Doctors That Overbook

[Walter123]

What is so freaking special about doctors that they are allowed to get away with overbooking and making us wait an hour or longer. Then they hustle you into another room to wait even longer. I challenged the receptionist, then the nurse then the doctor after waiting 45 minutes yesterday. The receptionist said my chart was mixed up and she was sorry. This was after I heard her tell someone on the phone that the doctor was not in the office yet. The nurse said they were running slow (I had a 9:15 appointment and they open at 9. The doctor said he was sorry and that his staff double booked. I guess we have to live with it.

[graciegirl]

I just take a book or save the newspaper. I try not to **** off people who write my prescriptions. I have one doctor that is always an hour late and another doctor who is on time and I was five minutes late and got a lecture. Doctors were almost always close to the appointment time back in good ole Cincinnati. sigh.

[perrjojo]

Perhaps they were double booked because a patient had an emergency....being late to work? Well I guess that's his bad.

[Flyinglady]

I have had 2 appointments with Dr. Ballingit and have walked out on both times because I was kept waiting for 1/2 hour, now I have to find a new doctor.
It wouldn't be quite so annoying if the staff kept the patients informed as to what was going on, a simple "Doctor is running about an hour late" would solve a lot of problems, one could leave an them come back rather than be left uninformed in a consulting room.

[Number 6]

In a medical office the scarce resource that has to be managed is physician's time. If it comes down to the physician or the patient waiting; well, the patient loses. Given the shortage of physicians, this is just an issue of supply and demand. Airlines and hotels overbook all of the time. Same reasoning.

[biker1]

You might be willing to justify and accept bad behavior by medical offices but I am not. It is rude and unprofessional and the only reason an office gets away with it is because patients roll over and let them. I will allow that emergencies happen but that is not what we are talking about. Class operations, such as the Mayo Clinic (where I have been more than once), do not keep patients waiting because they do not overbook. My limit is 20 mins and then I will leave. My last Dr. didn't keep me waiting, ever. We will see how it plays out here in The Villages but my one visit so far (to meet the Dr.) was on time. My two dental visits so far have been on time. If you want to put medical offices up on a pedestal and let them waste your time that is your business but please don't suggest that it is normal or acceptable behavior for the rest of us because it isn't. By the way, airlines and hotels do not overbook "all the time". In fact, overbooking by airlines is now a relatively rare event, which is actually too bad as I enjoyed volunteering in the past for a free ticket. Regarding hotels, I have only seen it once in the 20 years when I traveled frequently for business.

In a medical office the scarce resource that has to be managed is physician's time. If it comes down to the physician or the patient waiting; well, the patient loses. Given the shortage of physicians, this is just an issue of supply and demand. Airlines and hotels overbook all of the time. Same reasoning.

[onslowe]

I have mostly accepted the fact that I will have to wait in a doctor's office.The reason or reasons for the wait is beyond my control. I too bring a good book and 'go with the flow' as much as I can. I try to never schedule two medical appointments for the same day lest I get crazy with time elements.

I do get antsy when I cannot read due to inane and annoying day time television shows blaring away in the doctor's office with hair trigger and senseless prolonged clapping and standing ovations at the drop of a hat. That's when long waiting becomes torturous.

[CFrance]

You might be willing to justify and accept bad behavior by medical offices but I am not. It is rude and unprofessional and the only reason an office gets away with it is because patients roll over and let them. I will allow that emergencies happen but that is not what we are talking about. Class operations, such as the Mayo Clinic (where I have been more than once), do not keep patients waiting because they do not overbook. My limit is 20 mins and then I will leave. My last Dr. didn't keep me waiting, ever. We will see how it plays out here in The Villages but my one visit so far (to meet the Dr.) was on time. My two dental visits so far have been on time. If you want to put medical offices up on a pedestal and let them waste your time that is your business but please don't suggest that it is normal or acceptable behavior for the rest of us because it isn't. By the way, airlines and hotels do not overbook "all the time". In fact, overbooking by airlines is now a relatively rare event, which is actually too bad as I enjoyed volunteering in the past for a free ticket. Regarding hotels, I have only seen it once in the 20 years when I traveled frequently for business.
My thoughts exactly. An occasional wait is tolerable, but if I knew I had to take a book and read for an hour, I would find another doctor. My current doctor and dentist do not overbook. My dentist, Dr. Novak at Bushnell Family Dentistry, is extremely punctual, as are the hygienists there. Add a very nice staff into that mix, and it's a model office that doesn't treat its customers like cattle.

I have only once waited longer than 20 minutes for my family doctor, who then apologized profusely.

[biker1]

We also go to Bushnell Dentistry and I could not agree with you more - very nice practice and it gets my wife's stamp of approval - she is a retired dental hygienist.

My thoughts exactly. An occasional wait is tolerable, but if I knew I had to take a book and read for an hour, I would find another doctor. My current doctor and dentist do not overbook. My dentist, Dr. Novak at Bushnell Family Dentistry, is extremely punctual, as are the hygienists there. Add a very nice staff into that mix, and it's a model office that doesn't treat its customers like cattle.

I have only once waited longer than 20 minutes for my family doctor, who then apologized profusely.

[sunnyatlast]

You might be willing to justify and accept bad behavior by medical offices but I am not. It is rude and unprofessional and the only reason an office gets away with it is because patients roll over and let them. I will allow that emergencies happen but that is not what we are talking about. Class operations, such as the Mayo Clinic (where I have been more than once), do not keep patients waiting because they do not overbook. My limit is 20 mins and then I will leave. My last Dr. didn't keep me waiting, ever. We will see how it plays out here in The Villages but my one visit so far (to meet the Dr.) was on time. My two dental visits so far have been on time. If you want to put medical offices up on a pedestal and let them waste your time that is your business but please don't suggest that it is normal or acceptable behavior for the rest of us because it isn't. By the way, airlines and hotels do not overbook "all the time". In fact, overbyooking by airlines is now a relatively rare event, which is actually too bad as I enjoyed volunteering in the past for a free ticket. Regarding hotels, I have only seen it once in the 20 years when I traveled frequently for business.

This is not to condone doctors who make wait more than 15-20 minutes. I don't like it either. Our time has value, too.

But if you want the current shortage of primary care, private-practice, self-employed doctors to get a whole lot worse, just keep insulting their efforts and sacrifice of personal/family life by comparing their practice to research hospitals like Mayo, which has over 2,000 residents in training to take care of the emergencies of your doctor's patients there.

I do NOT think a 3-12 hour drive to research-teaching hospitals like Mayo--for primary care or even common specialist visits--is the answer to saving patients time in getting routine medical care.

Mayo Clinic - MN Campus
2012 Statistics

Staff physicians and scientists: 2,158

Residents, fellows and students: 2,899

Allied health staff (clinic and hospital): 29,166

Total: 34,223


Facts about Mayo Clinic in Minnesota - About Us - Mayo Clinic (http://www.mayoclinic.org/about-mayo-clinic/facts-statistics/minnesota)

[Flyinglady]

You might be willing to justify and accept bad behavior by medical offices but I am not. It is rude and unprofessional and the only reason an office gets away with it is because patients roll over and let them. I will allow that emergencies happen but that is not what we are talking about. Class operations, such as the Mayo Clinic (where I have been more than once), do not keep patients waiting because they do not overbook. My limit is 20 mins and then I will leave. My last Dr. didn't keep me waiting, ever. We will see how it plays out here in The Villages but my one visit so far (to meet the Dr.) was on time. My two dental visits so far have been on time. If you want to put medical offices up on a pedestal and let them waste your time that is your business but please don't suggest that it is normal or acceptable behavior for the rest of us because it isn't. By the way, airlines and hotels do not overbook "all the time". In fact, overbooking by airlines is now a relatively rare event, which is actually too bad as I enjoyed volunteering in the past for a free ticket. Regarding hotels, I have only seen it once in the 20 years when I traveled frequently for business.

