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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Woody Mann-Caruso Woody Mann-Caruso 11:32 pm 15 Sep 10

Do you need to go to uni to plan ahead like this

Yes, actually. An enormous computer helps, too. People write PhD theses on scheduling. It’s hard. NP hard, if you add time lags you can’t predict – you know, like doctors.

But please, share your solution. Start at 8am, finish at 6pm. How many slots do you set aside? How long is each slot? How long is your short appointment, how long is your long? How do you predict which will run over, and which will run short, and how do you manage this from appointment to appointment? When somebody calls and asks ‘how long?’, and you look at the waiting room and see 5 people, what’s your answer? Do you think it’s just a matter of saying ‘oh well, today we’ve been running at an average of 11 minutes, so about an hour?’ Because if you believe that I’ve got a roulette system you might like to buy.

Why, given the presence of a vast amount of research about the computational impracticalities of working out even fairly basic schedules that involve uncertainty, do you choose to believe that doctors – people with up to a decade of tertiary education, literally our brightest minds – are lazy or incompetent or both?

Don’t answer – I already know. “Well, I’m not a doctor, and have a grossly simplistic and inaccurate understanding of what’s involved in working out a daily schedule around unpredictable and unquantifiable uncertainty, but I’m convinced they’re all idiots. What they need is a good dose of my folksy common sense about how easy it all is.”

Woody Mann-Caruso Woody Mann-Caruso 11:38 pm 15 Sep 10

As for the dentist analogy: if everybody who went to the doctor needed a check-up of the same piece of anatomy, or one of a small number of consistent and predictable services to that same piece of anatomy, scheduling would be a breeze – particularly when diagnosis is separate to treatment. ‘You need a filling – come back Tuesday’. ‘You need a crown and two caps – come back Friday week’. Change your dentist to a model where people can rock up with something as vague as ‘I don’t feel well’, increase their scope to the entire human body, compound diagnosis with treatment, and chuck in the risk of life-threatening conditions and see how far you get.

It’s pretty obvious why you’re not a doctor.

JumpingTurkey JumpingTurkey 11:39 pm 15 Sep 10

@MrPC – I think triage system is not a bad idea, and there can be some innovative solutions to this problem of GP shortage if we had nurse practitioners and GPs working together. However nurse practitioners may not be a good solution either because more nurse practitioners means less nurses and currently we have a nurse shortage as well! Not only in hospitals but in nursing homes – and when I do my weekly rounds, I see nurses running around like headless chooks trying to take care of overwhelming number of residents.
I think the government has really got to try and entice more people into health professions in general – e.g. by increasing pays and improving working conditions for nurses and doctors in hospitals and also more men should be encouraged to enter nursing profession as well!

Leinna Leinna 12:20 am 16 Sep 10

Just because a doctor cares for the sick doesn’t mean he needs to take crap from a random person on a forum.

Good luck making your own health decisions.

You’ll need it. At least you won’t be wasting a doctor’s time.

JC JC 1:00 am 16 Sep 10

JumpingTurkey said :

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.

Actually we don’t needs doctors all the time, yet our system more or less forces us to see doctors. In the UK there are many services that can be done by trained nurses (as opposed to doctors) and it works. You say we need more doctors, but maybe what we need is to liberalise our views a little and consider other options to deliver GP services.

Also despite your ranting you have not explained why doctor surgeries in particular have such poor customer service. Yes different patients have different requirements and some will go overtime, but still no excuse for some of the policies that some surgeries seem to have in relation to this.

cleo cleo 1:41 am 16 Sep 10

Thanks Doc, There are alot of ungrateful pompous arses on here, I do appreciate the work you doctors put in here in Canberra, haven’t these people above heard there is a shortage of doctor’s in Canberra? I always ring in first to see where I am in the line, my doctor has told me himself how busy he is, and yes he does work non stop, when he’s finished with patients he does the paperwork that is required of a doctor. I was in Sydney on the weekend and needed an appointment with a doctor, I only waited 5 mins without an appointment, of course this was in Bondi, they have plenty of doctors there.

georgesgenitals georgesgenitals 6:17 am 16 Sep 10

When I read this thread I was so outraged I soiled myself a little.

BerraBoy68 BerraBoy68 7:54 am 16 Sep 10

Maybe it’s because I just pick good doctors or have just been lucky, but I’ve rarely waited more than about 15 min’s to get in to see the Doc once I turn up. Sometimes they can see me straight away even when I’ve been early! One exception to this was the old Melba medical centre many years ago, (80’s) when my normal GP wasn’t available. I made an appointment but still had to wait around 50 minutes because the nurse on the desk ran a triage systems where patients were prioritised. But even then, I was a teenager with a stuffed knee which even I could see didn’t compare with sick pregnant women or people with chest pains.

To the OP: maybe it was just one of those days for the Doctor. Did everybody that saw him have an appointment? Did they have more serious issues that required more time or were there just numerous queue jumpers, indicating a failed system? Knowing this could make a difference to your day.

pptvb pptvb 8:20 am 16 Sep 10

WOW!
Didn’t this get nasty?
My mate, a “Tradie”, turned up 10 minutes late to a GP’s house one day….the GP went off her nut!
“How dare he make her wait?”
“Do you know how valuable my time is??”
He just pissed himself laughing.

Woody Mann-Caruso Woody Mann-Caruso 9:14 am 16 Sep 10

Incidentally:

When you go to the doctor, and they’re running late – sometimes very late – it really throws your schedule out of whack, right? Maybe you have to cancel other appointments, or you’re late to other meetings, or you have to reschedule?

