During my 30 years of practice, Our office has been trying our best to remedy this chronic problem with some degree of success, but some degree of failure as well. As I thought about the question, I realized that it has a multitude of answers and explanations, as anyone who has ever worked in a medical office realizes. When I run behind schedule, it makes me absolutely crazy. The patients are angry, the staff is harried and I hate feeling rushed.. Here are just a few of the factors, which add up to a most difficult problem:
1. Unpredictability – When I walk into a room to see a child, I have no idea whether that child will have a minor illness or a major problem. Most kids are healthy, but when they are sick, they are often VERY sick. All it takes is one of these complex patients to completely disrupt a patient schedule. It is not like you can tell a family that you don’t have enough time to admit their child to the hospital today.
2. Seasonality – If you come in the middle of winter, there are going to be lots and lots of sick kids. We rarely, if ever, refuse to see a sick child on a same day basis. While we leave open many slots for same day calls, and are open until 9 pm every night, if it is winter, it will be busier and you may have to wait longer. If you come in the summer months, it seems every child in the universe needs a physical for camp or school. Certain laws and misguided insurance company policies make this problem even worse. If you can do your check up any other time, please do so. In summer it will be busy, and you do not want to be told that you cannot have your form filled out because we are completely booked up. We try to hire more doctors when we seem busier, but when the crunch time comes, we just have to get the job done. You don’t want your child to be ineligible for sports or miss the first day of school.
3. Human nature – This issue applies both to patients and doctors. Some doctors seem to think that it’s OK if they are late, but not if the patients are late. Your doctor should show up on time and start on time. But patients are subject to human nature as well. No one wants to take their child out of school or miss too much work, so I am often sitting around doing nothing from 1-3 pm while it is totally swamped from 3-5 pm. It is kind of like rush hour. If you don’t want rush hour traffic, try to drive some other time. It is always busier on Mondays and after school than any other times of the week. If you have an infant, don’t schedule your check up in the late afternoon for the reasons above. Our office does time and motion studies to try to figure out where the problem lies. We have discovered that a good part of the problem (assuming the doctor is arrives and starts on time) is patients coming 10 minutes early or 10 minutes late. That doesn’t seem like much, but it has enormous impact on the ability to see patients in a timely fashion. This will blow the schedule out of the water and disruption builds as the day goes on. Believe it or not, if everyone actually showed up on time both doctors and patients, things would be a great deal better for everyone.
So, I ask all of you to try to understand. Running an office on time is better for patients and their doctors. Scheduling enough time to discuss the problem is critical. You cannot expect to have your child’s chronic stomachaches for the past 6 months be properly addressed in a same day sick visit. There is not enough time scheduled. A good doctor will make you come back and schedule enough time to evaluate your child properly. Most doctors hate running late as much as their patients do. If we all could try to understand the above issues and work together a bit better, we would all be much happier.
Dr. Lessin has been practicing Pediatrician in the Hudson Valley since 1982. He is a founding partner and serves as both Medical Director and Director of Clinical Research at the Children’s Medical Group