I agree, if everyone cancelled their appointment after waiting 15 or 20 minutes, the doctors would soon realise this is not acceptable behaviour, it would also result in less revenue for the practice that should make them sit up and take notice. My family doctor explained to me that if you have an appointment at 2 o'clock she would not be considered late until after 2.15, the first 15 minutes is for the nurse to do weight, blood pressure etc.

[Avista]

I've had really good luck with short or no waits at tThe Villages Care Center-Colony.

[Walter123]

I think the doctor wants to keep us all together in a small room so we can all get each other illness and he makes more money.

On another note, I heard a good idea to control Ebola. Send all the affected people to Vegas because what happens in Vegas stays in Vegas.

[rubicon]

I have great respect for the doctors that care for me. I can be impatient but when it comes to issues such as this I remember that my docs give will give me the required time I need just as they had the previous patient. Those that want fast forget that thee are many competing vices for a doctor's attention. I would not want my doc tor rush me and miss something

[biker1]

I am not insulting anybody - not sure where you got that from - reread my post. I am objecting to any office that books appointments under the assumption that patients have nothing better to do then wait. As I indicated, I understand that emergencies can happen. My point is there are practices that don't routinely waste patient's time. If people stopped accepting bad behavior perhaps it would become less common. My visits to Mayo (in Jacksonville, not Minnesota, which is about 2+ hours away) were for an orthopedic problem and there were two issues that drove me there: waiting beyond my scheduled appointment time at two sports medicine practices and their inability to diagnose and repair the problem. Neither of these issues existed at Mayo. This was when I lived closer to Mayo. I also know people who go there for what many might consider routine stuff because of the way the place is run (i.e. patient scheduling) and that really has nothing to do with how many people work there. The orthopedic guy saw me on time (for multiple consult, and pre- and post-op visits) because they schedule enough time for each appointment. The nature of the operation at the Mayo is such that they need to do this because often a patient will have multiple appointments in a single day and chaos would break out if each appointment was not taken on time.


This is not to condone doctors who make wait more than 15-20 minutes. I don't like it either. Our time has value, too.

But if you want the current shortage of primary care, private-practice, self-employed doctors to get a whole lot worse, just keep insulting their efforts and sacrifice of personal/family life by comparing their practice to research hospitals like Mayo, which has over 2,000 residents in training to take care of the emergencies of your doctor's patients there.

I do NOT think a 3-12 hour drive to research-teaching hospitals like Mayo--for primary care or even common specialist visits--is the answer to saving patients time in getting routine medical care.

Mayo Clinic - MN Campus
2012 Statistics

Staff physicians and scientists: 2,158

Residents, fellows and students: 2,899

Allied health staff (clinic and hospital): 29,166

Total: 34,223


Facts about Mayo Clinic in Minnesota - About Us - Mayo Clinic (http://www.mayoclinic.org/about-mayo-clinic/facts-statistics/minnesota)

[biker1]

That is fine and they should schedule appointments to reflect the amount of time they need with patients. Some offices do this and others don't care about your time. While I understand that it won't be precise, if you find that you are consistently having to wait a "long" period of time after your scheduled appointment time then you are being told that your time is worthless.

I have great respect for the doctors that care for me. I can be impatient but when it comes to issues such as this I remember that my docs give will give me the required time I need just as they had the previous patient. Those that want fast forget that thee are many competing vices for a doctor's attention. I would not want my doc tor rush me and miss something

[looneycat]

I was dealing with a doctor with whom appts were impossible. He was a specialist, good ones are extremely hard to find here, and the average wait time was 3 hours. I do not wait 3 hours for ANY doctor....if he doesn't respect his patients, I have no respect for him. When the one hour mark arrives I get up and leave.I also do not accept a PA in place of a doctor because THEY ARE NOT doctors and when that is all being offered I will not pay for a doctor visit. Then you have our wonderful hometown hospital where anything more complicated then a bloody nose and they send you off to Shands hospital...it happened to me and my neighbor as well, forcing my wife to drive 1.5 hours each way. With very few exceptions, the medical experience that the villages health system tries to say is available is total BS! It's your health!

[sunnyatlast]

I am not insulting anybody - not sure where you got that from - reread my post. I am objecting to any office that books appointments under the assumption that patients have nothing better to do then wait. As I indicated, I understand that emergencies can happen. My point is there are practices that don't routinely waste patient's time. If people stopped accepting bad behavior perhaps it would become less common. My visits to Mayo (in Jacksonville, not Minnesota, which is about 2+ hours away) were for an orthopedic problem and there were two issues that drove me there: waiting beyond my scheduled appointment time at two sports medicine practices and their inability to diagnose and repair the problem. Neither of these issues existed at Mayo. This was when I lived closer to Mayo. I also know people who go there for what many might consider routine stuff because of the way the place is run (i.e. patient scheduling) and that really has nothing to do with how many people work there. The orthopedic guy saw me on time (for multiple consult, and pre- and post-op visits) because they schedule enough time for each appointment. The nature of the operation at the Mayo is such that they need to do this because often a patient will have multiple appointments in a single day and chaos would break out if each appointment was not taken on time.

Again, Mayo having 29,000 hospital and clinic employees, 2000+ attending doctors, and 2000+ resident doctors certainly helps to make patient scheduling run like a well-oiled machine….

..with doctors also having the benefit of "enough time for each appointment" to observe, think and analyze properly the patient's condition.

Developer Gary Morse (R.I.P.) explained that dilemma best when introducing the TV Healthcare concept:

"Medicare is a lifesaving program but it has been set up in such a way that doctors are no longer able to care for us senior citizens in the same manner that we grew up with,” said Villages developer Gary Morse.

“Medicare pays a doctor for every patient he sees, not how much time he spends with that patient. If the doctor sees 100 patients a day, he or she makes twice as much as seeing 50 patients.”

What is not mentioned in that is that the reason the primary care doctors have to see more patients is to bring in enough revenue to pay the fixed overhead costs of a practice, while Medicare pays less than cost, and private insurers pay accordingly.

http://www.thevillageshealth.com/articles/Healthiest%20Hometown.pdf

[ssmith]

I am a nurse or was a nurse up north. My doctor was always late. He never rested or loaf.
The reason he was late is that he cared for his patients. I don't know how many times he would be done with an exam only to have a patient start in on many many issues. This of course would make him late for the next patient. It would be one thing if he was in and out of the room but all too often he would find or discover a problem that would need more time and follow up or the patient would be scheduled for a yearly and then start asking him to remove moles etc etc and all of that took extra time.https://www.talkofthevillages.com/forums/images/smilies/bow.gif

The patient that was waiting would get his full attention when he was in the room with them.

BTW I tried to always let my patients know what was going on and bring them magazines to read.

I am not saying this is the case down here but it is my experience.

Also if the doctor is not in the office yet....he may be at the hospital taking care of someone.

[pivo]

I had 9:30 appointment for a test I got in at 10:30 and asked how it took so long.

The answer from the nurse and assistant was they overbook when it comes to testing it was doctors day off and they try to cram as many appointments as they ca, naturally more test more money even the aide and nurse were upset because they get stuck with pushing the testt as fast as possible.

[rubicon]

I am a nurse or was a nurse up north. My doctor was always late. He never rested or loaf.
The reason he was late is that he cared for his patients. I don't know how many times he would be done with an exam only to have a patient start in on many many issues. This of course would make him late for the next patient. It would be one thing if he was in and out of the room but all too often he would find or discover a problem that would need more time and follow up or the patient would be scheduled for a yearly and then start asking him to remove moles etc etc and all of that took extra time.https://www.talkofthevillages.com/forums/images/smilies/bow.gif

The patient that was waiting would get his full attention when he was in the room with them. so if people want to get mad tey may first look to government and insurance regulators
BTW I tried to always let my patients know what was going on and bring them magazines to read.

