The Picard ManeuverHow many other businesses would we be fine with operating like this?
N3Cr0It it was only an hour ⏳💀
I feel a lot of appointment-based businesses are like this. They’re trying to slot in as many services into one day as they can. Them making you wait is acceptable because they’re with another customer (Though I’m sure they wanna wrap it up with them quickly too). You making them wait is unacceptable because that’ll throw off their carefully timed appointment schedule.
It ain’t great but that’s the bitch of this damned money world huh
I started to just leave when this happen. There are a lot of good people who follow the schedule properly, i take my business to them instead.
But the question I ask myself everytime is : how carefully timed is it really, if everyone has to wait so much ?
Dunno bout your PCP’s office, but I know some hospital workers and it seems like there’s a lotta time waiting for transport because they’re understaffed, underpaid. Also, lotta piss and shit related delays. Sometimes those compound.
Believe it or not, lotsa “customers” in hospitals aren’t, like, operating at peak efficiency. So there’s a lotta small delays that occur for normal consequences of that. A fifteen minute delay here because a patient can’t move very quickly. A ten minute delay as a patient thinks they have to pee but no one can find a bed pan and they can’t use a toilet. Then they don’t have to pee. A thirty minute delay because they can’t find the right kind of stretcher for a particular patient. An hour delay because, while you were scheduled to get your outpatient test done at 4 P.M. sharp, someone else from the Emergency Room needed that sort of test done ASAP.
snooggumsWhen that happens frequently, not scheduling time for it is shitty scheduling.
This is a different kind of issue, one I think a lotta people would be more familiar with. Management setting unrealistic goals and targets. Yes, those kinds of delays are so common they should be baked into the time expectations. However, that would result in fewer billable services forecasted per period. That bad. Want more money. While doctors offices should be immune to that kind of shitty behavior, they are still ultimately business and thus they gotta operate with that forever growing, profit forward behavior.
NegativeLookBehindIf it’s so carefully timed, why is it ok for them to mess up the timing? I’m a paying customer and I have shit to do, too. Maybe it’s not true in the case of doctors, but for other businesses, the only reason you’re able to have this business is because I’m here, paying money.
I imagine it’s unlikely the doctor’s office “messed up the timing” such that the doctor isn’t doing work and simply making you wait for funsies, but rather the patient before you needed an unanticipated amount of extra time for one thing or another. This is “acceptable” to the business as the doctor is still performing a billable service. It’s not preferable, as it would be better if the doctor was performing MORE billable services per day, but acceptable. In hospitals, the number of services performed per day can be used as a KPI, for example. It’s “unacceptable” to have the doctor waiting around not performing billable services as that doesn’t make money.
If they’re messing up the schedule in a way that you both have to wait and no one is performing a billable service, something has seriously gone wrong.
Because life is unpredictable. They can’t know in advance if they’re going to have delays, so sometimes you just have to deal with it. This goes for any appointment based service.
But should the same courtesy and understanding be extended to the customer?
Yes, which is part of why they end up running late.
Maybe it’s not true in the case of doctors, but for other businesses, the only reason you’re able to have this business is because I’m here, paying money.
You hit the nail on the head there. Other businesses exist because they won your business in competition with other businesses. A doctor’s office exists because they got permission from the state to operate.
The incentive structure is different, leading to different strategies being used to stay open
In the US at least you could easily find a different doctor, unless you live in a rural area with no other doctors in it
I left two different practices because of schedule fiascos and stuck with the 3rd because they never make me wait.
Them making you wait is also often a consequence of earlier patients showing up late or an appointment requiring more time than expected.
The options to solve it are less patients per day, but that leads to even longer delays before you even get to your appointment date, OR more professional staff in the office…but that would cut into profits of the people in charge so is immediately off the table in this damned money world.
amniotic druidIn an ER, that’s understandable, but in a general doctor’s office there’s no reason that Docs should extend one patient’s appointment time just because they ended up late:
“Oh, you scheduled a 30 minute consultation because of a sore knee but now you’re asking for an ENT referral and blood work? You’ll have to schedule another appointment to go over that, we’re only covering what you told us the other day.”
You think someone should be penalised by having their diabetes review cut short because the traffic from their minimum wage job was unexpectedly slow?
Hyperbolic, made up scenario, but yeah pretty much. You get the time slot you scheduled and you should be held responsible for using it. Most offices ask you to check in at least a half hour early for a reason.
I could just as easily switch that around and ask if you believe some poor guy who finally got an extended lunch break from his minimum wage warehouse job should be fired because he had to wait an hour at the doctor’s office because some rich white lady spent 30 minutes past her appointment arguing about essential oils. Painting is pretty easy when it’s all black and white.
That sounds like an employment rights issue. Here we get as much time as required for health appointments.
