Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am 100% with you, OP. I am so tired of the social acceptance that doctors can keep you waiting an hour plus - all because they over schedule the same time slots. It is the sh$ttiest practice model and we all seem to take it over and over again. I have zero sympathy for most practices, as I've yet to have a doctor who was genuinely remorseful or sympathetic that a patient had been left in a waiting room to waste their valuable time.

I'm an attorney. I can promise you that if I left a client waiting for 45 minutes, they'd find another atty - and with good reason. We should not be shelling out money to professionals who disrespects their entire client base day in and day out.

And all of this "but it was an emergency!" BS. No, it is not an emergency every day. It is a culture of overbooking. Period.

I'm sure you are a good attorney. But you clearly don't understand what medical providers' work lives are like. DOCTORS don't "keep you waiting over an hour." They practices they work for create scheduling templates that are simply impossible to keep running on time. And practice managers/administration know this. So you might say - well go work someplace that doesn't overschedule. But outside of concierge practices those systems don't exist. Unless they are solo practitioners the people your beef is with is the administration and practice managers for pretty much every practice out there. I don't know any medical providers who feel their schedule is reasonable, and I know a lot of people in healthcare.

All my siblings are doctors. My parent is a doctor. My siblings' spouses are doctors, and my in-laws are doctors. But sure, I don't know doctors.
I can tell you that doctors - by and large - do not give a #$% about their patients' time. There is an unreasonably acceptable level of arrogance among physicians in our society. They treat us like crap, think we are making everything up and have no respect for their patients time and money. It is a systemic issue. I see it ALL the time. And yes, the managing physicians absolutely can instruct their admin to schedule less patients per block. All they have to do is say the word but they don't. Because gross revenue.

Ah, by all means you know everything. Because while you aren’t a doctor, you know a bunch.
I appreciated the thoughtful response from the actual doctor a couple pages back. This not so much. Why is your family so full of jerks is the bigger question.

LOL I'm the poster they are responding to and PP pretty much summed up my thoughts. I'm an NP, I have worked with specialists, GPs and other midlevel providers (NP/PA) over the years and have yet to encounter this critical mass of providers who "treat patients like crap and have no respect for their time and money" etc. Are those providers out there? I'm sure they are. But just about everyone I have worked with (in multiple states, in a variety of practice settings) is working their ass off to see patients and provider good care in a HUGELY imperfect system. I appreciate that there are those unicorn provider-owned practices out there where the doctors make the calls on the schedule and have a great deal of control over timing, but most of us don't work in one of those. Most of work in huge healthcare systems that dictate patient volume and evaluate provider "productivity" based largely on numbers. I don't like it. You don't like. None of us like it. But we gotta work somewhere right?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:With all these doctors feeling totally overwhelmed (and I absolutely believe that is true!) why in the universe is the AMA so vocally opposed to "scope of practice" creep.

Get some more NPs and PAs in these offices to treat the vast majority of issues.

Because I have taken care of patients after seen by NPs and PAs. It's a crapshoot what you get -- sometimes good, sometimes verging on malpractice the things they miss. If they were well supervised, it would be more reliable, but that sort of defeats the purpose.

So hire the good ones.

More excuses.

Wait -- what percentage of those coming out of training do you think are "good" enough in that way?

Anonymous wrote:With all these doctors feeling totally overwhelmed (and I absolutely believe that is true!) why in the universe is the AMA so vocally opposed to "scope of practice" creep.

Get some more NPs and PAs in these offices to treat the vast majority of issues.

https://www.reddit.com/r/Noctor/
Prompt care NP mistreated supracondylar fracture
NP misdiagnosed "dislocated" shoulder
Psychiatric NP gave me serotonin syndrome
etc

Docs miss things too, but it's a matter of the odds and a matter on whether you have a healthy fear/understanding of what you don't know.
https://www.reddit.com/r/Noctor/comments/yb0fjg/perhaps_the_most_crucial_thing_ive_learned_in/
Perhaps the most crucial thing I’ve learned in medical school, is just how much I do not know.

Our pediatrician is almost always running behind. I was slightly annoyed BEFORE my daughter had an accident at school and needed to be seen that day (head injury). They fit us in (thankfully it was nothing serious) and after anytime they are busy I don't mind in the slightest. I know they are doing their best to see everyone. They are absolutely amazing and we will wait a little longer if needed to see them.

Anonymous wrote:

Anonymous wrote:With all these doctors feeling totally overwhelmed (and I absolutely believe that is true!) why in the universe is the AMA so vocally opposed to "scope of practice" creep.

Get some more NPs and PAs in these offices to treat the vast majority of issues.

