My husband recently went to a new doctor and had to wait over 40 minutes for his appointment. This was especially frustrating for him because his car was at a meter. And when he told the doctor that he was in a rush, the doctor just continued to make small talk with him about his work and life, and didn't even really address the problems for which he was seeing the doctor.
Anyway he later emailed the doctor to complain about this. This was the doctors reply:
I wish you the best with your new physician. If you change your mind and wish to return for my care then I will try to give you the best but don't count on my being routinely on time. From the time I first became a physician I have known that to provide the best care to my patients I need to be engaging, persistent and creative. I cannot provide the quality of care my patients expect and which I believe is necessary by becoming a rapid throughput doctor. There are plenty of doctors available who are almost never late. I can guarantee that they are not providing the best care. The vast majority of my patients very much appreciate the extra time I spend with them, including what you described as "chatting." which is really part of engaging. Often they bring their laptops, their work, their books and their music CDs with them. Or, they reserve the first visit of one of my sessions when I am most likely to be on time.
Hmmm....
I have mixed feelings about this. As a patient with a rare, complex chronic illness, I would pretty much kill for any doctor who wouldn't treat me like a number, and I would certainly be willing to tolerate his or her running late if it was due to that physician spending quality time with each patient. If just one doctor had been truly engaged when I first fell ill, and they weren't always in such a goddamn rush to get me out the door within a certain window of time, I don't think that it would have taken me years to have been diagnosed. They all made snap judgments about my symptoms, as well as who I was as a person, which made it nearly impossible to convince them that their conclusions and diagnoses were wrong. The first doctor who finally sat and listened to me, and who spent time getting to know me, is the one who finally started figuring out what was actually wrong.
ReplyDeleteBut if your husband didn't even get his problems addressed after waiting all that time, then that's a whole other story. I think it also makes a difference if your husband is relatively healthy v. a chronic patient. I would probably be less tolerant of late, overly chatty doctors if I didn't have any serious health problems and was merely going for wellness checks or treatment of minor ailments, in which case I would have a much higher expectation of having my time respected.
I see two problems 1) not addressing what the patient was concerned about, 2) the mismatch between the doc's goals as a physician (i.e., engaging, "chatting") and the scheduling. The latter is easily worked on, the former is not acceptable. The most important person in the room is the patient, and if that means being "engaging" then do it but if it means "I'm in a rush, look at X please" then do it and skip the chat. Such blatant disregard of the patient in the name of the patient ("engaging") is simply inexcusable.
ReplyDeleteFor your husband there is only one solution: find a new physician.
This just happened to me on Thursday. I waited for an hour before getting in to my appointment. And yes, I was parked in a meter (pretty much the only available parking), plus I had a baby with me so I was really anxious. I'm hoping it's not a pattern, just that she was busy and behind that day.
ReplyDeleteFrom a Quebec's (canada) resident perspective, I find this somewhat.. cute.
ReplyDeleteIt shows how different our health care systems are. Waiting 40 minutes here is considered being lucky. We regularly wait over one hour to see a doctor, even with an appointment. If we have to go to the emergency department, we can easily wait 15 hours unless we have a life threatening condition (then you get to be seen immediatly). That's the "price" we pay for free access to the best threatments and care without regard to our capacity to pay.
I just find interesting to see how our opinion on a 40 minute wait can diverge depending from which perspective you look at it.
If something unforeseeable comes up then running late is understandable, and if running very late is the norm where you are, then at least patients can expect it and plan accordingly. Around here <15 min wait is typical.
DeleteI was in the office already when he first arrived at ~9am. His first patient was a 20 min slot that took 40 mins. His second patient was another 20 min slot that took another 40 min. Then with me he started asking me about my job, etc. after I told him I was in a rush. He isn't late b/c of unforeseeable things popping up; This guy just can't help but shoot the shit w/his patients. If he really thinks it is necessary to proper care then he just needs to schedule patients further apart so they know the real time they should come in. That was the first thing I said in my email to him, which he conveniently ignored. It serves absolutely no purpose to pretend you can see patients in 20 min but routinely take 40 min.
Well I have to agree with that, if he wants to always take 40 minutes per patient he should indeed schedule that much time.