I am not saying this is the case down here but it is my experience.

Also if the doctor is not in the office yet....he may be at the hospital taking care of someone.



ssmith i said the same thing. In addition docs are now required to develop emr as they visit with you. This creates additional office visit time. Add to that other government regulations paperwork etc and its a wonder waits aren't longer.

[zcaveman]

We always try to get an early appointment. That way we are first and do not end up waiting because of any backlog/overbooking.

I can take a 10-20 minute wait if the receptionist tells me he is running 15-20 minutes behind schedule. I do not and will not sit there for an hour when I have a scheduled appointment.

My EX-dermatoligist was the worst for booking several appointments for the same time and making you wait. First in the waiting room and then in the examination room.

Z

[NYGUY]

We now know why they call it a "waiting room":1rotfl:

[sunnyatlast]

I had 9:30 appointment for a test I got in at 10:30 and asked how it took so long.

The answer from the nurse and assistant was they overbook when it comes to testing it was doctors day off and they try to cram as many appointments as they ca, naturally more test more money even the aide and nurse were upset because they get stuck with pushing the testt as fast as possible.

And they'd be even more upset if the dr. cannot bring in enough revenue to pay them. The employees have to be paid regardless of even zero patients come in that day.

This is best explained by a family physician explaining why direct care on a small monthly subscriber fee works far better and lowers costs of providing care:

"The clinics frequented by most people bill insurance for the great majority of the clinic’s income. Once
 a decision is made to bill insurance for health care services it starts a chain reaction that ends in having to hire a large number of people and/or invest in a lot of technology.

Employees and software are needed to make sure that the patient’s insurance is active before the visit starts, employees have to be hired to call the insurance company to obtain prior authorization for suggested procedures, software is needed to prepare the bill that has to be in a certain format, and more people are needed to call the insurance company after the bill is returned unpaid with a note saying that an “i” wasn’t dotted or a “t” wasn’t crossed. Patients have to wait 15 to 30 minutes and listen to hold music to speak to an actual human being when you call your insurance company, health care professionals have to wait just as long.

Before doctors even open the doors of a new clinic that accepts insurance, they’ve had to hire a number of people just to manage the clinic’s relationship with insurance companies. Part of the clinic’s overhead expenses are these employees that must be paid even when no patients come in. And these paid positions have nothing to do with the quality of medical care that the patients receive.

Now let’s talk about what your insurance company will pay for your visit. For 
a typical follow-up visit for low to moderate severity issues, your insurance company pays anywhere from $45 to $75 to the doctor’s office. You can also add your $20 copay to this amount. The American Medical Association suggests that these visits are supposed to take 15 minutes face-to-face with the patient. That doesn’t happen very often.

If your doctor has 4 of these visits per hour, she is paid anywhere from $260 to $380 per hour when you include the payment from the insurance company and the collected co-pay. The last primary care doctor I spoke with told me that his hourly overhead is $700. When your expenses are greater than your revenue the math doesn’t work, but those are the numbers……"


How direct primary care reduces the costs of care (http://www.kevinmd.com/blog/2014/11/direct-primary-care-reduces-costs-care.html)

[CFrance]

I am a nurse or was a nurse up north. My doctor was always late. He never rested or loaf.
The reason he was late is that he cared for his patients. I don't know how many times he would be done with an exam only to have a patient start in on many many issues. This of course would make him late for the next patient. It would be one thing if he was in and out of the room but all too often he would find or discover a problem that would need more time and follow up or the patient would be scheduled for a yearly and then start asking him to remove moles etc etc and all of that took extra time.https://www.talkofthevillages.com/forums/images/smilies/bow.gif

The patient that was waiting would get his full attention when he was in the room with them.

BTW I tried to always let my patients know what was going on and bring them magazines to read.

I am not saying this is the case down here but it is my experience.

Also if the doctor is not in the office yet....he may be at the hospital taking care of someone.
I appreciate it when a nurse or office staff lets the patients know what is going on. The GI I had an appointment with last summer was an hour late getting to the office, and it was not because of any emergency. I know this because his procedure scheduler told me that the doctor had changed the time he normally arrives after lunch, and yet the person who schedules the appointments just kept right on putting patients in for that hour that he was never going to be there.

In this case, the staff made an announcement to the room that the GI would be over an hour late, and we would have the choice to reschedule or see the PA. I chose the PA as I had already cleared the decks for this appointment and needed to get the procedure scheduled in a timely fashion due to upcoming travel.

And that brings up another problem... sure, you can get up and leave, but you've gone out of your way to make room in your schedule for this particular appointment, and the doctor should do the same. Now you have to start back at square one.

There are good doctors here that don't overbook. If you go to a doctor more than twice and have to wait too long, you can search for another doctor.

[blueash]

Please don't use the Mayo Clinic as an example of how your local physician office should operate. Do you want your local MD to "squeeze" you in if you are ill? Try to walk in at Mayo... Here is what their website says about walk ins

Can I get into Mayo Clinic without an appointment?
Mayo Clinic in Rochester accepts "walk-in" patients. This method, however, is not encouraged, and you should be prepared to wait several days to a week or longer, depending on appointment cancellations and others waiting for an appointment. Waiting times tend to be shorter in winter.

So walk in is only ok in Rochester MN, and be prepared to wait several days to be seen. If you'd like Rochester MN in the winter the wait is shorter.

However, if the office is open at 9 AM the doctor should be there before 9 AM. Here is where it gets difficult. If your appointment is 9 AM does that mean you should arrive at 9 AM? If so then there is time checking in, getting your vitals done, nurse doing a brief history, updating your chart. You are not going to be ready until 9:15 or later. If as the 9 AM patient you show up at 9:10 figuring the doctor is always a bit delayed, now you have messed up everything. So should the office tell you 8:45 when they really don't expect you to be ready for the doctor until 9:15 just to be sure you are on time? Should they turn you away if you are 15 minutes late so as not to allow you to inconvenience all the later patients? Some practices wave schedule. Tell 4 patients to come at 9 AM and don't schedule the next one until 10 AM, 4 more. That way you even out the early and the late people but likely see your 4 patients in that hour. Now if all 4 are there at 9 AM and it is the "first" appointment of the day, somebody is going to be the last of those 4 to be seen, and be upset.

[ugotme]

I know this may sound silly but when I call for an appointment, especially with a new doctor, I inform the nurse that I will NOT wait more than 15-20 minutes to see the doctor. I inform the person that after that time I will leave.

They will usually inform you that either the doctor is usually on or close to schedule or is running late.

Too late - bye bye!

[Madelaine Amee]

My Doctor has never kept me waiting. I get there maybe 10 minutes early, the nurse does my vitals, asks if there are any changes, asks if I need meds etc., enters everything into the computer in the room, the doctor comes in, checks the computer and then talks to me.

I asked him about it and his reply was he has told his people not to overbook him and they don't.

I had an appointment with my Gyno and the nurse came out and said she had been called to the hospital for an emergency (surgery the day before) and she would be an hour late. Reschedule if you wish, or sit and wait. They then cancelled all the other appointments for the morning hours.

My husband sees other doctors and he just will not wait, gets up and leaves if they are not on time. They know him by now and he is NEVER kept waiting.

[Shimpy]

We always try to get an early appointment. That way we are first and do not end up waiting because of any backlog/overbooking.
Z


Me too..... but many times the very first appointment is 9:00am and the doctor walks in from the parking lot at 9:20. I can wait 20 mins, but once waited 1 1/2 hours and told the doctor I was just getting ready to have a pizza delivered there. I think it sunk in how I felt.