Because I have taken care of patients after seen by NPs and PAs. It's a crapshoot what you get -- sometimes good, sometimes verging on malpractice the things they miss. If they were well supervised, it would be more reliable, but that sort of defeats the purpose.

So hire the good ones.

More excuses.

Anonymous wrote:With all these doctors feeling totally overwhelmed (and I absolutely believe that is true!) why in the universe is the AMA so vocally opposed to "scope of practice" creep.

Get some more NPs and PAs in these offices to treat the vast majority of issues.

Because I have taken care of patients after seen by NPs and PAs. It's a crapshoot what you get -- sometimes good, sometimes verging on malpractice the things they miss. If they were well supervised, it would be more reliable, but that sort of defeats the purpose.

With all these doctors feeling totally overwhelmed (and I absolutely believe that is true!) why in the universe is the AMA so vocally opposed to "scope of practice" creep.

Get some more NPs and PAs in these offices to treat the vast majority of issues.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am 100% with you, OP. I am so tired of the social acceptance that doctors can keep you waiting an hour plus - all because they over schedule the same time slots. It is the sh$ttiest practice model and we all seem to take it over and over again. I have zero sympathy for most practices, as I've yet to have a doctor who was genuinely remorseful or sympathetic that a patient had been left in a waiting room to waste their valuable time.

I'm an attorney. I can promise you that if I left a client waiting for 45 minutes, they'd find another atty - and with good reason. We should not be shelling out money to professionals who disrespects their entire client base day in and day out.

And all of this "but it was an emergency!" BS. No, it is not an emergency every day. It is a culture of overbooking. Period.

and why do they overbook? Because people expect- no, demand!- to see a doctor for every little thing, and a specialist half the time at that. If you want them to see fewer patients, expect that you won’t ever get an appointment unless you’re aboht to die, and even then it will be for 2 weeks from now.

Then vet the patients. It is really not that difficult. I'm tired of all the excuses for why doctors are incompetent at running a business.
I vet my clients before a consult. Why can't they? Private practice can absolutely refuse service. They can also charge fees for services. If I have a PITA client, I charge for all the services.

I pay out of pocket for a concierge GP service and LOVE it. It absolutely can be done. Doctors are just greedy.

Please explain “vet them”. Like turn them away if they don’t pay what the doctor wants? You may get away with that in your law practice, but a doctor can’t. It’s not ethical. That’s probably really hard for you to understand.

Firstly, that's not true at all. Doctors are not ethically required to accept all patients. That's only incumbent on ERs. Try going to a plastic surgeon and explaining that you cannot pay the fees. They 100% can turn you away. And practices turn away bad fit patients all the time. This is not hard to understand.

But instead of over scheduling every single patient, they can triage through nursing, virtual appointments, tel consults, etc. when necessary. There are about a dozen different modern options available through technology which any medical practice can implement to provide services at different price points, convenience levels and urgency needs. BUT they don't. Because they can charge for every head that comes in.

Not rocket science, and clearly not difficult for anyone to understand.

Wait -- do you think that if a patient is booked for just one thing, then that is all you deal with in the visit?

For the love of Pete. It is not that freaking difficult. A doctor and/or admin can figure out the need for scheduling based on the patient's need and/or history. Again, not rocket science. I've been to a million doctor's appts for a number of specialists. Some are 15 min, while some are an hr. Across the board, doctors can scheduling all of them better. Literally every other industry on the planet does it and they can to. 1/2 my practitioners offer virtual consults these days. It is not hard so stop acting like it's incredibly complex. It's not.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am 100% with you, OP. I am so tired of the social acceptance that doctors can keep you waiting an hour plus - all because they over schedule the same time slots. It is the sh$ttiest practice model and we all seem to take it over and over again. I have zero sympathy for most practices, as I've yet to have a doctor who was genuinely remorseful or sympathetic that a patient had been left in a waiting room to waste their valuable time.

I'm an attorney. I can promise you that if I left a client waiting for 45 minutes, they'd find another atty - and with good reason. We should not be shelling out money to professionals who disrespects their entire client base day in and day out.

And all of this "but it was an emergency!" BS. No, it is not an emergency every day. It is a culture of overbooking. Period.

I'm sure you are a good attorney. But you clearly don't understand what medical providers' work lives are like. DOCTORS don't "keep you waiting over an hour." They practices they work for create scheduling templates that are simply impossible to keep running on time. And practice managers/administration know this. So you might say - well go work someplace that doesn't overschedule. But outside of concierge practices those systems don't exist. Unless they are solo practitioners the people your beef is with is the administration and practice managers for pretty much every practice out there. I don't know any medical providers who feel their schedule is reasonable, and I know a lot of people in healthcare.

