Do you have an appointment? Yes, but you’ll still be waiting.

schmeah 15 September 2010 125

A recent experience at an Ainslie practice recently has left me pretty pissed off at the treatment of people who make appointments, keep them and yet are still expected to wait inconveniently long times for the other half to come to the party!

I had a scheduled appointment for 4 pm to see my doctor. Being retentive about making appointments and turning up on time, I rocked up at 4 and was told that said doctor had ‘1, 2, 3 oh no, 4’ patients ahead of me still waiting. I responded politely saying that I had left work early at 3:30 to make the appointment and it would have been equally polite for the surgery to call me and advise me that my doctor was so far behind schedule. I was told that ‘we don’t do that here, would you like to go away and come back in 40 minutes or stay’. Failing to see the attraction of waiting in a room full of sick people for 40 minutes, I said I’d come back.

So, turning up at 4:45 (5 minutes late I know) I was told that the doctor now had 2 people in front of me and ‘please take a seat’ – having already come from work to the doctors, gone home and returned I failed to see the benefit in going home again. So I waited, a full 30 minutes until my name finally got called .. at 5:15 pm a full hour and 15 minutes after my appointment time and nearly 2 hours after I had left work.

As I was leaving said Doctor’s office about 10 minutes later I politely stated that my appointment was at 4 pm and I didn’t get in until 5:15 pm, ‘could I please just pay the gap and be gone’. Perhaps I was stupid to think that an inner north doctor would be sympathetic to my situation because to say the least said doctor got snarky. I was told – ‘I’m not in here on holidays you know, I work hard, I’m thorough with my patients and I appreciate their patient, it’ll be $75’. Shut door.

Well said: I’d like you to note that, I too am not on holidays – in case my work clothing looks like theatre costume – I came from work to keep my appointment, leaving a full 90 minutes early. It’s very obvious that you are thorough with your patients, this is admirable, but perhaps in order to remain so diligent with their treatment and to not piss off you other patients you might like to expand your consultation times out by 10 minutes because the current system is obviously not working. Further, I am patient like everyone, I’ve waited 10 minutes here, 20 minutes there to see my doctor and I’ve never found this time lag inconvenient, it’s almost expected (sad as it is). Said doctor’s attitude was totally perplexing and offensive to say the least- I, and I imagine other patients have lives outside of the off visit to the doctor – I don’t expect to make an appointment, turn up on time and be told I will have to wait over an hour to get in – forgive me for not calling in advance but really, shouldn’t that be the surgery’s job?

When I went to pay – the full $75, I asked quietly – (even though the waiting room was empty except for one poor man who’s appointment no doubt was scheduled for 4:30) ‘is it the policy of the surgery to not contact patients when their doctor is running more than an hour behind?’. I was given the response that ‘we don’t have the facilities to do that here – we do however recommend that patients call ahead .. Just in case’

Right, so what you’re saying is that – I have to do your job for you, not only do I have to wait more than a week for an available appointment time with said doctor, I also have to call on the day to make sure everything is chugging along happily and I can expect to get in on time. Does that phone next to you work by the way? When it rings, and you answer are you just talking to yourself?

Rubbish!

I was completely outraged by this situation, that I had to wait so long beyond my appointment time to get in and then be told that in the future, it’s my job to call ahead. Unless you’re dying .. I would say go to a doctor elsewhere because the phones at this practice don’t work.

Oh goodness, is that the time? I have an appointment with my bank manager in 2 hours, I should call ahead now to make sure said manager will be available at 4 pm, like I arranged for.


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125 Responses to Do you have an appointment? Yes, but you’ll still be waiting.
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JumpingTurkey JumpingTurkey 11:14 pm 15 Sep 10

@nhand42: first of all, you are not my patient, and you are the one who started accusing me of not knowing logistic regression / and then accused me of being a cast member of wizard of oz.

And I’ve never wrote anything about ‘common people’ – these are your quotations, not mine. Have a look through my post and all I have been doing is responding to your comments that doctors are simply there to profit out of patients, and that you are capable of making medical decisions without seeing a doctor. And seriously you have got to read things into context – the point about the long GP training is made in order to compare how much dentists get paid (relative to their shorter years in training).

You are right – I am showing you an attitude but you are wrong – my attitude is directed only at you, who reduce our hardworking doctors (and many other health professionals) who have spent many years of training and spend many hours in order to primarily help other people into bunch of money hungry blood suckers.

