Feeling Held Hostage By Your Provider?

An all too frequent complaint that many patients have when they go see their healthcare provider, they are never seen on time (ugh, insert eye roll).  Their provider is always running at least 30 minutes past their scheduled time.  Don’t they know their time is valuable too?  Why do they overbook themselves?   Why do Physicians, Physician Assistants, and Nurse Practitioners put their numbers before their patients time?   Patients have schedules too!  Tired of taking time off work, planning your life around their next opening, and then spend more time waiting than you actually spent being seen?

Here’s the Skinny

As health care providers we get it.  We have seen the research on the internet that validates all your thoughts and feelings (plus if it’s on the internet it’s true, right?) While some offices may over book themselves and herd patients through like cattle, I believe those offices are few and far between.  I am not denying that providers have to see a certain number of patient in order to cover the cost of themselves, staff, rent, utilities, supplies, etc.  If  that doesn’t happen, their doors are closing regardless, and reimbursement as it currently stands causes new challenges each year.  The struggle is real ya’ll.

Researchers in general try to make sense of numbers and statistics, but one thing that cannot be accounted for is the variance of acute health problems that present to the office.   People don’t usually plan on becoming sick or acutely ill.  Providers and their staff can’t always know how much time it will take to address certain issues and adjust the schedule to reflect the time that patient will require.   I wish there was a better answer or solution to this long standing problem, but unfortunately it remains a problem no matter how hard we try to run on time.

Keeping It Real

While I don’t have a solution, I did feel the need to add a little perspective.  Last month I had a patient that waited 20 minutes past his appointment time, yelled at the front staff (unfortunately these women take the brunt of most patient complaints and tantrums, God bless them), and left.   I searched and searched for something that describes our perspective, and came up empty.   So I wanted to share a typical day.  I would like to say these days are few and far between, but that is not the truth.  We are in the business of taking care of sick people, people who are often really sick, people who avoid the Emergency Room in order to avoid outrageous bills.

I hope you’re still with me, and I hope you’ll take the time to read this.   Maybe the next time you are sitting in the waiting room and feel yourself getting frustrated, you can say a little prayer for whatever patient may be holding up the schedule and for you provider  to help them feel better.

The Provider’s Perspective:

Dear Patient,

I’m sorry we are running behind, we know your time is valuable. We know that you took time off work in order to be here, and it was NOT to sit in the waiting room for 30 minutes past your scheduled time. We planned on being on time today. I planned on taking cupcakes to my daughters class during my lunch break for her birthday. I planned on making it to my sons football game at 5 o’clock. Now it isn’t going to happen for either of us because these inconsiderate patients came in with chest pain, suicidal thoughts, and a diagnosis of cancer that had to be explained to the ENTIRE family. So many questions. My kids were disappointed too. Every minute we run behind is time we don’t get to eat lunch, we don’t get to go home to our families, and we miss out on big moments that happen outside of work.

I know when you asked google about offices running behind, all the research shows that it is because we overbook ourselves because we are greedy and want to make more money. We are inconsiderate and hold you hostage in order to run as many patients through the mill as we possibly can. You feel held hostage and like we don’t value your time. While some offices may operate that way, I would have to argue that most offices do not. Some offices limit their patients to one problem at a time so that they don’t get behind, others of us do not. That would mean you have to take off work not only for your annual exam, but also for each refill, each illness, each problem. That’s more co pays, more days off work, more time wasted and spent with us. More office visits we get to bill for. Since we don’t all operate that way, patients are often scheduled for 15 minutes and only mention 1 problem when being scheduled, once we enter the room, they pull out a list of 10. Try getting out of that room in 15 minutes.

The day of your appointment, I started my day off getting my kids to school, 3 different drop offs in the rain, and lost a fight with an umbrella on the final drop off. I arrived at work looking like a drowned rat, had to discard my wet socks, and slip my wet sneakers back on. I quickly hurried to my desk to review patient and labs and return patient calls prior to my first patient arrival.

My morning started off fairly smooth, but I had a patient arrive with chest pain that refused to go to the ER. She had to immediately be evaluated, have an EKG performed, and EMS had to be called. Needless to say, this put me 30 minutes behind. I started to catch up before lunch, but my last patient of the morning showed up with sever depression and was suicidal. I had to spend some extra time counseling her and finally talked her into going to an inpatient psych facility. Already having been behind, this visit went through lunch, and my first afternoon patient had arrived shortly after she left.

I missed bringing the cupcakes to the school and quickly scarfed down some trail mix before starting my afternoon. I started seeing patients at 1pm and was making good time for the afternoon, although I had 10 patient cases to address, plus countless lab results and med refills. My patient that was scheduled at 1:45 was seen by 2, which I was feeling good about. He had brought his wife and adult children to his visit to review his labs and recent imaging. A pancreatic mass had been noted on CT scan and appropriate referrals had already been sent. His family had numerous questions and needed me to take the time to explain everything. This was an extensive visit that was only scheduled for 15 minutes. 45 minutes later they felt better about the explanations they had received and left.

You were scheduled at 2:15 and my nurse was unable to bring you back until 2:45. She was busy sending records on the patient we sent to the ER with chest pain, tracking down results and setting up appointments with specialist for the man with pancreatic cancer. She was trying to send in as many refills and call as many patients back as she could, some patients had called multiple times already. We did not forget you. We know your time is valuable and you are valuable to us. Please know that if you or your loved one had a problem, we would spend the same amount of time with you.

We care about our patients. We put them and their needs over our families all the time. I finally made it for the last quarter of my sons football game. Had you not gotten mad and left I doubt I would’ve even made that. After finally getting my kids to bed that night, I had several hours of charting to do. This is a crucial part of our job as we live in such a litigious society. The old saying goes if you didn’t chart it, you didn’t do it. You can bet the one time you do forget, is the time you will get sued. You see we are expected to not miss anything and often time that requires us to take the time to listen and properly evaluate people.

This is not one day, this is most days. It may be a different set of patients with different problems, but illnesses unfortunately aren’t planned. So I understand that you’re upset, but please know that no one is trying to hold you hostage and our running behind has nothing to do with you, it’s not personal.

Sincerely,

Your Healthcare Provider