Anonymous wrote:I feel bad for doctors. Many work for large organizations that make their money on the number of contacts that their providers have during the day. So they're incentivized to double book patients, book patients over doctors' breaks and lunch, etc. Then the doctors run late because they had to see two patients in one patient slot, take all the sh*t from patients for being late, and make zero extra dollars for having an insane patient schedule.

My friend is a doctor who is currently trying to negotiate into her contract that the organization won't do this to her anymore because it's terrible for patient care. Guess what? The organization is refusing to do that.

So she should start her own practice or find one that matches her values. No one is forcing her to work at that "organization".

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
1. "It takes far too long to get an appointment."
--> schedule more patients per day

2. "I have to wait too long for the appointment I made, and it's too short a visit."

Pick one. Either one, just commit. Or go concierge, I suppose.

1. Run on time.
2. Inform your patients when they arrive how late you are running and when they can realistically be expected to be seen.

Pick one. Either one, just commit. Or be totally inconsiderate and have your patients waiting an undetermined amount of time without any communication at all, I suppose.

Neither of these will ever happen, so either resign yourself or stay mad.

Why can't #2 happen?

Because there are too many moving parts to estimate when you will be seen. And heaven help them if they make an estimate and are wrong! Your wrath will rain down on them.

"too many moving parts." If only you had decades upon decades of experience to call upon. I am certain that successful practices have this figured out already. Look at all of your excuses! Lame.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As a provider, I often run late because I actually listen to my patients.

If a patient complains about the timing, I apologize profusely and then do my absolute best to see them in 5 minutes or less. It is what they wanted me to do with the ithrrs, so that is what they can have.

I work in an obgyn field. Every time you read about maternal mortality and morbidity in the USA, or that it takes 10+ years to diagnose endometriosis (takes a 15-20 min detailed interview), I assure you these docs run on time.

I would love to have a scheduled 30 min appt to see each patient, but it is unrealistic.

Listen doctors, your patients are not morons. We know the doctors that run late because they spend time with each patient, listening attentively, and the ones who cannot manage themselves if their practice depends on it. We know when doctors are late for emergencies -- because when it's an actual emergency -- the staff and doctor let you know. We know when are BSing us because you were late due to bad scheduling.

You actually could schedule 30 min appt per patient. You've just decided that it's not financially worth it for you.

Sure they could do this and charge you twice as much. And since doctors would see half as many patients, the wait time for an appointment would double. You'd just have something new to complain about.

Lord, your post above shows you absolutely don't understand scheduling. Seeing half the patients doubles wait times ONLY IF YOU DO NOT KNOW HOW TO MANAGE A CALENDAR. I'm beginning to see the real issue. You guys have no ability to manage and deal with a calendar.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
1. "It takes far too long to get an appointment."
--> schedule more patients per day

2. "I have to wait too long for the appointment I made, and it's too short a visit."

Pick one. Either one, just commit. Or go concierge, I suppose.

1. Run on time.
2. Inform your patients when they arrive how late you are running and when they can realistically be expected to be seen.

Pick one. Either one, just commit. Or be totally inconsiderate and have your patients waiting an undetermined amount of time without any communication at all, I suppose.

Neither of these will ever happen, so either resign yourself or stay mad.

Why can't #2 happen?

Because there are too many moving parts to estimate when you will be seen. And heaven help them if they make an estimate and are wrong! Your wrath will rain down on them.

Oh my goodness, then say that if there is really so much uncertainty that you really have no idea if the patient will be seen within 30 minutes or 2 hours then you need to tell your patients that. Or that there are x number of patients in front of them. We have children who can't be left with their caregivers indefinitely, and jobs and meeetings.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
1. "It takes far too long to get an appointment."
--> schedule more patients per day

2. "I have to wait too long for the appointment I made, and it's too short a visit."

Pick one. Either one, just commit. Or go concierge, I suppose.

1. Run on time.
2. Inform your patients when they arrive how late you are running and when they can realistically be expected to be seen.

