for their appointments. I'll be scheduled for 800, there at 740, get seen at 840.

And you know what? That's perfectly fine. I feel taken seriously, he listens, he asks, he quips, he shares his own experiences, he does all he can to make me comfortable telling him about the shit going on in my head. I'll work up the courage to tell him something I find hard to phrase and unpleasant to talk about and he takes it with a relaxed professionalism, waiting patiently for me to finish, asks questions (usually very precise ones, both unpleasant in how close to home they hit and reassuring in the implications that I'm not the only one with these issues) and looks for the best way to help me.

So when I sit in that waiting room, watching the minutes tick by, I imagine he's taking the same time with a different, far more difficult patient. Perhaps someone got slotted in for an emergency, perhaps someone needs blood drawn for a routine check and really, really hates needles, perhaps someone is having a breakdown... I don't know and I don't care what ails the other patients, but I know that I want them to receive the same quality of care as I do. To me, that's worth waiting for.

[–] [email protected] 110 points 8 months ago (2 children)

There's a movement inside of Healthcare to get the average Dr's office humming like a dentist. Which, if you're concerned with patient care at all, is impossible. You'll see it with posters saying only one issue per visit, which also greatly imperils the patient as sometimes a diagnosis will change based off one symptom. You've got a good attitude about this. Please share it

[–] [email protected] 59 points 8 months ago (2 children)

This is the product of clinics being owned by corporations chasing a specific return, and not being owned by a local group of physicians who actually want to care for people.

Shop local applies.

[–] [email protected] 21 points 8 months ago (2 children)

We get the same issue in Ontario with family health teams. The structure of the corporation matters, but so does the funding model

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[–] [email protected] 23 points 8 months ago

As far as I can tell, my psych is doing well enough to not worry about his living, not particularly keen on getting rich, deals with some super heavy things and curses at the stupid computer system he's required to use, so he's probably chronically low on fucks to give for seeing the maximum amount of patients per day.

But yeah, when you see him walk out of one room with a heavier-than-usual frown on his face, taking a deep breath to compose himself before walking into the next one, you start to wonder how many times he's had to put on a stoic face before seeing you. And then he sits down, asks how you're doing, whether you've done that thing you mentioned wanting to do last time and gives you full attention.

I have nothing but respect for that man. I've moved a good bit away from him now, but I'd still rather take the long trip to see him for my regular appointments than search for a new one.

[–] [email protected] 26 points 8 months ago (3 children)

If the appointments last longer....maybe he should schedule them properly

[–] [email protected] 19 points 8 months ago

You got downvotes for it but nah, it's on the Dr if this is a regular occurrence. Once or twice or going over a min or two is fine, but regularly being 45 minutes late (hello my last Dr) is a sign you've lied to everyone scheduling an appointment about how long they are and when to even be there for one

[–] [email protected] 17 points 8 months ago

It's hard to predict just how long an appointment will take. Some have been done in five minutes, just a brief check-in and new prescription, and scheduling half an hour for that would mean twiddling his thumbs for twenty minutes he could have spent helping someone that arrived rather punctual for their appointment. I think scheduling for the average appointment but allowing overtime for those who need it is the more patient-friendly approach.

[–] [email protected] 10 points 8 months ago

Exactly, but if you the patient are late or a no show, then here's a $50 fee for you.

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[–] [email protected] 126 points 8 months ago (1 children)
[–] [email protected] 48 points 8 months ago

This comic is based on a true story. I'm certain, as father of a two year old.

[–] [email protected] 93 points 8 months ago (5 children)

I usually don't get all that pissy about doctors running late. However, there was one time I was really irritated.

I took my wife to the doctor for an appointment. She got the first appointment of the day. We were there 45 minutes early. We waited more than 30 minutes past when the appointment was supposed to start. While we were waiting there, the doctor came in through the waiting room.

It's one thing to be running late because of the normal day to day delays that happen in a medical practice, but if you're actually just running late getting to work, you should call and have your staff let the patients know.

[–] [email protected] 43 points 8 months ago (1 children)

I had an appointment booked at my GO. Get there 10 mins early. Everything’s normal, one other person in the waiting room.

Other person gets called in. Still normal.

Receptionist walks through the waiting room, locks the front door, then shuts the shutter to the reception desk. “Uh what”

20mins pass, haven’t seen another soul. Not tooo unusual to wait 20mins.

40mins, sunk cost fallacy sets in. Can’t leave anyway as the front door is locked.

50 mins later, receptionist comes in “the doctor will see you now, sorry for the wait we had our weekly staff meeting”

You fucking what. You booked me in at the time you have your fucking weekly staff meeting?!

[–] [email protected] 18 points 8 months ago

Holy shit that's bad!

[–] [email protected] 14 points 8 months ago (4 children)

My first day at my duty station I was 10 min early to work and a staff sergeant told me if I wasn't 15 min early I'm already 5 min late...good words to live by

[–] [email protected] 41 points 8 months ago (1 children)

You gonna pay me for those 15 minutes?

[–] [email protected] 7 points 8 months ago (1 children)

Exactly. My meetings I time to the T to be there exactly on time. I don't want to sit around and waste my time small talking with people before the meeting.

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[–] [email protected] 31 points 8 months ago (3 children)

In what world should anyone be criticized for not being early enough? I agree if you’re not early, you’re late.

But for fucks sake, five minutes, ten minutes, fifteen minutes, whatever… dude sounds like an asshole.