As for your information – yes I don’t know much about logistic regression and yes to be honest I did not see the divided by 2 there – assumed it was 40*75. However I do not claim to be an expert in logistic regression and I am happy to be corrected.

However if you kept on believing and insisting that you don’t need doctors and you can make all the health decisions without them, then what else are you but a fool? In case you are going to quote me out of context again, note that I have never said that doctors are making decisions for you – I am simply insisting that for important medical decisions, you need their input and advice – and if you were a reasonable person I am sure that you’ll agree to this.

nhand42 nhand42 10:43 pm 15 Sep 10

JumpingTurkey said :

If I am from wizard of Oz, then you are a FOOL.

What a wonderful bedside manner you have, doctor. This discussion started because of a rude doctor who believed his time was so much more valuable than his patient (!) customers. It was that condescending attitude from the doctor that got the OP so fired up. It is such expected behaviour from doctors; they can’t wait to tell you about their 6+3 years training, and how all the uneducated “common people” couldn’t _possibly_ hope to diagnose their own ailments, and as such the uneducated people deserve to wait for the judgement of the mighty doctor, and then arrogantly dismiss any dissent because (in your own words) the dissenters must be “fools”. This holier-than-thou attitude is unfortunately all too common amongst doctors.

An attitude which you so aptly demonstrated in a mere half dozen posts. Impressive. Some sort of record I suspect.

And as you’re the person who couldn’t even follow the maths behind 40*75/2, you really should be more careful throwing the word “fool” around.

MrPC MrPC 10:36 pm 15 Sep 10

Short term solution: Stuff the small time GPs. Take a slight interest in how to summarise your medical history in a few sentences and take your chances with the roulette wheel of doctors at the Ginninderra or Phillip medical centres.

If you don’t want to pay the $30 gap upfront, or wait 2 hours, then go to the Walk-In centre in that gully next door to Emergency at TCH, which is free, but is primarily staffed by nurse practitioners.

Long term solution: Since we will never train a significant number of GPs (it’s an ineffective model of care as it isn’t scalable) then the powers that be need to train up nurse practitioners to act as both triage and minor duties. If the nurse practitioner thinks you aren’t there to have a free 15 minute chat on medicare’s dollar (as many pensioners and health care card users do regularly) they will be able to intercept the geezers and keep the real doctors free to quickly take the consultations for those who are actually sick.

JumpingTurkey JumpingTurkey 10:20 pm 15 Sep 10

@nhand42: You’ve got to learn to read quotes in context – you’ve selectively quoted what I wrote:
“nhand42, if your attitude is that way to doctors, then basically you are saying that you think that you are capable of making all the decisions yourself so you can determine what disease you have, you can examine your own body, you can make decisions on best treatment options, and you can prescribe yourself and be able to work out how you can monitor yourself for side effects? I really doubt that you can sustain that attitude and philosophy throughout your life.”
I don’t think that anyone of sane mind would think that one can make informed decisions about things that they have no idea about without getting advice from experts – e.g. I’m a complete fool if I actually believed that I could sue somebody without getting advice from a lawyer, or if I thought that I could treat my dog’s sore ear without consulting a vet first. If I am from wizard of Oz, then you are a FOOL.

JumpingTurkey JumpingTurkey 10:16 pm 15 Sep 10

@nhand42 – this is unfair – I am sure that you won’t be kept waiting at all if the GP could charge you the same amount as your dentist does – who knows how much they charge – mine charges something like $200 for a 20 minute appointment where they do the same thing – inspection of teeth, scaling, and then tooth whitening – and if you could continue opening your mouth during the consultation so you can’t actually speak to me and thus make the time tick past.
And this is for a dentist who requires 5 years of university training and no internship – vs 6 years medical school for a GP + internship + residency + 3 years of GP training.

And you go on and on about $75 but don’t forget that you get $35 back from medicare.

nhand42 nhand42 10:08 pm 15 Sep 10

OpenYourMind said :

how come I get consistently good, if expensive, service from dentists.

Same experience here. My dentist is always on time. Never keeps me waiting. Always quotes accurately. Keeps me informed. And his entire staff are polite and professional. It’s an absolute delight going to the dentist.

Contrast this with the experience of the OP; hour and a quarter wait, unhelpful receptionist, a rude doctor who slams the door in his face, and then a $75 charge for a 5 minute consult. Unbelievable. Name and shame.