Pick one. Either one, just commit. Or be totally inconsiderate and have your patients waiting an undetermined amount of time without any communication at all, I suppose.

Neither of these will ever happen, so either resign yourself or stay mad.

Why can't #2 happen?

Because there are too many moving parts to estimate when you will be seen. And heaven help them if they make an estimate and are wrong! Your wrath will rain down on them.

Anonymous wrote:

Anonymous wrote:As a provider, I often run late because I actually listen to my patients.

If a patient complains about the timing, I apologize profusely and then do my absolute best to see them in 5 minutes or less. It is what they wanted me to do with the ithrrs, so that is what they can have.

I work in an obgyn field. Every time you read about maternal mortality and morbidity in the USA, or that it takes 10+ years to diagnose endometriosis (takes a 15-20 min detailed interview), I assure you these docs run on time.

I would love to have a scheduled 30 min appt to see each patient, but it is unrealistic.

And there you have it. It is "unrealistic" to expect responsible scheduling from doctors. You will get 10-15 minutes and be scheduled at the same time as 10 other patients. Anything else is unrealistic.
In what other field is this acceptable? Why do we permit doctors to treat their patients so terribly? The lack of respect is a slap in the face.

You are aware that there is a doctor shortage, right? This is not the fault of current doctors.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
1. "It takes far too long to get an appointment."
--> schedule more patients per day

2. "I have to wait too long for the appointment I made, and it's too short a visit."

Pick one. Either one, just commit. Or go concierge, I suppose.

1. Run on time.
2. Inform your patients when they arrive how late you are running and when they can realistically be expected to be seen.

Pick one. Either one, just commit. Or be totally inconsiderate and have your patients waiting an undetermined amount of time without any communication at all, I suppose.

Neither of these will ever happen, so either resign yourself or stay mad.

Why can't #2 happen?

Anonymous wrote:

Anonymous wrote:
1. "It takes far too long to get an appointment."
--> schedule more patients per day

2. "I have to wait too long for the appointment I made, and it's too short a visit."

Pick one. Either one, just commit. Or go concierge, I suppose.

1. Run on time.
2. Inform your patients when they arrive how late you are running and when they can realistically be expected to be seen.

Pick one. Either one, just commit. Or be totally inconsiderate and have your patients waiting an undetermined amount of time without any communication at all, I suppose.

Neither of these will ever happen, so either resign yourself or stay mad.

Anonymous wrote:

Anonymous wrote:As a provider, I often run late because I actually listen to my patients.

If a patient complains about the timing, I apologize profusely and then do my absolute best to see them in 5 minutes or less. It is what they wanted me to do with the ithrrs, so that is what they can have.

I work in an obgyn field. Every time you read about maternal mortality and morbidity in the USA, or that it takes 10+ years to diagnose endometriosis (takes a 15-20 min detailed interview), I assure you these docs run on time.

I would love to have a scheduled 30 min appt to see each patient, but it is unrealistic.

Listen doctors, your patients are not morons. We know the doctors that run late because they spend time with each patient, listening attentively, and the ones who cannot manage themselves if their practice depends on it. We know when doctors are late for emergencies -- because when it's an actual emergency -- the staff and doctor let you know. We know when are BSing us because you were late due to bad scheduling.

You actually could schedule 30 min appt per patient. You've just decided that it's not financially worth it for you.

Sure they could do this and charge you twice as much. And since doctors would see half as many patients, the wait time for an appointment would double. You'd just have something new to complain about.

Anonymous wrote:

Anonymous wrote:As a provider, I often run late because I actually listen to my patients.

If a patient complains about the timing, I apologize profusely and then do my absolute best to see them in 5 minutes or less. It is what they wanted me to do with the ithrrs, so that is what they can have.

I work in an obgyn field. Every time you read about maternal mortality and morbidity in the USA, or that it takes 10+ years to diagnose endometriosis (takes a 15-20 min detailed interview), I assure you these docs run on time.