[looneycat]

My husband sees other doctors and he just will not wait, gets up and leaves if they are not on time. They know him by now and he is NEVER kept waiting.

no reflection on your husband whatsoever but that only means they make someone else wait...
more disturbing is the trend to have you accept a PA visit in place of a doctor, no offense to most, but some PAs are too obtuse to diagnose their own headaches, yet people are supposed to accept their word on things like cancers, etc.

[CFrance]

Please don't use the Mayo Clinic as an example of how your local physician office should operate. Do you want your local MD to "squeeze" you in if you are ill? Try to walk in at Mayo... Here is what their website says about walk ins

Can I get into Mayo Clinic without an appointment?
Mayo Clinic in Rochester accepts "walk-in" patients. This method, however, is not encouraged, and you should be prepared to wait several days to a week or longer, depending on appointment cancellations and others waiting for an appointment. Waiting times tend to be shorter in winter.

So walk in is only ok in Rochester MN, and be prepared to wait several days to be seen. If you'd like Rochester MN in the winter the wait is shorter.

However, if the office is open at 9 AM the doctor should be there before 9 AM. Here is where it gets difficult. If your appointment is 9 AM does that mean you should arrive at 9 AM? If so then there is time checking in, getting your vitals done, nurse doing a brief history, updating your chart. You are not going to be ready until 9:15 or later. If as the 9 AM patient you show up at 9:10 figuring the doctor is always a bit delayed, now you have messed up everything. So should the office tell you 8:45 when they really don't expect you to be ready for the doctor until 9:15 just to be sure you are on time? Should they turn you away if you are 15 minutes late so as not to allow you to inconvenience all the later patients? Some practices wave schedule. Tell 4 patients to come at 9 AM and don't schedule the next one until 10 AM, 4 more. That way you even out the early and the late people but likely see your 4 patients in that hour. Now if all 4 are there at 9 AM and it is the "first" appointment of the day, somebody is going to be the last of those 4 to be seen, and be upset.
If my appointment is at 9:00, I expect to be taken in by the nurse at 9:00 and seen by the doctor shortly after she's done with me--like within 5 or 10 minutes.

I consider it my responsibility to arrive in the waiting room and be ready to be taken in by the nurse by the time 9:00 rolls around. I am always ten minutes early and do not count those ten minutes against the doctor.

I wouldn't try to walk into Mayo unless my family doctor was at Mayo.

[Mikeod]

To provide a view from the other side.

The last 28 years of my professional life were spent in a medical group where everyone was salaried, so our income was not affected by how many patients we could cram into the day. My day was fully booked in advance, all day. We also had a policy that if someone presented to the clinic with a problem, they would be seen. If a patient was very late for their appointment, they would be seen. If a patient showed up on the wrong day, they would be seen. Added to those were patients sent to us by other departments. And, of course, we added our own patients who required follow-up even though there were no available appointments.

My early patients were generally seen on time. But, as the morning progressed, patients who required more time than was booked plus those other add-on patients caused me to be farther behind time. Most of the time I would finish my AM patients a bit after my PM patients were already checking in. A lunch break was a dream. Grab a bite of sandwich and a sip of a drink and get back to work. I would finish my PM patients well after the clinic closing time. Then I could embark on finishing my charting, preparing for the next day's patient load, read my messages, return phone calls from patients or colleagues, or go over lab or technician results.

Fortunately, my front office staff kept our patients informed of the wait.

Just to say that overbooking occurs for other reasons than revenue. Sometimes it's medically necessary.

[CFrance]

To provide a view from the other side.

The last 28 years of my professional life were spent in a medical group where everyone was salaried, so our income was not affected by how many patients we could cram into the day. My day was fully booked in advance, all day. We also had a policy that if someone presented to the clinic with a problem, they would be seen. If a patient was very late for their appointment, they would be seen. If a patient showed up on the wrong day, they would be seen. Added to those were patients sent to us by other departments. And, of course, we added our own patients who required follow-up even though there were no available appointments.

My early patients were generally seen on time. But, as the morning progressed, patients who required more time than was booked plus those other add-on patients caused me to be farther behind time. Most of the time I would finish my AM patients a bit after my PM patients were already checking in. A lunch break was a dream. Grab a bite of sandwich and a sip of a drink and get back to work. I would finish my PM patients well after the clinic closing time. Then I could embark on finishing my charting, preparing for the next day's patient load, read my messages, return phone calls from patients or colleagues, or go over lab or technician results.

Fortunately, my front office staff kept our patients informed of the wait.

Just to say that overbooking occurs for other reasons than revenue. Sometimes it's medically necessary.
It seems to me that if your day is fully booked from the get-go, it's guaranteed that there will be no time to fit this in without causing patients to wait... "if someone presented to the clinic with a problem, they would be seen. If a patient was very late for their appointment, they would be seen. If a patient showed up on the wrong day, they would be seen. Added to those were patients sent to us by other departments. And, of course, we added our own patients who required follow-up even though there were no available appointments."

That's the same thing as overbooking, in my opinion. They shouldn't have booked your day so fully that you couldn't accommodate these other issues that pop up. Or else establish some rules that latecomers would not be seen, wrong-day patients would not be seen, patients sent by other departments scheduled in at another time. And limit the number of patients or appointments to accommodate these things.

There were many good doctors in my former state who simply got to the point where they would not accept new patients because they couldn't be accommodated.

[Mikeod]

It seems to me that if your day is fully booked from the get-go, it's guaranteed that there will be no time to fit this in without causing patients to wait... "if someone presented to the clinic with a problem, they would be seen. If a patient was very late for their appointment, they would be seen. If a patient showed up on the wrong day, they would be seen. Added to those were patients sent to us by other departments. And, of course, we added our own patients who required follow-up even though there were no available appointments."

That's the same thing as overbooking, in my opinion. They shouldn't have booked your day so fully that you couldn't accommodate these other issues that pop up. Or else establish some rules that latecomers would not be seen, wrong-day patients would not be seen, patients sent by other departments scheduled in at another time. And limit the number of patients or appointments to accommodate these things.

There were many good doctors in my former state who simply got to the point where they would not accept new patients because they couldn't be accommodated.
Booking fewer patients in advance per day results in extending the wait time for a routine appt to an unsatisfactory level. While this thread is about the wait once you get to an appt, there are other threads/posts that have concerns regarding the wait to get that appt. For example, at one point, the wait for a routine appt with me was approaching three months. Completely unacceptable. The best solution would be to add staff to better handle the patient volume. But that means additional space for them to work and additional support staff and room for them. Then there needs to be more OR time for the additional staff, and more beds for patients that require admission. And on and on. So, let's build another facility. But the response of insurance companies and government to increasing health care costs is to cut reimbursement to health care providers, so where does the money come from to make these changes.

Another's solution is to add extenders such as PAs or NPs. But we've seen how some patients object to not seeing the doctor.

Do I have an answer? Nope. I guess I just am troubled by the inference that because a patient is kept waiting that the doctor doesn't care. My personal experience is that most of the time a patient may be kept waiting because the doctor really does care, for the patient right there in front of them, which is their primary concern at the moment.

[CFrance]

Booking fewer patients in advance per day results in extending the wait time for a routine appt to an unsatisfactory level. While this thread is about the wait once you get to an appt, there are other threads/posts that have concerns regarding the wait to get that appt. For example, at one point, the wait for a routine appt with me was approaching three months. Completely unacceptable. The best solution would be to add staff to better handle the patient volume. But that means additional space for them to work and additional support staff and room for them. Then there needs to be more OR time for the additional staff, and more beds for patients that require admission. And on and on. So, let's build another facility. But the response of insurance companies and government to increasing health care costs is to cut reimbursement to health care providers, so where does the money come from to make these changes.

Another's solution is to add extenders such as PAs or NPs. But we've seen how some patients object to not seeing the doctor.