JumpingTurkey JumpingTurkey 9:51 pm 15 Sep 10

@openyourmind
You know what the difference between vets and humans are? The vets charge you $90 for a basic consultation and then they sell you medications for a huge mark up – I’ve had my cat who was constipated and it cost us $1000 to fix him up… no kidding! And no one complains about money you pay to vets… If I could charge $90 for a consultation and then sell you a box of panadol for a 1000% markup then I’d be more than happy to see only 2 patients per hour…

As for your comment regarding GPs skills lying between nurses and specialists – well its because of attitudes like yours that result in doctors not wanting to enter general practice, and research clearly shows (landmark research by Starfield and Shi – google it if you are not sure) that strong General practice system and strong primary care health service is a much stronger predictor of good health care outcomes in a community or a country – whereas strong specialist or tertiary health sector is NOT a good predictor of good health outcomes – in fact it often works in reverse believe it or not in case of US.

nhand42 nhand42 9:47 pm 15 Sep 10

JumpingTurkey said :

nhand, your arithmetic is wrong because you are assuming that all 40 patients will be waiting 75 minutes each – when most likely only people towards end of the day (or morning) will be waiting that long.

Nope. I used 40/2 which is a linear progression from 0 minutes wait for the first customer and 75 minutes wait for the last. Try and keep up.

JumpingTurkey said :

nhand42, if your attitude is that way to doctors, then basically you are saying that you think that you are capable of making all the decisions yourself

If your comment says what I think it says, then basically you are saying you think you are a cast member in the Wizard of Oz.

OpenYourMind OpenYourMind 9:32 pm 15 Sep 10

I know somewhere you can visit where appointments are kept, you get cheerful highly qualified medical staff and your business is important. The only catch is you’ll need fur, feathers or scales. I still recall taking a dog to our vet with an injured paw. The whole practice was genuinely concerned, they did examinations and x-rays on the spot, were careful not to hurt the boy and rang up that night just to check he was still ok. Why do we get this with our pets, and yet we humans get treated like cr@p by GPs? And before you say, well they’re just a vet, how different is it really? and also, if being human is really so different, how come I get consistently good, if expensive, service from dentists.

GPs aren’t even that special if you ask me. Half the time they are dealing with something that a nurse could diagnose and prescribe for, the other half they refer you to specialists. Ok, maybe there’s a tiny bit in the middle of those two halves where they actually do something other than d1ck you around. RiotACTers bitch about taxis needing to be de-regulated, hell let’s do something to open up the closed shop medical profession.

Leinna Leinna 9:32 pm 15 Sep 10

@nhand42

What? A GP gets to drive a BMW and have yearly European holidays??

Wow, I should have signed up to be a GP then, because, y’know, my father is a rural GP (no bulk billing there), and he drives a Mitsubishi, and I think the furthest I ever went as a kid was the coast. And he runs behind time. And then he does home visits so he’s not home until 8 pm. And my mum yells at him for missing dinner. And then he has to go BACK to work to finish off all the paperwork which he didn’t do because he was too busy seeing patients.

Yeah, great life there.

He’s totally in it for the money.

JumpingTurkey JumpingTurkey 9:22 pm 15 Sep 10

nhand, your arithmetic is wrong because you are assuming that all 40 patients will be waiting 75 minutes each – when most likely only people towards end of the day (or morning) will be waiting that long.

nhand42, if your attitude is that way to doctors, then basically you are saying that you think that you are capable of making all the decisions yourself so you can determine what disease you have, you can examine your own body, you can make decisions on best treatment options, and you can prescribe yourself and be able to work out how you can monitor yourself for side effects? I really doubt that you can sustain that attitude and philosophy throughout your life.

nhand42, there are some doctors who does treat patients like customers and are in it for money. But this is the case for all professions – what profession is exempt? Clergy, politicians, accountants, lawyers, nurses, pharmacists – you could go through every single profession or occupation in the land and you could argue that all of them are out to get you or are dodgy. However most doctors and GPs that I know do care about patients – especially to those who do need our help the most – people who are seeking our help with depression or mental disorders, or people who don’t have anywhere to turn to, or people with multiple chronic illnesses who take a gazillion medications, people with chronic pain, people who genuinely cannot afford to pay.
I suspect that you are someone who has enjoyed a quite a healthy life so far so you probably have never found a need to form a long trusting relationship with a GP, and so you obviously have absolutely no idea on what GPs do or how much GPs care for their patients.

I don’t know of many other professions willing to continue to do home visits (bulk billed) and nursing home visits (bulk billed and medicare is very stingey with these) for elderly patients who really cannot afford to pay and are unable to come into surgery. Whatever profession you are in, are you willing to do that???

