So today I went to visit an ear, nose, and throat specialist to hopefully help me get rid of this perpetual stuffy nose I've had for a month. I was impressed that I was able to get in an appointment so fast, which was imperative because I'm leaving for Stupidfest Atlanta on Sunday. The lady who took my info said that I should arrive at 3:45 PM, and my appointment was for 4 PM. I said great, although one of my pet peeves is when doctors ask that patients be on time, but then make us wait while they're running late.
So I arrive at 3:42 PM (although I was shooting for 3:55 PM just to spite them). I'm at the desk filling out forms when a lady next to me checks in for another doctor. She asks how low he's behind. The guy behind the counter says, about an hour. She says, what really? He says that's pretty good, he's usually 2 hours behind. The lady asks if it's OK for her to leave and come back in 30 min. The guy says he can't guarantee anything and she may lose her place in line if they call her while she's gone. At this point I say pretty loudly, half joking, "So we hafta be here 15 minutes before our appointment, but the doctor can be an hour late?" Three or four of the patients in the waiting room laugh. The guy behind the desk seems to have a case of selective listening and didn't respond (when I first got there he greeted me, said to sign in... so I did, but then he went back to his work... I asked if I needed to fill out any forms, but he didn't say anything... then after like 10 seconds of silence he says, oh, I don't work for that doctor). Anyways I get to see the doctor at 4:45 PM, he pokes and prods me for 5 minutes and send me off with a stack of prescriptions and says if it doesn't get better come back and see him.
So here's the second part, which will lead to my question. I go off to Walgreens to cash in my stack of prescriptions. I hand them off to what looks like a college aged pharmacist. She tells me it'll be 15-20 minutes. OK, I've always wondered but now I hafta ask...
WHAT ARE THEY DOING BACK THERE THAT TAKES 15-20 MINUTES?????
Counting out pills? Grabbing stuff off the shelf? Why does that take 15-20 minutes? Maybe I need to look up Mrs. Sachs...
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I think they are counting out pills. Probably printing out labels and looking up possible drug interactions as well. I think the doctor thing would annoy me more than the pharmacist thing.
I think the pharmacist thing is legit. It can take 5-10 min to fill out a prescription (getting the pills, filling out paperwork). And then they can be backlogged at busy times.
Basically, doctors, dentists, etc are way more important than you peon. =)
but computers count out pills for auto-dispensing a lot of times!! if it really takes that long to count pills how is anything accomplihsed there.
My biggest question with this is when i get my birth control and it's PRE-PACKAGED and still takes 20 minutes...
waiting for the doctor doesn't annoy me at all. i expect the doc to give me his full attention when i'm there, and whatever he may need to do... blood work, strep cultures, etc. may add a few minutes to my appointment time. and my point is this, if i believe that i deserve quality time with my physician, then doesn't every other patient deserve the same? even further, my doctor has opened his office at 9pm to see me when i had a fever of 103 and bronchitis, brought me ice cream when i had my appendix out, and always personally calls me with test results. he always takes care of me, and i can only assume that he's doing the same for the rest of his patients. so...what's an hour of my time when i'm getting the highest quality of care?
Sounds like this doctor is a "time optimist" and doesn't think he takes as long as he does. It's rude and bad business to consistantly run that far behind. It wouldn't take long to figure out what his TRUE average time per patient was and mandate that as the appointment time blocks.
The phamarcy thing is bad too. I believe sometimes they are busy, other times I have been the only one and they still need 10-15 minutes, I can only hope that they need that long to run some sort of "drug abuser" check in a national database because otherwise if you are the only one there it does get annoying.
Lets relate it to cars. I've never had an appointment for car service that was on time.
I'm fine w/a doctor taking extra time since he doesn't truly know what he will get into w/ each patient. I wouldn't want my time cut short for schedule if I needed extra tests.
From economics that would end up leading every patient's sick symptoms to the most common answer and prescription, when in fact extra work or tests could show it was more serious.
15 min at the pharmacy seems ok since they are releasing a drug considering how much paperwork it takes to release deodorant.
I have a harder time waiting 1 hr at costco to have tires put on while I buy stuff I don't really need (like 100 slim jims).
when you walk into a pt's room, you have NO IDEA what the physical assessment will uncover, therefore; it is impossible to group appointments into any general category of time. going into an appointment with complaints of fatigue and weight gain could be depression or hypothryoid disease... neither of which anyone would want their doctor to mistreat. how can someone demand to be seen on time, with never any delays, but still demand thorough, personal care? and moreso, how can you demand that another's needs not be met because your needs must be met RIGHT NOW.
and, regarding the pharmacy... even if you are the only one in the store, prescriptions are still being constantly called in, and all insurance must be verified. which brings me back to universal health care... if you want the convenience of not having insurance verification for every single thing, then remove it from the equation.
and, for all of you who will read this and say, "but, i'm not going to pay for someone else's health coverage when they can't be bothered to get a job like mine," please reconsider what health insurance actually is. and then consider this: does the fire department only rescue those who are insured? why should the public service of health care be any different?
OK so about the doctor thing... I'm approaching this as an engineer and not as a politician...
There's a lot of uncertainty in how much time it takes to properly see a patient. For sure. My problem is there doesn't seem to be any attempt at trying to manage it. Companies like Dell can build you a computer almost on demand with very little inventory. Are there concepts in there that can be applied to the doctor's office? Have any Industrial Engineers tried ot do this?
