Wait time in Dr.’s office

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  • #1460361

    funnybone
    Participant

    What is your average wait time? Do you complain if it’s more than one hour?

    #1460402

    iacisrmma
    Participant

    Yes

    #1460433

    Joseph
    Participant

    Some doctors keep people waiting for no other than to seem busier than they are.

    #1460529

    Little Froggie
    Participant

    What’s your problem?!? Take the Coffee Room with you!!!

    #1460530

    The little I know
    Participant

    Joseph:

    You wrote: “Some doctors keep people waiting for no other than to seem busier than they are.” I also believed that. There are certain realities that suggest this is a myth. Firstly, doctor’s offices are seriously understaffed. Secondly, the use of doctor’s for impromptu visits is commonplace. In this era when payments to doctors are significantly decreased, and insurance premiums for malpractice are skyrocketing, the funds to provide more staff are limited. There is newer technology that makes things quicker and easier, which also costs. There are more non-physicians (nurses, PA’s, etc.) providing services today, and this all comes with its disadvantages.

    One of the most respected medical journals carried an article many years ago where the suggestion was that the patient send the doctor a bill for the waiting time, which makes sense if that patient works in a field where charge is levied by units of time.

    A down side of waiting in doctors offices, aside from the delay factor is the exposure to other sick people and the microbes they carry. This poses potential risk, especially when there are contagious diseases like flu that have been at epidemic levels.

    #1460594

    Gadolhadorah
    Participant

    Very fact specific….too many scheduled visits and overbooking in many cases simply as basic economics for small practices trying to meet “quotas” to cover their costs. Unscheduled emergency visits or patients with more complex issues add to the delays since their is no “free time” built into the schedule.

    #1460691

    a mamin
    Participant

    Ezra Medical Center in Boro park boasts a waiting time average of 5 minutes! Thats the upside!

    #1460798

    funnybone
    Participant

    GH: if we all complain and make a fuss, maybe they will realize that they need to put emergency time into their schedule!

    #1460803

    WinnieThePooh
    Participant

    I’ve found that the doctors I have to wait a long time for are behind schedule because they give more time to each patient than is scheduled. Which is a good thing- they actually do a thorough exam, listen to the patient, take time to explain things, and don’t just shove you out the door because your 10 min is over. The problem stems from the tight scheduling of the appointments, which in the system in E”Y, is beyond the Dr’s control. I once went to a Dr (a specialist who only works 1 morning a week) and several of us realized we were booked for the same time slots- and these were appointments made long in advance, not emergencies that were squeezed in. The dr still gave each patient the time she needed, which meant that not only were patients waiting, but the dr had to work overtime. When i asked her why they schedule an impossible schedule, she said that this way people can get appts within 6 months, and don’t have to wait 1 yr.

    #1460837

    CTLAWYER
    Participant

    After 30 minutes I get up and walk out. I also refuse to give the receptionist the co-pay before I see the doctor. Once they have your money, they don’t care how long you sit and wait.

    #1460970

    lesschumras
    Participant

    CT, then you really weren’t sick.

    #1460982

    CTLAWYER
    Participant

    @lesschrumras
    There are many occasions for ‘well doctor’ visits: Annual physical, Flu Shots, Eye Exam, every six month teeth cleaning, orthotic adjustment at the podiatrist.

    Not every doctor visit is because one is sick.
    In fact, I went on Monday to update certain vaccinations for travel to travel to southern Africa this month.

    #1460986

    mentsch1
    Participant

    Frankly , in my office I try to run on time and am fairly good about it. Rarely more then five to 10 min late.
    But those days when I’m backed up can almost always be blamed on patients .
    Either patients coming late , or new patients not coming early to fill out paperwork and then the alloted appointment time passes while their info gets entered and now they are into someone else’s time.
    As for emergencies, it’s nice to say to leave time in the schedule for them but by definition they are impossible to predict. Do I leave two slots a day? What about days with six emergencies? What about days with none? Whose paying for those empty slots ? What about all those annoyed patients who desperately wanted an appointment asap but I told them we were full when we really weren’t?
    Get where I’m going with this?
    Old business adage . You can’t have all three of the trinity of price, service and skill. But in healthcare everyone wants all three and hates on us providers when we don’t provide it.