OK cool don’t care and that didn’t even address half of my comment
Half an hour early? That feels excessive. At my GPs it’s 10 minutes early
Hyperbole indeed.
What about the 25 other patients who do not have a really, really important diabetes consultation, but a head cold or are just alone and need to talk?*
What about that one person who had their really, really important diabetes consultation at 6pm but was told to come back another day two hours later at 8pm once the other appointments were all stretched out ad infinitum, but can’t return anytime soon due to their boss not giving them any time off in their minimum wage job, who then DIES of diabetes? Come on, let’s not resort to hyperbole and made up scenarios - improvements are possible, and we should aim for those.
*Loneliness, in particular in elderly patients, is a real problem which I’m not trying to downplay. This needs to be solved, too.
It’s a hypothetical scenario. Penalising people for being late or for missing appointments has a higher adverse effect for people in poverty or with disabilities without actually addressing the cause. It’s why doctors in the UK are generally against introducing fines for missed appointments.
We need more capacity, yes.
but that would cut into profits of the people in charge
You mean the municipality, which you also are a part of, and pay tax to?
If the commenter you’re responding to is from the US then no. We have privately owned for profit hospitals and often they’re the only option in ones area.
Well, I can tell you the wait time is just as bad when it’s covered by taxpayer money
People always get called out for assuming everything is about the US but Europeans do it just as much lol
Quite a few doctor’s offices are owned or ran by a management group. Partly to share or reduce their costs due to bureaucratic insurance companies and HIPAA compliance. Those same management groups use the doctors like a cash cow and attempt to shovel as many patients at them as they can because a venture fund is running the group behind the scenes.
Maybe in the USA. Dr Dropin is the only privately owned doctors office I know about in Norway, and they are generally not that often used
That’s a funny name for an urgent care place, from the english “drop in appointment.”
We have “legevaktå” for urgent doctor visits, so Dr Dropin isn’t realøy needed for that either. Or anything for that matter. Which is way nobody uses it. It has to be paid fully out of your own pocket and it’s expensive, and options exists.
I hear you, I just thought it was a funny name from my American perspective. Du dutger dritgodt.
Kamelåså
You mean the municipality, which you also are a part of, and pay tax to?
There aren’t very many hospitals or medical facilities owned by municipalities anymore. Most are either owned and operated by a private hospital network, or operate under a private trust.
The hospital I work at used to be owned by the state via the university, but our governor literally gave the campus away to a private trust that operates for profit. Super fun times.
There aren’t very many hospitals or medical facilities owned by municipalities anymore. Most are either owned and operated by a private hospital network, or operate under a private trust.
Doctors offices are. Hospitals are funded by thr government. Either way paid for by your tax.
The hospital I work at used to be owned by the state via the university, but our governor literally gave the campus away to a private trust that operates for profit. Super fun times.
Unless you are American? Things are fucked there, that’s no news. But most of Europe doesn’t operate like that
Doctors offices are. Hospitals are funded by thr government. Either way paid for by your tax.
I think we may be talking about two different countries…
Unless you are American? Things are fucked there
Ahh, yep. Definitely different countries.
but that’s the bitch of this damned money world
This isn’t a result of money. It’s a result of having insufficient medical providers and them therefore being guaranteed business no matter how much they suck at customer service.
If money were the most powerful thing in medicine, new players would enter the market given its ridiculous revenue levels, and those new players would introduce competition and suddenly medical providers would be facing a world where their flow of customers is not guaranteed, and they would have to learn to respect and be grateful for their customers.
That’s how it would work if it were actually a “money world”. But medicine doesn’t run on money. It runs on government permission to exist, and that permission is always kept below demand levels, meaning once a provider gets a spot they don’t have to worry about someone else taking it.
Because money is fickle. To get money to come your way you need to provide good service consistently. If you stop, the money stops coming.
But a government license to operate is not fickle. Nobody can take that from you merely by offering better service. A government license to operate, in a market with severely limited supply, is a license to treat your customers like shit and see them crawling back for more.
It runs on government permission to exist, and that permission is always kept below demand levels
This is the first I’ve ever heard of this. Got anywhere I can read more about it? Sounds uncompetitive if not outright corrupt.
Our patient visits are set as 15 minute slots standard.
This isn’t enough time to practice good medicine for anything much more than something like a flu or strep throat. How does one squeeze in an entire rooming process followed by a solid HPI, physical, poc testing and then plan review with pt in 15 minutes?
They don’t.
But with how medicine works (in the US) it’s the how clinics make enough money to stay open.
I think this is a cross-disciplinary issue.
My last optometrist appointment was wicked fast. Eye test speed run. I think it took 15 minutes for the examination and the optometrist was using the time it took for a patient’s pupils to dilate in response to those horrid drops to do the initial exam on another patient, so they always had two patients “being seen” at a given time.