Do I have an answer? Nope. I guess I just am troubled by the inference that because a patient is kept waiting that the doctor doesn't care. My personal experience is that most of the time a patient may be kept waiting because the doctor really does care, for the patient right there in front of them, which is their primary concern at the moment.
I don't think the doctors don't care, Mikeod. I think the accountants don't care, and push the doctors into an unacceptable position. Then the patients/customers suffer.

Maybe the answer is to enter a teaching hospital's medical system. Our experience with the University of Michigan health care system, for example, was so far superior to our experience with local medical groups in our location outside of Grand Rapids, MI. We encountered so much overbooking and poor service and attitude in our local community that we switched our total health care over to U of M even though it was almost three hours away. The difference was amazing. No overbooking, acceptable waits, better treatment of us "customers," (none of the "doctor-is-God and you're lucky he's seeing you" attitude from the staff) and excellent care. We asked two of the doctors at U of M what they perceived the difference to be, and their answer was that they had no idea what the billing and profit-making practices were, did not have to be involved with that in any way, and could simply concentrate on their patients.

I don't know what the answer is, and I certainly don't think that doctors don't care. But I do know that we have been able to find some good doctors down here who don't overbook.

[sunnyatlast]

I don't think the doctors don't care, Mikeod. I think the accountants don't care, and push the doctors into an unacceptable position. Then the patients/customers suffer.

Maybe the answer is to enter a teaching hospital's medical system. Our experience with the University of Michigan health care system, for example, was so far superior to our experience with local medical groups in our location outside of Grand Rapids, MI. We encountered so much overbooking and poor service and attitude in our local community that we switched our total health care over to U of M even though it was almost three hours away. The difference was amazing. No overbooking, acceptable waits, better treatment of us "customers," (none of the "doctor-is-God and you're lucky he's seeing you" attitude from the staff) and excellent care. We asked two of the doctors at U of M what they perceived the difference to be, and their answer was that they had no idea what the billing and profit-making practices were, did not have to be involved with that in any way, and could simply concentrate on their patients…….

It's interesting that you bring up university hospital systems which are buying up physician practices. Patients not on Medicare, who have to pay for their new higher deductibles of $3,000 to $8,000 per year now, are painfully aware of the facilities fees being added onto doctors' office visits/procedures simply because they are part of a "hospital" system. What were "physician office visits and procedures" are now "Hospital visits and procedures", at a much higher price.

These out-of-pocket costs are forcing many people to NOT go to the dr. when they need to, because they do not have the cash and still have the ethics to not run up bills they cannot pay:


"Facility fees’ add billions to medical bills" (Kansas City Star)

"ST. LOUIS
It was a minor skin infection. The visit to the dermatologist’s office at SSM Cardinal Glennon Children’s Medical Center took just a few minutes.

Before she left, Allison Zaromb paid $40 for her 4-year-old son’s care, the amount listed on her insurance card for an office visit to a physician specialist.

Zaromb assumed she had settled the bill, until a shocker arrived in the mail: After paying for the doctor, she still owed about $200 for a “facility fee” charged by Cardinal Glennon.

“I had no idea you would have to pay another fee because the doctor’s office was on a hospital campus,” Zaromb said.

“It’s just not fair. It’s like paying the barber for a haircut and then being charged extra for sitting in the barber chair.”

Fair or not, facility fees are built into the way Medicare and commercial insurance plans pay for health care. Hospitals have charged them routinely for years for services at their outpatient clinics.

But the fees are getting new scrutiny now that hospitals nationwide are buying up physician practices and putting thousands of physicians on their payrolls.

Sometimes by making few visible changes beyond putting their logos on the door and issuing new ID badges, hospitals can declare newly acquired practices part of their outpatient department and start billing patients more.

The doctor’s office doesn’t have to be in the hospital or even on the hospital campus to charge facility fees. It can qualify if it’s as far as 35 miles away.

Facility fees can more than double the cost of a visit to the doctor, a major hardship now that many people have high-deductible insurance plans with substantial out-of-pocket expenses…...

Read more here: Day 2: (http://www.kansascity.com/news/special-reports/_news_special-reports_doctors-inc_/article334895/Day-2-%E2%80%98Facility-fees%E2%80%99-add-billions-to-medical-bills.html#storylink=cpy)

[CFrance]

Never had any facility fees added, before or after being on medicare. Besides, the issue here is wait times at doctors' offices.

[The Great Fumar]

I give them 20 min. maximum unless there is a good excuse,and then I'm outta there.......There is no shortage of lawyers or physicians here and I'm living a tight schedule myself........:icon_wink:

fumar

[Halibut]

And yet many of them will charge us if we're late or miss an appointment! So galling.

We always try to get an early appointment. That way we are first and do not end up waiting because of any backlog/overbooking.

I had the first 8 am appointment with Dr. Chin recently and when I arrived and signed in, saw that there were two other patients with 8 am appointments for Chin. If she wonders why I was crabby and ill-tempered when I finally got to see her at 8:50, she should look examine her own conscience.

I had an appointment yesterday where I was getting ready to walk out after 69 minutes sitting in the exam room, but the stupid guy is only here once a week and I'd already waited 5 weeks for that appointment. During which he didn't listen and scolded me for taking a certain medication. Hey! I DIDN'T WRITE THE PRESCRIPTION MYSELF, you know. Thank the bozo before you.

And get this -- is it a thing now for a dr. to ask a question, then while I'm answering, take out his cell phone and start texting with someone? WHILE I'M TALKING. No apology, no explanation, just ignoring me. It's bad enough that half of them sit with their backs to you while they enter info into the computer. The last guy who did that (eye dr), I turned my back to him when I answered.

[CFrance]

Patients unite! If enough people complain about these things, something will change. If the doctor was texting something that had nothing to do with me, I would be mad enough to walk out. I would certainly ask him what and to whom he's texting, and why.

So good for the posters who have said they will not wait past a certain amount of time, and for the ones who tell that to the office when they make the appointment. We have to look at ourselves as consumers and demand fair treatment, or we'll take our business elsewhere.

[gjbl8114]

Complain about delayed appointments if you must, but a better solution would be to find another doctor, that of course would be too inconvenient right? If you keep going back and the same thing is happening then you are not giving that doctor of his/her office any reason to do anything different. If enough people start taking action instead of complaining to their friends and neighbors, things would definitely change. But, no, we just keep doing the same thing over and over and getting upset because we don't get better results. Did you know that this is a sign of insanity?????

[sunnyatlast]

And yet many of them will charge us if we're late or miss an appointment! So galling.



I had the first 8 am appointment with Dr. Chin recently and when I arrived and signed in, saw that there were two other patients with 8 am appointments for Chin. If she wonders why I was crabby and ill-tempered when I finally got to see her at 8:50, she should look examine her own conscience.

I had an appointment yesterday where I was getting ready to walk out after 69 minutes sitting in the exam room, but the stupid guy is only here once a week and I'd already waited 5 weeks for that appointment. During which he didn't listen and scolded me for taking a certain medication. Hey! I DIDN'T WRITE THE PRESCRIPTIONS MYSELF, you know. Thank the bozo before you.

And get this -- is it a thing now for a dr. to ask a question, then while I'm answering, take out his cell phone and start texting with someone? WHILE I'M TALKING. No apology, no explanation, just ignoring me. It's bad enough that half of them sit with their backs to you while they enter info into the computer. The last guy who did that (eye dr), I turned my back to him when I answered.

Not to excuse the wait times at all, but the dr. might have been entering data to your electronic health record on the computer. Many hospitals and dr. offices are using iPads to enter all orders, notes, etc, as mandated by the government push for electronic medical records, which is another cause of delays and major frustration by office and hospital staffs.

Anyone who's ever tried to type on an iPad/smartphone, or tried dictating with Siri should be able to realize how frustrating, time wasting, and inaccurate that can be! Drs. and nurses are quitting because of these train wrecks forced onto them for billing Medicare and insurance.