    #1460987

    mentsch1
    Participant

    CT
    a beautiful system would allow dr’s to get paid by the hour. Imagine a world where I can charge my pt’s in six minute increments. Let’s say $35 every six minutes even when they are late. Then I could compensate those waiting in the waiting room . Sounds fair right ?
    Instead I can’t even begin to imagine the amount of money I’d be worth . Because I don’t get paid for time. I can spend an hour with a patient taking a complex medical history, or giving treatment advice and answering unending questions from patients that come with long sheets of paper filled with imaginary concerns and symptoms. Or the patient who is depressed and just needs someone to listen for a few minutes. That’s my day, I help people. And I don’t get paid for a lot of itit. But that’s why I went into the medical field instead of becoming a lawyer.

    #1460991

    TheGoq
    Participant

    I could deal with the long wait time if it wasn’t accompanied by rude staff doctors office receptionists are some of the rudest most obnoxious people you will ever have to deal with maybe they think the glass sliding window means that they are the gatekeeper and the patients are the undeserving hordes asking to see the king.

    #1461017

    Yiddishedoctor
    Participant

    Perhaps if ….doctors could charge for every minute that they speak on the phone with patients, and charge extra for the time they spend with pts who say, “oh by the way doc, while I’m here can you look at….” when the visit was really over, and charge a retainer for those pts who refuse to pay their copay when they come and have to be chased, and to cover insurance denials….then they wouldn’t have to book so heavily.
    And if only patients would have the common courtesy of calling to cancel if they’re not going to come in (my average no show rate is 25-35%)

    #1461049

    takahmamash
    Participant

    In America, I walked out of the office after waiting an hour. I spoke to the practice manager and told her why I was leaving. She threatened to send me a bill for the missed appointment. I told her I would send her a bill for my missed work time. I never heard from her, and switched doctors shortly afterwards.

    #1461093

    funnybone
    Participant

    I would be happy to pay for phone calls. Instead, lately, i jave been told by a dr to make an appointment to discuss results of a test! I did and he told me it was negative, do you have any questions?

    #1461116

    Joseph
    Participant

    funnybone, many doctors like to force patients to come to the office unnecessarily when they could have easily answered the question quickly by phone, without a visit, or just have related basic information because by coming to the office they can bill the insurance and copay.

    #1461125

    a mamin
    Participant

    There are many choices in the medical field, make them! If your time is important to you , don’t stick around in those type of offices!

    #1461114

    Mammele
    Participant

    The pediatricians in my neighborhood that are the best doctors are basically the ones with the longest wait times. And yes, they overbook because it’s almost impossible to say no to a sick child. That holds even more true when the flu or some other virus is out there infecting many kids.

    But if you end up waiting a while at a medical center even when there are almost no patients, it’s most likely that the bureaucratic system and staff are at fault.

    It’s always good to check what’s going on after half an hour or so, perhaps the receptionist simply didn’t check you in properly. And for them to know you don’t appreciate waiting…

    If it’s an emergency speak up loudly, and if staff doesn’t listen, walk in straight to the doctor. (Years ago, my then toddler needed nebulizer treatment and perhaps medication for breathing difficulties that I couldn’t safely handle myself. When I told the receptionist that my child was breathing rapidly her response was an empathetic “Yes, I see that.” but continued to let me wait… So I walked in to the pediatrician who B”H had the sense to treat right away.)

    #1461131

    CTLAWYER
    Participant

    @mentsch1
    Contrary to your belief, lawyers also help people.
    Unlike doctors, the first consultation is generally free. My firm spends 20% of its time on pro bono cases…work done free for the public good.
    I can’t tell you how to run your practice and schedule your time. That’s your business. I know that you can charge different amounts for a brief office visit and a long one. The problem is that you are constricted by insurance payments, I am not.
    My internist has a concierge practice. I pay an annual fee that grants access and short wait times. Not every doctor offers that nor can every patient afford it.
    My dentist is in the same building as my office. I have his staff trained to phone me when the previous patient gets up from the chair in the procedure room. I am able to be in the room by the time the dentist is ready to see me.
    I dropped my eye doctor when I found he was making 6 ‘first’ appointments, sticking patients in exam rooms and wasting hours of me time.

    I went to my internist for vaccinations this week. He schedules a vaccine clinic each week for three hours. Patients are in and out. No other issues are discussed or treated. He only sees adults as patients. This leads to a much more orderly flow to the workday.

    #1461153

    mentsch1
    Participant

    CT
    all very nice
    but as i said in a business paradigm you cant have all three
    we all assume the doctors to be skilled
    that means that either you need to choose between price or service. Since you can afford it you chose service. the other 99% want healthcare for free AND concierge service. That’s not a fair expectation. But its what we healthcare providers hear all day long.
    In your concierge service, if you didn’t show for an appointment you would be charged for it.
    Yesterday, my colleague had a full day when she walked in to the office. By the end of the day she had 30% cancellations. Time is money, that cost her tons and if she dares charge for it people leave.
    Im sorry but from my POV, patients are far more inconsiderate then the health care providers they complain about.