The Frots The Frots 9:17 pm 15 Sep 10

Great to see that this subject is getting some air time – and lively debate. Alas, I’m on the side of Schmeah for this one.

We have had to wait……………..wait for it……….3.5hrs to see a specialist in the inner north. And this isn’t an unusual time wait for this particular surgery. And we are not alone. I have seen patients walk out, shout out, come out…….in some cases I am sure we’ve celebrated birthdays in the waiting room such has been the length of delays.

Oh sure, the doctors a busy man/woman…….the doctor is thorough, the doctor sees everyone, the doctors this and what have you. BUT SO ARE WE!

As someone said, we are busy also. I asked a receptionist once where I could send the bill for my time (after a wait of 2hrs or so). By the way, in this case humour in a waiting room doesn’t go down that well.

But there really needs to be a solution…….this waiting, waiting, waiting really is poor.

nhand42 nhand42 9:11 pm 15 Sep 10

Noezis said :

Do you even know how a doctor’s surgery works?

As a patient he shouldn’t have to know. The doctor does know and he should schedule accordingly. Why should the patient be expected to know the inner machinations of a doctor’s practise?

Why is it that every other industry understands the phrase “Customer Focus”, but doctors think they’re oh-so-special that they can keep treating us like crap? There’s only one answer; because they can get away with it. Every visit to a doctor involves a rude receptionist, an even ruder doctor, and an obligatory 1-2 hour wait. If any other business treated you like that you’d go elsewhere.

Even Telstra, the best example of useless customer service in Australia, has achieved the impossible. My last experience with Telstra was … and God forgive me for saying this … PLEASANT. They’ve completely changed direction in the past 12 months. No doubt because they were losing customers to their competitors. If Telstra can do it, why can’t doctors?

JumpingTurkey JumpingTurkey 9:11 pm 15 Sep 10

As a practicing GP (who knows, maybe the very surgery you are all talking about??!!) I can see that many people are upset by long waiting times. And of course I could understand that no one likes waiting – including myself – for instance if it took the waiting staff 30 minutes to get me a menu in a restaurant.

And in some cases yes you have a genuine cause for complaint – doctors do run late for personal reasons or they come to work late or they take a longer lunch break, etc. And this is not professional and you should vote with your feet – ideally – and find someone else who is willing to treat their patients with respect.

But in other cases as many people in this forum have pointed out, being late is often beyond our control. This is especially the case due to GP shortages in Canberra. Most GPs are booked out, so its not as if we can choose to see less patients – if we did then everyone would have to wait longer to see GPs – not just 2 hours, but 2 days, even if you wanted to see someone urgently.

If patients are booked in at 15 minute intervals, then some people will finish early and some people will finish late. But if one finishes early, then often the next patient has not arrived yet, so the doctor will not be able to run earlier than time. However if one finishes late, then this will become reflected in every single patient afterwards until there are a couple of patients who only take a few minutes each. And often people who have waited for 2 hours will want to see their GP for longer – and feel that they deserve to – meaning that patients after them will need to wait even longer. And many patients simply take longer, and this cannot be predicted in advance. If someone rocks in and then starts to cry spontaneously (and this happens on average once every couple of days) then our heart sinks as this automatically takes at least 45 minutes, and you’ve got to be kidding if we can somehow predict this in advance and limit the consultation to 15 minutes.

And the suggestion about making changes to appointment system from 15 minutes to something longer – while this will make it more convenient and reduce waiting times, this will effectively reduce the number of patients a doctor can see in a day – thus putting additional pressure on doctor shortages. And also this will mean that doctors will increase their fees – and no GP in their right mind will book in 6 patients per hour as someone here suggested, but they book in 4 patients per hour, and no its not $75 per patient, but believe it or not I think that at least 25% of my patients are bulk billed – those who really cannot afford to come to see me I choose to bulk bill them and I think many GPs do this too – I just don’t advertise this fact because if I did then I’ll get everyone asking to be bulk billed (like many of you lot in this forum who I suspect can easily afford to pay a doctor as you’d be willing to lay off $100 easily on a Friday night on dinner and drinks but are too cheap to spend $35 out of pocket to see a doctor).

The solution is that we need more GPs, plain and simple. These kinds of problems don’t happen in inner city Melbourne or Sydney because they have enough GPs to service the population. So let’s stop blaming the GPs, and let’s focus on the real issue of getting more GPs into Canberra!

nhand42 nhand42 8:50 pm 15 Sep 10

Doctors are selfish. Simple as that.