All my siblings are doctors. My parent is a doctor. My siblings' spouses are doctors, and my in-laws are doctors. But sure, I don't know doctors.
I can tell you that doctors - by and large - do not give a #$% about their patients' time. There is an unreasonably acceptable level of arrogance among physicians in our society. They treat us like crap, think we are making everything up and have no respect for their patients time and money. It is a systemic issue. I see it ALL the time. And yes, the managing physicians absolutely can instruct their admin to schedule less patients per block. All they have to do is say the word but they don't. Because gross revenue.

Ah, by all means you know everything. Because while you aren’t a doctor, you know a bunch.
I appreciated the thoughtful response from the actual doctor a couple pages back. This not so much. Why is your family so full of jerks is the bigger question.

RE:

Firstly, that's not true at all. Doctors are not ethically required to accept all patients. That's only incumbent on ERs. Try going to a plastic surgeon and explaining that you cannot pay the fees. They 100% can turn you away. And practices turn away bad fit patients all the time. This is not hard to understand.

But instead of over scheduling every single patient, they can triage through nursing, virtual appointments, tel consults, etc. when necessary. There are about a dozen different modern options available through technology which any medical practice can implement to provide services at different price points, convenience levels and urgency needs. BUT they don't. Because they can charge for every head that comes in.

Not rocket science, and clearly not difficult for anyone to understand.

Wait -- do you think that if a patient is booked for just one thing, then that is all you deal with in the visit?

PS: I mean, so if you screen out anything other than the single complaint for which you have scheduled the booking, and if the person doing the booking reviews the triage guidelines, are you saying that most visits will just be about that one thing?

No "While I have you here .." or "by the way ..," and no "one other thing, doc, while I'm here ...?" And that patients will tell you the most important, time consuming thing that should be the purpose of the visit, not some little thing that can be squeezed in and then they drop the time bomb in the room?

Most of the visits can avoid that, you think? Just checking.

we've ended up going out of network or pay concierage, the lowest quality doctors are overloaded with in network patients

Anonymous wrote:I beat feet when the time is a half hour after my appointment time. Only waited past a half hour for a company mandated physical for my CDL.

Don’t you waste more time rescheduling? What are you accomplishing?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am 100% with you, OP. I am so tired of the social acceptance that doctors can keep you waiting an hour plus - all because they over schedule the same time slots. It is the sh$ttiest practice model and we all seem to take it over and over again. I have zero sympathy for most practices, as I've yet to have a doctor who was genuinely remorseful or sympathetic that a patient had been left in a waiting room to waste their valuable time.

I'm an attorney. I can promise you that if I left a client waiting for 45 minutes, they'd find another atty - and with good reason. We should not be shelling out money to professionals who disrespects their entire client base day in and day out.

And all of this "but it was an emergency!" BS. No, it is not an emergency every day. It is a culture of overbooking. Period.

and why do they overbook? Because people expect- no, demand!- to see a doctor for every little thing, and a specialist half the time at that. If you want them to see fewer patients, expect that you won’t ever get an appointment unless you’re aboht to die, and even then it will be for 2 weeks from now.

Then vet the patients. It is really not that difficult. I'm tired of all the excuses for why doctors are incompetent at running a business.
I vet my clients before a consult. Why can't they? Private practice can absolutely refuse service. They can also charge fees for services. If I have a PITA client, I charge for all the services.

I pay out of pocket for a concierge GP service and LOVE it. It absolutely can be done. Doctors are just greedy.

Please explain “vet them”. Like turn them away if they don’t pay what the doctor wants? You may get away with that in your law practice, but a doctor can’t. It’s not ethical. That’s probably really hard for you to understand.

I'm guessing PP means triage, but doctors vet based on ability to pay all the time. Try getting an appointment without making arrangements to pay

Why would you assume that when everything that follows is regarding cost?

Doctors jam in as many patients as possible because reimbursement rates for PCPs doing wellness visits are terrible. If you want more time with your doctor and a doctor more likely to keep a schedule either see one who doesn't take insurance or pay for a concierge practice

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I look forward to the day when doctors are replaced by computers which can scan your body and analyze test results and diagnose your prognosis.

Alas, the most sensitive predictor of neonatal sepsis is still an experienced clinician's hands, eyes, and brain, not any lab tests.

Perhaps soon.

And computers now out preform radiologists reading mammograms. Certain things are easier to automate than others

And PAs can take off a good chunk of patient load so MDs can deal with the more complex issues.