    #1461227

    DovidBT
    Participant

    When doctors have to compete with personal robots that cost the same as refrigerators, they’ll find ways to make their office visits more convenient.

    #1461237

    mentsch1
    Participant

    DovidBT
    ridiculous statement obviously made by someone who doesn’t run a business
    All those conveniences cost
    lets do math
    whats a fair salary for a doctor?
    I think $200K is low but lets go with it
    how much does the doctor need to generate/bill to make that money? Besides for basic overhead, rent etc which is a large percentage of gross, there is the biggest fixed cost, payroll. Each staff member is costing 40-50 k per year minimum. So to make your experience at the doctor more convenient, you need more staff and less patients taking up your time. The price of employment is going up while the reimbursement is going down, how can a doctor who takes insurance afford to cut the amount of patients he sees?! just the opposite, he needs more volume
    In your scenario, doctors will be out of business bc they need to have a salary that justifies being in school till they are 30+. Otherwise, no one is going to med school.

    #1461368

    CTLAWYER
    Participant

    @mentsch1
    Here in the country things are different.
    No shows and cancellations with less than 24 hour notice are billed a fee (there are exceptions, such as being admitted to the hospital). Don’t pay the fee and chances are the doctor will drop you as a patient.

    Unlike, some of the Frum enclaves often mentioned in the CR, the doctors here are not seeing a large number of Medicaid patients.

    My time is money…that’s what attorney’s do, they bill time. I respect the doctor’s time as well. When booking an appointment I let the receptionist know if I need a brief or extended visit. The internist who is my primary care doctor does not see children. That speeds things up. Also, people who call and say they’ve just come down with a kronk are referred to the walk-in facility in the building, not told to come in and be squeezed in.

    As far as your statement about costs, in this areas almost 50% of MDs have sold their practices to the area hospitals and are employees, not business owners. Excluding my dentist. all of my doctors are in practices now owned by two hospitals. This includes the concierge practice owned by Yale.

    #1461705

    funnybone
    Participant

    Why can’t I expect all three, is it too hard for a Dr. to give some service and accommodate patients without having them wait an hour?

    #1461760

    mentsch1
    Participant

    Funny
    Like any other business a doctor office needs to generate a certain amount per hour to pay expenses and salaries. That’s the starting point in this equation. Of course doctors may be greedy and trying to milk every available dollar. But let’s assume a practice were the doctor is making an average salary for his field.
    In order for things to run smoothly the following needs to happen
    1) the doctor doesn’t overbook, rather he leaves enough time per patient . This is difficult to guess but doable.
    2) every patient shows up on time (or early to fill out paperwork)
    3) if a patient doesn’t show on time then the doctor needs to make a decision, reschedule the patient or allow the schedule to start to get backed up . Ideally the patient would be rescheduled but the patient would…
    4) ability to charge patients for missed or late shows. With dedicated appointment slots comes the need for definite revenue . Otherwise several missed appointments and the dollar per hour is in the negative range.
    It all comes down to insurance. Low reimbursement means a need for high volume in general. The worst Is a Medicaid practice, besides for low reimbursement,doctors can’t charge for missed appointments . And when patients have no skin in the game they have no incentive to not show so multiple cancellations is the norm and thus overbooking by doctors is the norm.
    I’m not saying doctors can’t do a better job. I’ve left doctors for being bad about wait times. I’m saying that a lot of this rests on pt insurance and pt irresponsibility.
    Like in all other areas of life , those that are on time end up having to wait for those that have no concept of time.

    #1466294

    funnybone
    Participant

    Metsch,
    Would you say that its the Dr’ s fault that we are late? Why should we come on time ifvlast time he overbooked, saw two emergency patients and ran an hour late?

    #1467388

    jdf007
    Participant

    It’s interesting that we’re talking about costs and finance in a thread about doctors. Has anyone ever asked a doctor or dentist office how much something simple cost? Sometimes I can’t even get a quote. They bill a third party payer, who has the rates set, normally based off of Medicare set rates. Then if you are lucky enough to have worked in health insurance, you can discuss things with the rude and snobby receptionist who billed wrong, although she can do no wrong, although you were the professional who denies her bills for doing them clearly wrong.

    If time = money, and no one knows the value of their services or money as it just gets typed into a computer with a code (that’s usually wrong), then who knows the value of time?

    #1467450

    laskern
    Participant

    We might want to take along a sefer to learn not to waste the time.

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