Think of it this way; 5 customers per hour, 8 hours, that’s 40 patients with an accumulative delay by the end of the day of 75 minutes. So an average is 40*75/2 = 1500 minutes of wasted time by the customers. That’s 25 wasted hours per day.

This is all so the doctor can charge for 40 customers per day rather than 35 customers per day. Those extra customers pay for his BMW, his yearly holiday to the Mediterranean, and his expensive golf club fees. He couldn’t care less about you; he’s counting his money. He could solve the problem by reducing the bookings per day by 10%, but why would he do that when you’ll wait anyway?

Notice how I kept saying “customer” rather than “patient”. That’s because doctors run a business. They’re in it for the money. And that’s reflected in the obnoxious way they treat their customers by packing us in like sardines and disrespecting us when they can’t keep to their own damned schedule. Imagine if we turned up 75 minutes late and demanded to be seen. Simply wouldn’t happen.

Screw the doctors. The only reason we have them is because the law says we’re not allowed to prescribe the actually useful medicines to ourselves. So the doctors have a monopoly on prescribing medicine, which means they get to set the rules and the fees, and the whole corrupt system flows from that.

Special G Special G 8:40 pm 15 Sep 10

It’s an in demand service. Times blow out. You can always go and wait in Emergency at the hospitals.

MrNurseRatchet MrNurseRatchet 7:58 pm 15 Sep 10

I can understand your being frustrated…but did you feel as if you got a quality consult? If so, please consider that he (or she) was providing that same quality consult for you as he was for other patients that were likely just as or more complex than your presenting problem. He/she was likely just trying to provide decent care and his commentary was a result of frustration with people not appreciating how hard he was working at trying to make sure that he was spending an appropriate amount of time with each patient. And anyway: WHO SAYS that a doctor’s consult has to be 15 minutes??? I would like to think the doctor (or nurse) will spend as much time as necessary to ensure that I get the correct assessment, diagnosis, and treatment…regardless of the queue waiting outside the consult room.

schmeah schmeah 7:48 pm 15 Sep 10

The suggestion is not that doctor’s should practice 7 minute medicine, but instead allocate more than 15 minutes for each patient especially if it’s a regular happening at certain times (flu season) or with certain people. Do you need to go to uni to plan ahead like this and to know that people don’t really like waiting for excessive periods – and yes I call 75 minutes with an appointment close to excessive (if I was at the Canberra Hospital, I’d probably be pretty happy with that turn around).

I appreciate that people need time with their doctors and this doctor is clearly happy with their thorough treatment (but apparently it was OK to stand up halfway through my health questions, indicating that my session was over – I guess you have to make up 75 minutes where ever you can and the kids no doubt still at the baby sitters waiting to be picked up) but if it means sick people are all sitting around breathing each others funk, or people have to reschedule the rest of their day and parents which restless children are waiting for long periods, then maybe we should all just go and wait at the Canberra Hospital. It’ll take only twice as long and not cost anything.

If a doctor ordered a sandwich from me and I took an hour to get it to them, would they be happy with the ‘I’m not on holidays in here’ attitude? I’m sure they wouldn’t take it very well at all.

I don’t see why everyone thinks it’s ok for Doctors to disregard people’s time and bookings in this manner -do you turn up to meetings an hour late and not even apologise to the people you left waiting – because I never got one? If your taxi turned up an hour late and you missed your fight would you be upset? Or are you happy to just spend your living hours waiting for other people to finally get around to meeting their half of the arrangement, and to hell with other plans you had made, jobs you had to do, kids you had to pick up or dinner you wanted to cook, or roast you left in the oven because your doctor .. your precious, above basic expectations doctor was too busy to see you at the right time, or to rude to advise you to make another appointment.

schmeah schmeah 6:56 pm 15 Sep 10

apologies J Jones – my post was directed at VG who seems to have a bottomless tolerance for doctors not keeping appointments – although apparently, only having waited 6 minutes with a sick child .. yeah, not sure what part of my ‘I’m happy to wait 30 minutes’ statement didn’t register there.

Woody Mann-Caruso Woody Mann-Caruso 6:52 pm 15 Sep 10

So it’s okay for GPs to constantly be running late and have people waiting for hours on end because … they’re busy?

Try it yourself. Divide your day into 32 discrete 15 minute chunks, a different task for each. See how long it takes you to slide. Now your day is halfway as complex as a doctor expected to practice 7 minute medicine.

You can fight it, or you can make assume you’re going to be late, make an appointment for earlier than you need, and call ahead.

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