I would love to have a scheduled 30 min appt to see each patient, but it is unrealistic.

And there you have it. It is "unrealistic" to expect responsible scheduling from doctors. You will get 10-15 minutes and be scheduled at the same time as 10 other patients. Anything else is unrealistic.
In what other field is this acceptable? Why do we permit doctors to treat their patients so terribly? The lack of respect is a slap in the face.

Your anger is misplaced.
Because of insurance, doctors can’t schedule that way and remain in business. That is why many are going to concierge. Please complain about insurance companies. They are the ones ducking up the system.

I'm used to waiting, but it does especially suck with a baby. You try to schedule the appt for when they are awake and don't need to eat and then you sit there for an hour while they get tired and hungry and as soon as you start nursing or they fall asleep the Dr is ready. It would help if they gave (accurate) updates on timing, but they never seem to know how long the Dr is going to be

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As a provider, I often run late because I actually listen to my patients.

If a patient complains about the timing, I apologize profusely and then do my absolute best to see them in 5 minutes or less. It is what they wanted me to do with the ithrrs, so that is what they can have.

I work in an obgyn field. Every time you read about maternal mortality and morbidity in the USA, or that it takes 10+ years to diagnose endometriosis (takes a 15-20 min detailed interview), I assure you these docs run on time.

I would love to have a scheduled 30 min appt to see each patient, but it is unrealistic.

And there you have it. It is "unrealistic" to expect responsible scheduling from doctors. You will get 10-15 minutes and be scheduled at the same time as 10 other patients. Anything else is unrealistic.
In what other field is this acceptable? Why do we permit doctors to treat their patients so terribly? The lack of respect is a slap in the face.

I see, you'd rather have a 6 month wait for a primary care visit. They squeeze in as many patients as they can see because the need is there. All it takes is one late patient or one lousy medical assistant to throw off the whole morning's schedule. I'm only in my 40s but I'm old enough to know that going to the doctor usually means a long wait. I always try to get the first appointment of the day when possible because these are usually on time.

I already need to schedule 3 or 4 months in advance. Not sure 6 months would make any difference.

It’s even worse when they make you wait in the examination room. One of those times, I gather my stuff and went to the hallway to cancel my appointment because 80 minutes had passed from my appointment time. I saw the doctor sitting relaxed in his office.

Anonymous wrote:

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.

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.

Lovely anecdotes you've got there.
I'd love to see some real statistics by someone other than an organization dedicated to keeping doctors in business.

Okay. Just to clarify -- published academic research showing an increase in negative outcomes would be convincing to you? Or are there other restrictions you have that we can get on the table before someone wastes time on it for you?

Absolutely. And the first two published academic research that came up on google were posted above - and show no negative outcomes. But I'd be interested in reading something different if you have it.

(For your convenience, here's the previous post with real research and not a reddit post)

rom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594520/

This review demonstrates that the involvement of nurses in advanced practice in emergency and critical care improves the length of stay, time to consultation/treatment, mortality, patient satisfaction, and cost savings.


https://www.ncbi.nlm.nih.gov/books/NBK384613/
This evidence brief discovered little new evidence regarding health outcomes of patients receiving care from an independent advanced practice nurse (APRN) or physician. In primary and urgent care settings, there was no difference in health status, quality or life, mortality, or hospitalizations favoring either APRN or physician care, although the strength of evidence was generally low

Anonymous wrote:The bottom line is that it would have cost the doctor nothing to start with something along the lines of "thank you for your patience" or "I'm sorry that we are running behind".

I had a similar experience with a doctor during my pregnancy who kept me waiting for 45 minutes (with a full bladder so they could do a sonogram) and then was a complete a$$ to me about it. And it turns out his office scheduled the appointment too early in my pregnancy and they couldn't do the test. I walked out of that appointment and never went back to that doctor.

+1 this

The healthcare system has a lot of problems. I would love to snap my fingers and fix them. In the meantime, doctors can still treat patients with a basic level of courtesy.