As for who pays for health insurance, I think american's are spoiled and lazy. As we all know, if you have food on your table and a roof over your head you are among the richest 25% of the world's population. Now we all know HEALTH CARE is expensive, and I don't think we should put that huge financial burden upon anyone with some major health issue be it heart disease or cancer. That's what HEALTH INSURANCE is for and I think it makes sense. If I am healthy I don't mind paying a little more than what it would cost me to get the care I need so that the extra money can go into a big pool for others who are sick (or if i get sick) to use for their huge bills. However even large pool health insurance has a cost, and someone has to pay for it, and when we say it should be the "government" well the government doesn't have ANY money, it all comes from taxes which comes out of the working populations pockets either directly or indirectly. Therefore I think any health insurance reform needs to hold people in the program accountable for some burden, otherwise it will become a system with waste and abuse (hallmarks of poorly designed government programs) and these systems overtime fail.
I think if we as individuals don't take ANY responsibility for the cost of what we "need" in ourlives, then where do we stop? Should everyone just get a new car on the government's payroll? If you think I am crazy with this analogy, just remember americans are spoiled, we take HEALTH CARE for granted and think we -need- HEALTH INSURANCE when think about all the other people in the world who don't even have adequate health care! We don't NEED health insurance, we NEED health care, in my opinion HEALTH INSURANCE is a great thing to do for the people of the world's richest nation, assuming the participants are doing what INSURANCE does, and that is SHARE THE COST not avoid it because "someone else will pay for me."
Have you seen Sicko?
I think additionally we need to get all government employees to be in the same pool for health insurance, social security etc. Has anyone thought it might be a bad idea to have the decision makers in different systems than the people they are making decisions for? That one never made sense to me.
I agree with Tom S's last comment. However it is nice when you DO work for the govt and you put your retirement funds into your own account...
How does the health insurance work?
I think docs can give more time...or be a little bit more respectful of our time. Why make us show up 15 minutes early, but then, we "lose our space in line" if we show up 30 minutes late...even if we would have had to wait the hour.....The doctors who are routinely late, yes. change their schedules to be more accurate. My old doc in Ohio would give me more than the allotted time, even for "wellness" exams just talking and getting to know me and such - great quality and much appreciated, but they could also plan better. Besides, don't they normally have times allotted for "emergencies" or sickness/last minute visits? Those can be cross functional - make up for lost time if they aren't booked.
My sister had an appt once at 11. she waited and wait and waited. finally got in after 12:30. Turns out the doctor went on her "scheduled" lunch hour without catching up patients...making my sister sit in the waiting room while she got to have her long lunch. Then she treated my sister once she got back. Is that how it should work?
I agree with Karen on the birth control thing - even if it's a refill, prepacked, all that. Minimum time is 20 minutes. WTC?
Yeah, even though doctors can't accurately predict how long an appointment can take, however they can estimate the number of patients they are able to see in a day and build in catch up time if they are always behind. If they are routinely behind, then something has to change because no one should have to wait an hour for an appointment, otherwise it's like a walk-in deal. First come first serve like super cuts or something.
At least to some degree the market forces are at work and you can go somewhere else, I worry that if the government were to run healthcare and market forces are weakened (like service, value) then you will get medical service on par with the DMV or any other place that doesn't have to compete with others on service or price. I think former Russia proved that one out for us!
That's why I like naked economics, it basically says if people don't have skin in the game (i.e. money) then the market forces disappear and everything gets more expensive for bad care. But when there is competition and you let the market dictate, then it'll end up being the best value.
NET - boycott these bad practices that make you wait over an hour! Our time is too valuable!
I have to say my doctor was really good about being ontime and providing service I liked. No complaints here. My dentist, on the other hand, is REALLY slow, so while he isn't usually too much behind, he schedules 45 min cleanings! If he wasn't worth it, I wouldn't go, but he is awesome and I prefer a dentist doing the cleaning than a hygenist, who wants to pay for a doctor to look in your outh for a min, I say have him know it inside and out.
PS - Dale great blog on an experience everyone goes through, lots of energy here! Can we tackle traffic next :)
I think health insurance shouldn't be connected to your job. Wouldn't it be nice if you could consider going to get your MBA or starting your own company without having to think about the risk of not having health insurance? Especially when you are making that decision for your entire family and not yourself? Or if you come down with any diseases while uninsured that would cause you to be no longer insurable.
Dave - I agree it shouldn;t be tied to a job, though it cheaper since you get closer to a REP sample of health issues veruss "self selecting' into plans based on health issues. I think if it's not tied to a job then it'd have to be a REP plan that anyone could buy into (therefore you really do have distributed costs based on health issues as a % of pop), but you'd also have to somehow fragment it so that there is still competition, or it'll defeat the whole purpose of having a large pool.
we can talk more about this when you "get it together." until you experience the OTHER side of the health care field, you can't make any judgments.
Not sure what that means... but to Dale's whole point of the blog, I talked to a Nurse of 20 years who basically said if a practice is consistantly running behind, it's a bad practice, they are over scheduling and more concerned about volume than service. If they think the Doc's time is more valuable than all these patients, don't go there.
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