Buck wild. Seems like a bad trend for quality care.
Agreed.
There’s an argument that more appointment slots means more access but if it’s access to poor quality medicine what’s the point?
PsychadelligoatBuck wild. Seems like a bad trend for quality care.
On the one hand, yeah holy shit.
On the there, though, eye exams aren’t exactly something that couldnt be administered in a group setting to help speed things along a bit
In my ideal world they’d have a machine for it at Walmart like they do blood pressure that just flips the prescriptive lenses in front of you and asks all the same questions, then sends the results to an optometrist to confirm
exams aren’t exactly something that couldnt be administered in a group setting to
Anyone else imagining a Democratic: Does 1 or 2 look better?
Sorry Alex. Looks like everyone else voted 1 so you’re getting the wrong prescription.
But with how medicine works (in the US) it’s the how clinics make enough money to stay open.
This is the truth. PCP offices in particular have razor-thin margins and insurance reimbursement goes down every year while supply, fixed, and staff costs go up every year. This is an insurance industry and healthcare system problem. Your doctors’ offices are just doing everything they can to stay open.
CrackaAssCrackaFortunately CMS is rethinking the role of primary care and realizing we can save money if we’re able to provide high quality preventive care like we’re supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.
MicrowOne of my doctors clearly has it this way. When I’m there in the afternoon, there are dozens of people waiting because each person takes longer than the appointed slot and so everyone moves back in time… but at least they have good managing there and the receptionist will tell me when I arrive whether it will be 30 or 50 minutes to wait.
My eye doctor, on the other hand… I arrive 15 minutes before my appointment and there are only three other people there, two of whom arrived at the same time as me. How the hell does it take an hour for me until I can go in? What are they doing in there that every patient takes 20-25 minutes for an eye exam?
cheezoid2Inland Revenue has entered the chat
A previous provider of mine changed locations. The front office staff took 2 months to tell patients. We showed up for an appointment we had made a month earlier and they laughed at us. Easiest decision I have ever made.
Ex NummisAn hour? Try three to four hours. I’d pay through the nose to only wait one hour past appointment time.
hauiWhat country and private or universal healthcare/insurance?
Flanders, Belgium. Universal, but specifically psychological/psychiatrist appointments, since they’ve been overbooked since over a decade and the situation keeps getting worse instead of better (more patients, less doctors, less budget). I have little doubt it’s being left to fail deliberately by our very right-leaning government. Private entities can help you almost immediately but you’ll pay prices out of the range of most working people.
Medical care suffers from the same thing all heavily-regulated quasi-markets suffer from: severely restricted supply.
This results in:
- Insufficient competition
- High prices
- Low quality work
- Low quality customer service
- Low availability and hence queueing
People complain that medicine should not be a free market, and look how bad the free market screwed up American medicine but we do not have a free market in medicine.
If we did have a free market, supply would be allowed to organically grow to match demand, introducing competition and solving all of the above problems.
But we artificially suppress supply of medicine and medical services. We call it regulation, and sure maybe it’s got its reasons for existing, but the natural and predictable result of such heavy-handed regulation is a lack of supply, leading to a lack of competition, leading to a lack of quality.
If we did have a free market, supply would be allowed to organically grow to match demand, introducing competition and solving all of the above problems.
No, health care companies would just be more “free” to make choices that cause people to die because it is more profitable.
Full stop that is the only real difference you would see.
MagisterAt one point I setup an appt with a doctor, 3 weeks set date, and to be the first one in the morning, like 9AM, he cannot be late, right? I left at 11:30AM without seeing him.
Jeez, how is that even possible? Like did some other asshole sneak in and get seen for some crazy disease somehow?
He is a surgeon and was in the hospital nearby, I guess saving life, so it’s ok :)
Ahhh that makes much more sense! I thought it was just a regular clinician type of doctor.
Sterile_TechniqueThose are often the same people. I work exclusively in the OR, and we occasionally need to pull a doctor from their clinical hours to do an emergency surgery, which means some patient who’s expecting a clinical appointment just got fucked.
This comes down to staffing issues, but every hospital on the planet is apparently running a skeleton crew right now, so we work with what we got.
Last time i was a the doctors office, my appointment was at 11. At 11:45 i was still waiting and i heard them laugh in the break room 😑…
My favorite was my psychologist who knows I’m autistic and routine and schedule is everything to me. Then doesn’t show up for 30 minutes and then call me saying their previous appointment went on longer than expected… this happened almost every other appointment. Eventually i quit because it gave me more anxiety and stress than the trauma’s i was dealing with. 🤦🏻
I think veterinary offices are the only places I can understand. Everyone there is underpaid, working hard, enduring trauma, and doing it because they love animals. Although I’ve never seen them get upset at someone for being late!