[Avista]

I don't know about others, but my experience at The Villages Health Care has involved very little waiting. It has been wonderful. Would never go back to old days unless I had to.

[Walter123]

Patients unite! If enough people complain about these things, something will change. If the doctor was texting something that had nothing to do with me, I would be mad enough to walk out. I would certainly ask him what and to whom he's texting, and why.

So good for the posters who have said they will not wait past a certain amount of time, and for the ones who tell that to the office when they make the appointment. We have to look at ourselves as consumers and demand fair treatment, or we'll take our business elsewhere.

YES!!!! Let's vote with our feet just like we would do at a bad restaurant or any other business. WE are being taken advantage of by the medical profession. The treat us like cash cow cattle. At my next doctor appoint I will tell the receptionist that I have another appointment that day (or some other lie) and I can only wait 15 minutes past my scheduled time.
Also, when I wait too long my bp goes up and the doc gets a false reading. Last week the doc asked if I had "white coat syndrome" I said no, I had "wait too long syndrome". Of course he laughed it off then told me it was his staff's fault.

What was that movie where everyone was yelling out of their windows, "I'm mad as hell and I'm not gonna take it anymore"?

[Walter123]

We should tell our doctors to read this thread. I would love to see some responses.

[CFrance]

Complain about delayed appointments if you must, but a better solution would be to find another doctor, that of course would be too inconvenient right? If you keep going back and the same thing is happening then you are not giving that doctor of his/her office any reason to do anything different. If enough people start taking action instead of complaining to their friends and neighbors, things would definitely change. But, no, we just keep doing the same thing over and over and getting upset because we don't get better results. Did you know that this is a sign of insanity?????
You're right. I think a lot of people on this forum have already stated that they either refuse to wait, or they find another doctor. I consider walking out on an appointment a good way to take action, as well as finding another doctor.

I remember back in the '60s when all veterinarians were first come/first served. It was a zoo, so to speak, in their waiting rooms. Terrible waits. Then a couple of vets in our area started giving appointments. Everybody switched to those vets. Voila, all the vets started giving appointments.

It's all about demanding customer service.

[graciegirl]

You're right. I think a lot of people on this forum have already stated that they either refuse to wait, or they find another doctor. I consider walking out on an appointment a good way to take action, as well as finding another doctor.

I remember back in the '60s when all veterinarians were first come/first served. It was a zoo, so to speak, in their waiting rooms. Terrible waits. Then a couple of vets in our area started giving appointments. Everybody switched to those vets. Voila, all the vets started giving appointments.

It's all about demanding customer service.

I know for a fact that there is more than one M.D. reading and responding to this thread.

[CFrance]

I know for a fact that there is more than one M.D. reading and responding to this thread.
That's good!

[Flyinglady]

I do not have a problem with my family doctor at Colony, she is usually on time or just a few minutes late, my problems have occurred when she has referred me to specialist, so far I have walked out 4 appointments, thank goodness none were life threatening conditions.

Whilst we are on the subject of doctors, why do some doctors insist that you have a follow up appointment so they can tell you everything is fine, see you in 3 years- this a waste of our time, the insurance money and our money if we have a co-pay, I also refuse follow up appointments unless they have found a problem.

[graciegirl]

I do not have a problem with my family doctor at Colony, she is usually on time or just a few minutes late, my problems have occurred when she has referred me to specialist, so far I have walked out 4 appointments, thank goodness none were life threatening conditions.

Whilst we are on the subject of doctors, why do some doctors insist that you have a follow up appointment so they can tell you everything is fine, see you in 3 years- this a waste of our time, the insurance money and our money if we have a co-pay, I also refuse follow up appointments unless they have found a problem.


You are just like me only different.

I trust the need for a follow up appointment in MOST cases and particularly if your trusted M.D. saw the need.

If I had had the time OR the smarts to go to medical school, I wouldn't need a doctor's advice.

[2BNTV]

I have gone to doctors that felt their time was much more important than my time. They seem to forget who the customer is and who is paying their fee. I tend to fire them!!!

A friend of mine son, is a doctor, and he said that doctors in general, are afraid of people, who would bad mouth them, to their friends and neighbors. I have had only one doctor in my lifetime, who was sensitive to complaints.

My PCP does not overbook, as he keeps a couple of appointments open for people who have an emergency. For now, my PCP takes me right away, but I usually sit in his examining room, for a while. He is worth the wait. :smiley:

[rn1tv]

Wait time in the event of an emergency is understandable and, for me, acceptable; but my previous PCP double and triple booked every day!, I know this because I questioned the office manager who said the dr. did not want to refuse any patient. Obviously, he did not care that those of us who had appts. had to wait longer (I waited up to 2.5 hr.) and also had less time with him because he was so far behind. He still advertises he is accepting new patients and same day appts. even though it appears he cannot handle the ones he currently has. Although he is a great physician, I changed MDs and happy I did.

[Madelaine Amee]

When I was working and living in Massachusetts I was a patient at the Beth Israel in Boston. They finally put a satellite clinic out in a town called Burlington, so I was able to avoid driving in and out of Boston. At the time they opened this clinic I received a letter telling me to please bring a note containing all the questions I wished to discuss with the doctor. At the time I was a bit annoyed, but after seeing how efficient it is to have your questions written out before you and to be able to hand that the doctor for him/her to answer, I realized how smart it was. I still do it to this day, and now they scan it into my chart.

How many times do you get to the doctor's office and forget what you wanted to ask him/her?

[Halibut]

The problem with walking out of an appointment is that I'm punishing myself more than the doctor. They have patients coming out of their ears, so what does one more or less matter to them? Whereas I'm only there because I have a real need. Am I not supposed to have glaucoma surgery because the doctor has overbooked?

If anyone is looking for a no-nonsense primary care doctor, try Larry Foster at Leesburg Family Medicine. His (un-fancy) office is on LaGrande near the Medical Gate in Lady Lake. You can see the sign from 27.

Think you need an extensive nerve conduction study? He'll take out his tuning fork, give it a thump and put in on your hand to see if you can feel the vibration. He doesn't believe in a lot of referrals to specialists for conditions he can handle himself, or in dispensing the drug of the week for no good reason. He keeps his practice running smoothly and has always been spot on time when I see him. Is he warm and comforting? Nope. But he's been practicing long enough to have seen most everything and knows what he's doing.

[shcisamax]

I went for an initial appointment at 3 p.m.at one of their several offices. We were getting up to go when they moved us out of the waiting room at 3:50. We were told to make appointments in the morning before they get backed up. For the follow up, we went in to a different office for a 9:10 a.m. appointment. As I signed in, I noticed two of the seven people in front of me had appointments for 9:10. I inquired and was told it could be for other doctors; I said they signed in for the same as we did. They said that one was for blood work. I sat down next to woman that overheard my conversation as she was about to go up to sign in and she too had a 9:10 appointment. She told me it was normal. So far, and I emphasize so far, he is the best doctor we have found so I guess we are stuck with the system but I did discuss it with the office manager. I am sure it fell on deaf ears. I really don't get it either. I mean booking three people for the same time..I would think you would be covered by booking every 10 minutes.

I have been to the Mayo in JAX twice and both times it was exceptional. Runs like a swiss watch. The only problem was getting the initial appointment. But once you are in, it runs like clockwork.

[Villages PL]

When my doctor was new in this area, I hardly had a chance to sit down in the waiting room. I was called when I got there and he spent a lot of time with me.

As the years when by, and he got more patients, I gradually waited longer and longer. Last time I waited for an hour. I didn't complain but they all apologized anyway.

Now I'm wondering if next time I should call the doctor's office before I leave my house to see if they might be running behind schedule. I wouldn't mind as much waiting at home.