DeleteIn response to DrMistics comment about Canadian healthcare, I'd like to point out that as with most healthcare, it depends on where you live. I live in BC and have no problem scheduling appts or getting in to see my Dr. He's on time most appts and if he's not, I like him and take the view that someone must have really needed more attention and threw off his schedule. I have taken my 83 year old mother to the local ER several times this year (non life-threatening) and each time she has been treated quickly and professionally.
DeleteI lived in California for a few years -- in fact my daughter was born there. We paid $600 per month for my healthcare coverage (not my husband's) and another $400 per month once my daughter was born. We couldn't find a doctor within 10 miles who took our plan. There were hundreds around -- available to take patients -- but only those in our plan could take us (the plan was dictated by my husband's company). The paperwork, extra fees and stress from worrying about misinterpreting something and potentially ending up paying thousands of dollars in costs was part of the reason we returned to Canada.
I could understand how some pts would prefer this guy, personally I'm not looking for a friend in my doctor. However, he should schedule more time for each patient rather than waste everyone else's time.
ReplyDeleteOMB. Totally unprofessional. I wish doctors would say their "philosophy" up front. Jerks like this ...
ReplyDeleteI would much prefer this kind of doctor to some that I have seen recently. They interrupt, put words in my mouth, don't listen or respect me, judge me, then bill for "counseling" not done. First and last appointments with them. I can wait, I have my ebooks, smart phone. Don't make ASSumptions about your patients, LISTEN to them and let them finish their sentences.
ReplyDeleteFunny, but for all his big talk, this guy also interrupted me (with useless opinions that were unrelated to medical care), assumed I had complaints that I never made (and put them into my medical record as my complaints!), and, as Fizzy said, he didn't wind up addressing my initial reason for the visit!
DeletePerhaps this Physician should have gone in to Psychiatry.
ReplyDeleteHowever, on second thought.......
ReplyDeleteDifferent doctors have different styles. Back when I was doing primary care, I often ran late because I had complex patients with multiple issues, and when we were done dealing with what they wanted to address, we still had health issues that actually needed to be addressed (e.g they wanted to talk about their chronic foot pain, and I needed to discuss their out-of-control glucose). The problem with clinic medicine is that you can't always predict how long a patient takes. If my first two "quick" postpartum visits end up having feeding difficulties and/or depressive symptoms, then that's gonna push me back, and my 3rd patient is unfortunately just going to have to wait, meter or not. I think the best thing is for Mr. McFizz (or any patient who values punctuality above all else) to find another doctor, as there are many of us primary care docs who simply cannot offer that.
ReplyDeleteFinding a doctor that suits your style can be so hard, I now drive four hours to see mine (I admit the issue is more a cultural one for me though, I accept that and work around it). Chatting about mundane stuff? Not one of my requirements, I have friends for that.
ReplyDeleteThis guy sounds like a real jerk - and I think that's the heart of the problem more than the wait time per se. The reason for the wait time is this guy is a jerk who likes the sound of his own voice. I spent some time shadowing a lovely family doc who was routinely late. It made ME nervous and upset, especially for one patient in particular who clearly had difficulty taking time off work. The upside? She was a REALLY GOOD doctor and took extra time with patients who needed it. When patients didn't, especially when they expressed frustration with her lateness, she apologized sincerely and helped them cut to the chase.
ReplyDelete"There are plenty of doctors available who are almost never late. I can guarantee that they are not providing the best care."
ReplyDeleteThis thing, to me, makes him a total asshole. As he painted himself as an egocentric asshole, the rest of that email means nothing.
The fact that he ran late should be forgivable. Stuff happens. But once in the room with Mr. Fizzy, "engaging" should mean listening to the patients needs. Per the story, Dr. X didn't listen to Mr. Fizzy's concerns and pick up the pace. The response email is so passive aggressive it's ridiculous. Good riddance.
ReplyDeletewas the guy just trying to take a social history? i've had people flip out on me when i do their intake interview for my general practice.
ReplyDeleteI've been with my PCP for 15 yrs., and her willingness to slow down and chat was one of the things I found most appealing about her. She's also not averse to moving it along if I'm suffering an extreme - pain, sick, etc. or if I tell her I'm in a hurry. I guess that's why I've stayed with her so long. She's intuitive and attentive without being annoying or condescending. Apparently, I'm very lucky.
ReplyDeleteOh, and I will always try to schedule first of the day or first after lunch break if I want to be seen right on time. That is for things that are not emergent issues.