I’m sure the first thing that crosses your mind when this happens is ‘Wow, I’m so incompetent. Why can’t I plan ahead to take account of stuff like this?’ Somebody calls to see if you’re still OK to meet: you say you’ll be late, but you’re not sure how long, and they get on a website and complain about you, right?

Yeah, right. When one things throws your day out you’re hard done by. But when twenty things compound to throw a doctor’s day out, they’re an idiot.

‘Double standards’, indeed.

Thumper Thumper 9:21 am 16 Sep 10

My mate, a “Tradie”, turned up 10 minutes late to a GP’s house one day….the GP went off her nut!

A tradie that actually turned up?

On time?

Oh come… 🙂

Jim Jones Jim Jones 9:57 am 16 Sep 10

WMC, there’s a difference between events conspiring to make you late on the occasional basis – I think everyone is mature enough to realise that this happens and work around it.

But with many (not all) GPs, it has become the norm, rather than the exception. What’s worse, it has become so much the norm that the expectation is that patients should expect it. It’s a poor practice in any business, regardless of how much Western culture deifies doctors.

Kizzle Kizzle 10:15 am 16 Sep 10

I had to see a specialist and the waiting list was 2 months. When I got there I had to wait about 45 minutes. Then the 2nd appointmentwas 6 weeks later I had another appointment and had to wait an hour and 20 minutes 🙁

lobster lobster 10:16 am 16 Sep 10

nhand42 said :

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.

Hmmm would you happen to be wearing a tin foil hat?

BimboGeek BimboGeek 10:27 am 16 Sep 10

If I were a practice manager, I’d schedule the doctors for “study” from 2 to 3 each day which would be cut if they fell behind during the day. They need to read their Australian Doctor and MJA anyway, right? So why not put it in the middle of the afternoon when energy levels tend to drop a little, and they just won’t have the mojo to catch up if they’re behind time? There’s less pressure on them that way. This time can also be set aside for admin work, CPD, and other “doctor” stuff that happens behind the scenes.

I’d grant them a lunch hour if they were on time but only a half hour if they need to catch up.

Ideally I’d also segment appointments since the person getting their chronic condition checked up can wait but you need to save some next-day and same-day appointments for when someone suddenly catches the flu (or whatever).

Anyone else have any suggestions for how our doctors can keep their calendars running efficiently? Or are you just blowing off steam?

sirocco sirocco 10:39 am 16 Sep 10

I went to the Ainslie practice for years and would always be waiting around for appointments until I stopped making afternoon appointments – the soca are never late if you are booked for 8am.

Also, last time I was there $75 was for a “long appointment” one that was for 25mins not 15mins; so either they over-charged you or you inadvertently contributed to that day’s long waiting times.

And Sleaz274: General Practice is a specialisation, just like oncology or dermatology etc, many people after think cos it’s “general” it’s not a serious field of medicine with years of specialist training.

I now go to a new practice in Kingston where only younger people seem to go (Ainslie is so blue-rinse) it’s sooo much quicker, newer, nicer and the GPs there have come from other Canberra surgeries where I get the feeling they were tired of only dealing with oldies.

sirocco sirocco 10:41 am 16 Sep 10

I have no idea why the word “soca” was inserted into the third line of my last post – bloody iphones

JumpingTurkey JumpingTurkey 11:01 am 16 Sep 10

Hahaha yes sorry if I contributed to this forum turning ‘nasty’. I got a bit heated up last night because here I was as a GP working hard to try to take good care of my patients, and someone accuses me and the entire profession of being reduntant / useless and also driven by nothing but self-interest and desire to make a profit.

I think that the reason for doctors for running late is complex – it may be due to their fault, and some may think that they can run late deliberately because they are superior to patients. And this is unacceptable and unprofessional and ideally people should vote with their feet. However in many other cases they are running late for many other reasons.

However automated system for SMSing people automatically if a doctor is running behind seems like a good idea – and something that would be worthwhile mentioning to your GP next time you see them. Chances are that they probably don’t know that such a thing exists (I didn’t know).

Jim Jones Jim Jones 11:26 am 16 Sep 10

… and the big problem is that the argument ends up taking part in universal terms (i.e. ALL doctors do this, ALL patients are like this, etc.) when the truth is, like anything else, there are practices that spend a lot of time and effort on planning and effective patient management, and there are those that need to work at it a bit harder.

bikeshopgirl bikeshopgirl 11:28 am 16 Sep 10

I had to check it wasn’t my other half who posted this, as it is a hobby horse of his. (Don’t these people know how valuable my time is, etc.) The time we had to wait for two hours to see our obstetrician I nearly wet myself at his rant – although to be fair that was mainly due to the 800mls of water I had to drink beforehand so that the ultrasound would be effective.
As he knows, if you want to go somewhere else, no-one is stopping you; if you think the health system in the ACT has been appallingly managed for too long, and that we need more doctors, better pay for all health workers & proper parking at TCH, well then tell your local pollies. And don’t stop until they do something about it. Above all, don’t take it out on your GP and their staff. That will get you nowhere. It’s not their fault there aren’t enough GPs to go around. Jon and Katy, however…
P.S. There is one doctor in Canberra who won’t see you if you’re 5 mins late to your appointment, as I have learned to my chagrin – never keep a certain allergist waiting!

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