[Shimpy]

Now I'm wondering if next time I should call the doctor's office before I leave my house to see if they might be running behind schedule. I wouldn't mind as much waiting at home.

Good idea if you can believe what they tell you. I've done this and still had to wait over an hour when they said the doctor was on time.
With all the patients they have and the money they make you would think they could get some magazines that are less than 2 years old. A dozen subscriptions wouldn't break them. I asked my PCP if I was her only male patient. She said "heavens no, why do you ask?" I told her because all the magazines in her waiting room were for women, like Ladies Home Journal, and Home and Garden. The only up to date ones were the free ones that we all get anyways and have read.

[Madelaine Amee]

I have been to the Mayo in JAX twice and both times it was exceptional. Runs like a swiss watch. The only problem was getting the initial appointment. But once you are in, it runs like clockwork.

My initial appointment with Mayo in Jacksonville was initiated by my specialist here in TV. A Mayo employee called that same afternoon and an appointment was set up immediately, no waiting.

My husband's appointments with specialists have all been initiated by the Doctor recommending the appointment.

[rn1tv]

Halibut, someone who has serious neurologic problems needs a neurologist and certainly not Larry Foster. Patients with true neurological problem need more than a "thump of the tuning fork" and to make such a comment is insulting to those with problems. He has to be one of the rudest, condescending drs. I have ever met.

[sunnyatlast]

Halibut, someone who has serious neurologic problems needs a neurologist and certainly not Larry Foster. Patients with true neurological problem need more than a "thump of the tuning fork" and to make such a comment is insulting to those with problems. He has to be one of the rudest, condescending drs. I have ever met.

Good to hear other patients' experiences……the more, the better.

Personally I think it's worrisome when a primary dr. is reluctant to refer patients to a specialist because he "thinks he can handle it himself". In fact I think that's the most dangerous kind of dr.--the kind that thinks they know it all and will not change course.

The specialists don't go thru grueling extra years of residency-fellowship training, annual continuing education coursework/credits, and board certification exams because a primary dr. knows it all already.

[rubicon]

Too many posters are taking this issue too personally. There is a substantial community here and around The Villages that keeps growing leaps and bounds.
The government continues to expand its regulations while decreasing payments for services rendered. Insurance companies also entangle a physician in paperwork. Mal practice insurance only goes up and the costs to run an electronic medical records systems, billing etc are eating up doctors profits. Many physicians are walking away or joining groups.

Many doctors want to provide quality care to their patients, guard against errors and respond to people's health needs.

So what some may define as overbook others may say that all of the abov place a doctor un an untenable position

[dillywho]

To provide a view from the other side.

The last 28 years of my professional life were spent in a medical group where everyone was salaried, so our income was not affected by how many patients we could cram into the day. My day was fully booked in advance, all day. We also had a policy that if someone presented to the clinic with a problem, they would be seen. If a patient was very late for their appointment, they would be seen. If a patient showed up on the wrong day, they would be seen. Added to those were patients sent to us by other departments. And, of course, we added our own patients who required follow-up even though there were no available appointments.

My early patients were generally seen on time. But, as the morning progressed, patients who required more time than was booked plus those other add-on patients caused me to be farther behind time. Most of the time I would finish my AM patients a bit after my PM patients were already checking in. A lunch break was a dream. Grab a bite of sandwich and a sip of a drink and get back to work. I would finish my PM patients well after the clinic closing time. Then I could embark on finishing my charting, preparing for the next day's patient load, read my messages, return phone calls from patients or colleagues, or go over lab or technician results.

Fortunately, my front office staff kept our patients informed of the wait.

Just to say that overbooking occurs for other reasons than revenue. Sometimes it's medically necessary.

Thank you! A voice of reason and should be able to be understood by all. That is a much better way than being told that you can be seen in two weeks/months when you have a problem NOW. (Or clogging the ER unnecessarily.)

Many of the doctors here ask that you NOT make any other commitments for the day of your appointment because the length cannot be guaranteed, and especially so if you are having some procedure done.

I personally prefer the doctor that takes his time and especially the time to listen to me. I hate the Wham-Bam-Thank-You approach.

Not only do I write down my questions but also what scripts need to be renewed/refilled. I do this on the notepad of my phone. I also record with my phone the visit with the doctor and that way I know exactly what he told me. I do the same for their hospital visits. They are really receptive to that idea and it saves their office time in case I have a question that they would have to interrupt their day to answer. I am my husband's caregiver so I have both of us to keep all of this for.

I have only ditched one doctor and that was because he didn't have "time" to answer a very important question concerning a medication for my husband. I needed to know if he wanted him to continue a med that the cardiologist who placed his stent had prescribed and if so, I would need a new script since the one he had was only for 30 days with no refills. The doctor who I got to replace him said, "Absolutely." and wrote a new script. He still takes that particular one and always will.

I will always gladly wait for caring and competent care.

[MoeVonB61]

Read and listen to Gracie Girl's and Sunnyatlast's posts...YOU ARE IN THE VILLAGES....people 55 years old and up go to the Dr., get diagnostic imaging and take prescription drugs 3 TIMES more than the younger population.......BTW Biker1......the MAYO clinic Jacksonville not only has "excess staff headcount" but they also deal with very advanced or complex illnesses and the CPT CODES they can bill Medicare reimburse a much higher rate ....... I spent 11 years as a Revenue Management Analyst at Disney....hotels and airlines ALWAYS overbook at least by the percentage of their historical no show factor.....always have, always will......

[biker1]

Mrich1, the number of staff members at Mayo doesn't matter when it comes to the overbooking of a specific Dr. The fact is the orthopedic guy I saw on several occasions wasn't overbooked and saw me on time. This was not true at two sports medicine practices I tried first. That was my only point. Also, I didn't say airlines and hotels don't overbook. I only stated that airline overbookings are not nearly as common as in the past. When I traveled frequently, I only saw a hotel overbooking once in 20 years. I believe over 2 million miles on airlines makes me some what qualified to comment on this.



Read and listen to Gracie Girl's and Sunnyatlast's posts...YOU ARE IN THE VILLAGES....people 55 years old and up go to the Dr., get diagnostic imaging and take prescription drugs 3 TIMES more than the younger population.......BTW Biker1......the MAYO clinic Jacksonville not only has "excess staff headcount" but they also deal with very advanced or complex illnesses and the CPT CODES they can bill Medicare reimburse a much higher rate ....... I spent 11 years as a Revenue Management Analyst at Disney....hotels and airlines ALWAYS overbook at least by the percentage of their historical no show factor.....always have, always will......

[biker1]

Mrich1,

I can't comment on Medicare reimbursement rates as I am not on Medicare and my insurance does cover Mayo. I saw all the insurance statements from the times I went to Mayo and it wasn't clear to me that they were charging some sort of premium over other facilities and I doubt they would have been in my network if they did.



Read and listen to Gracie Girl's and Sunnyatlast's posts...YOU ARE IN THE VILLAGES....people 55 years old and up go to the Dr., get diagnostic imaging and take prescription drugs 3 TIMES more than the younger population.......BTW Biker1......the MAYO clinic Jacksonville not only has "excess staff headcount" but they also deal with very advanced or complex illnesses and the CPT CODES they can bill Medicare reimburse a much higher rate ....... I spent 11 years as a Revenue Management Analyst at Disney....hotels and airlines ALWAYS overbook at least by the percentage of their historical no show factor.....always have, always will......

[Abby10]

Too many posters are taking this issue too personally. There is a substantial community here and around The Villages that keeps growing leaps and bounds.
The government continues to expand its regulations while decreasing payments for services rendered. Insurance companies also entangle a physician in paperwork. Mal practice insurance only goes up and the costs to run an electronic medical records systems, billing etc are eating up doctors profits. Many physicians are walking away or joining groups.

Many doctors want to provide quality care to their patients, guard against errors and respond to people's health needs.