[–] [email protected] 9 points 8 months ago

The military. It's ingrained in you from like day one that if you're not 15 minutes early to everything, you're late. It's also why you'll hear folks from the military talking about standing in formation waiting for 3 hours before the Colonel/Captain even shows up. By the time the order gets from the Colonel to the Private, everyone in between has padded the arrival time by an extra 15 minutes.

You don't clock in and out in the military, so sure, fine. And for job interviews, it looks good to employers. But beyond that, I'm in the "if you want me here early, you need to pay me for that time" club.

[–] [email protected] 9 points 8 months ago

It's a common saying and it's usually meant as something you should hold yourself to, rather than others.

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[–] [email protected] 12 points 8 months ago (1 children)

I'm willing to bet this is more common than we all think, probably a self fulfilling prophecy.

Some doctors may get complacent thinking, oh I'll be late by the end of the day anyway.

At least, this has happened to me on a handful of occasions too.

But really, the problem is that the practices are booking too many appointments.

[–] [email protected] 13 points 8 months ago (2 children)

Yeah. My wife was an eye doctor in private practice, and she was positively militant about never getting behind schedule.

She very rarely ran behind. It would require a cascade of emergencies.

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[–] [email protected] 46 points 8 months ago (2 children)

Unless that doctor is performing emergency surgery there really is no reason they need to keep people waiting that long. it's so disrespectful, doesn't matter they are a doctor.

[–] [email protected] 108 points 8 months ago (8 children)

It’s awesome being a doctor because you get to try your best to help people all day, get held up by patients talking about 6 different issues they didn’t even book their appointment for, held up by admin demanding you finish your notes between patients, held up by arguing on the phone with insurance that won’t authorize clearly necessary treatments, held up by nursing staff (understandably) needing your input on things between patients, and then read people bitching online like you were just spending that time drinking coffee and flirting with the nurses when you have a caffeineh eadache because you haven’t even had enough time to stop and drink coffee at all AND admin is bitching at you because you aren’t seeing enough patients every day.

[–] [email protected] 37 points 8 months ago (1 children)

I don’t think people mean it’s the doctors fault or that they’re sitting around doing Jack. The frustration is that doctors time is so packed full that they don’t have time for all those things, which is an administration problem.

Clinic/hospital admins want to pack the doctors schedule full of 15min increment appointments, where they’re expected to see the patient, diagnose/treat, and complete notes/charts within an incredibly short amount of time.

Worst part is that most of the time this is not done because the clinic is having trouble making money, but because they want MORE profit from every person walking into their doors.

[–] [email protected] 13 points 8 months ago* (last edited 8 months ago)

It's the culmination of decades of cost cutting measures in the medical field as small practices get eaten up by large companies.

I used to get mad at the doctors who worked for those big companies, now you are lucky if you can avoid them.

[–] [email protected] 29 points 8 months ago* (last edited 8 months ago) (2 children)

A doctor tha expects those things to happen should schedule based on that knowledge.

If the admin has unrealistic expectations, then those expectations need to be addressed.

[–] [email protected] 29 points 8 months ago* (last edited 8 months ago) (7 children)

Unfortunately the doctors usually aren't the ones managing the schedule. The admin / secretaries are.
And good ones, that understand that a new patient with no file, that doesn't speak the language, that has a history of complications with her previous pregnancies, etc is not gonna be a normal half hour consultation are extremely rare.
Even kind ones that see that you are swamped day in day out just seem to assume that these are teething difficulties, adapting to the position, etc (even after almost two years).

And so that's how my wife ends up doing a ten hour workday. Nonstop. With no break for lunch because hey, too bad, she finished the morning shift two hours late and now her first afternoon appointment has been waiting for half an hour...

But of course if you tell patients there is no time for them because the few doctors that are here are already overworked...

(to be clear, I've been saying the same thing as you to my wife for two years now. But apparently the message is not getting across)

[–] [email protected] 13 points 8 months ago (1 children)

And you haven't even gotten to the medical billing phase that's been strangling American healthcare systems for decades!

[–] [email protected] 11 points 8 months ago (4 children)

Thankfully we are in France and everybody is fighting tooth and nails to not become that. So far so good.

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[–] [email protected] 10 points 8 months ago (1 children)

Doctors don’t do the scheduling. The idea of telling admin to change their expectations is laughable.

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[–] [email protected] 13 points 8 months ago* (last edited 8 months ago)

Then book fewer patients per day (assuming it's your own practice). It's one thing to have a bad day where you fall behind. It's another thing when you fall an hour behind every day.

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[–] [email protected] 18 points 8 months ago (1 children)

So what happens if a patient lies about their concern and a 15 minute checkup is all of a sudden a 45 minute spiel. You can’t just leave a patient you’re treating, they try to allow for some leeway, but they’re a business too after all, can’t be sitting around either.

[–] [email protected] 25 points 8 months ago (12 children)

they’re a business too

Without meaning to go completely off the rails, maybe this is part of the problem? I mean we can't sink our entire GDP into toenail fungus, but there ought to be some middle ground somewhere.

[–] [email protected] 13 points 8 months ago

I don't think "they're a business" properly captures the concern. It's probably more accurate to say that they have a desire to operate efficiently and not waste resources, but it has to be balanced against the need to treat patients effectively and fairly.

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[–] [email protected] 39 points 8 months ago (5 children)
[–] [email protected] 33 points 8 months ago (2 children)
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[–] [email protected] 26 points 8 months ago

Idk toddlers be like that

[–] [email protected] 24 points 8 months ago (1 children)

Why not? Toddlers do things like point out clocks all the time. The "passive agressive" part is the parent's interpretation. The actual action that is described is so very normal.

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[–] [email protected] 14 points 8 months ago

“Nurse, can you bring me the big needles?”

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