So what some may define as overbook others may say that all of the abov place a doctor un an untenable position

Bingo!! I think you summed up the real issues very well. Unless you are in the industry, it is very hard to see and understand the hurdles that many of us in healthcare are expected to jump to provide the quality services that we were able to provide many years back when the issues that you mentioned above were not in play. Thank you for voicing so well what many of us who in the industry feel, but often are too exhausted and frustrated by the end of the day to manage to put into words.

[biker1]

Rubicon,

I am not sure how your statements apply to the concept of overbooking patients and then expecting them to routinely wait extended periods of time past their scheduled appointments. Not all offices do this but presumably all offices are subject to the same pressures you expanded on. Also, this is not a phenomenon unique to The Villages. Medical practices are businesses providing a services. In my mind, they are no different than any other business. Again, I can accept that there are emergencies but these can be accounted for in the scheduling. I don't take it personally - I actually take it professionally - they are wasting my time for their own bottom line and I won't play and neither should anyone else. Keeping you waiting is a business decision - plain and simple. I dismiss the concept that "Drs are special and we should be thankful they keep us waiting". I bend over backward for my customers, often working evenings and weekends so they are provided the level of service they were promised.

Too many posters are taking this issue too personally. There is a substantial community here and around The Villages that keeps growing leaps and bounds.
The government continues to expand its regulations while decreasing payments for services rendered. Insurance companies also entangle a physician in paperwork. Mal practice insurance only goes up and the costs to run an electronic medical records systems, billing etc are eating up doctors profits. Many physicians are walking away or joining groups.

Many doctors want to provide quality care to their patients, guard against errors and respond to people's health needs.

So what some may define as overbook others may say that all of the abov place a doctor un an untenable position

[rn1tv]

Rubicon,

I am not sure how your statements apply to the concept of overbooking patients and then expecting them to routinely wait extended periods of time past their scheduled appointments. Not all offices do this but presumably all offices are subject to the same pressures you expanded on. Also, this is not a phenomenon unique to The Villages. Medical practices are businesses providing a services. In my mind, they are no different than any other business. Again, I can accept that there are emergencies but these can be accounted for in the scheduling. I don't take it personally - I actually take it professionally - they are wasting my time for their own bottom line and I won't play and neither should anyone else. Keeping you waiting is a business decision - plain and simple. I dismiss the concept that "Drs are special and we should be thankful they keep us waiting". I bend over backward for my customers, often working evenings and weekends so they are provided the level of service they were promised.[/QUOTE]

:agree:

[Villages PL]

1) Now that I'm retired I need to remind myself that my time is no longer valuable, except in my own egocentric mind.

2) Multiple health issues means more doctor visits and more waiting, so I must always remember to take my health seriously, and refrain from eating junk food.

3) If I have to wait, I might use the time to read my newspaper, which I would do anyway if I were home. Other than that, I might use the time to think and reflect on why I need to be so busy with non-essential retirement activities.

Beware the barrenness of a busy life. -----Socrates

[CFrance]

When I was working and living in Massachusetts I was a patient at the Beth Israel in Boston. They finally put a satellite clinic out in a town called Burlington, so I was able to avoid driving in and out of Boston. At the time they opened this clinic I received a letter telling me to please bring a note containing all the questions I wished to discuss with the doctor. At the time I was a bit annoyed, but after seeing how efficient it is to have your questions written out before you and to be able to hand that the doctor for him/her to answer, I realized how smart it was. I still do it to this day, and now they scan it into my chart.

How many times do you get to the doctor's office and forget what you wanted to ask him/her?
I agree about writing questions down. Also, our doctor, Martinez Cruz, gave us his email address, which he checks twice a day, even on Saturday. He will send in refill prescriptions, order prescriptions for a condition you've seen him for previously and now need something else for, critique specialists you are thinking of choosing--all by email. I don't have to take up his office time with follow-ups unless I want to.

He's on his own and doesn't overbook. I've only had one wait, due to an emergency.

[Halibut]

Most of the time I would finish my AM patients a bit after my PM patients were already checking in. A lunch break was a dream. Grab a bite of sandwich and a sip of a drink and get back to work. I would finish my PM patients well after the clinic closing time.

I understand getting behind, I do. But if it happens on a daily basis, to me that means you're scheduling too many patients per hour. Since you were salaried and seeing more patients did not equal more income, why not reduce the number of appointments per day?

I've been in offices where more than one patient was scheduled at the exact same time. How doctors can in good conscience allow/encourage that in their practice is a mystery.

[CFrance]

I understand getting behind, I do. But if it happens on a daily basis, to me that means you're scheduling too many patients per hour. Since you were salaried and seeing more patients did not equal more income, why not reduce the number of appointments per day?

I've been in offices where more than one patient was scheduled at the exact same time. How doctors can in good conscience allow/encourage that in their practice is a mystery.
I think it's what happens when accountants take over.

[CFrance]

1) Now that I'm retired I need to remind myself that my time is no longer valuable, except in my own egocentric mind.

2) Multiple health issues means more doctor visits and more waiting, so I must always remember to take my health seriously, and refrain from eating junk food.

3) If I have to wait, I might use the time to read my newspaper, which I would do anyway if I were home. Other than that, I might use the time to think and reflect on why I need to be so busy with non-essential retirement activities.

Beware the barrenness of a busy life. -----Socrates

Now that I'm retired, I consider my time to be even more valuable, because there is a reduced amount of it left. And I might use the overbooking and consequential long waiting-room time to reflect on why it is wasting my day and what I can do about it.

[BarryRX]

1. No Shows
2. People call up and are ill and want to be seen without an appt.
3. Interruptions from labs, pharmacies, parents, etc.
4. People are late for their appts.
5. Really sick patients need more time or hospitalization or referrals.
6. People lie about the reason they want to be seen and more time is needed.
7. Paperwork
8. Try to see a patient every 15 minutes, but if each patient runs just a few minutes late the time is compounded by the end of the day.

[Mikeod]

I understand getting behind, I do. But if it happens on a daily basis, to me that means you're scheduling too many patients per hour. Since you were salaried and seeing more patients did not equal more income, why not reduce the number of appointments per day?

I've been in offices where more than one patient was scheduled at the exact same time. How doctors can in good conscience allow/encourage that in their practice is a mystery.

Let me answer by giving an example of a frequent occurrence in my day. Urgent care sends me a patient with an eye infection. I have to work them into my schedule. Turns out they have a serious internal ocular inflammation that could damage vision. I start them on a treatment and need to see them next day, but my schedule is already full, so I have to add them on again. To delay seeing them is malpractice, so, no choice. Then, next day, a patient of mine calls with ocular pain, so I must see them. And so forth and so on.

So, if I reduce my appointments to accommodate the "extra patients", I make routine patients wait longer and they're not happy. Access to care is a major concern among patients.

It is a delicate balance between too few staff and too many. The group has to be profitable enough to hire and retain quality staff. With insurance reimbursements falling and the ancillary costs of providing care rising (EMR, paperwork/reporting requirements, rent, utilities, equipment and supplies) the solution to keeping both patients and staff happy is not an easy one.

[Villages PL]

Now that I'm retired, I consider my time to be even more valuable, because there is a reduced amount of it left.

There's always a reduced amount of it all through our lives, so nothing has changed.


And I might use the overbooking and consequential long waiting-room time to reflect on why it is wasting my day and what I can do about it.

There are 24 hours in a day, so waiting 20 to 30+ minutes won't waste your day.

After you see your doctor, what else is so important? Ice cream bingo?

[Barefoot]

Now that I'm retired, I consider my time to be even more valuable, because there is a reduced amount of it left. And I might use the overbooking and consequential long waiting-room time to reflect on why it is wasting my day and what I can do about it.

There's always a reduced amount of it all through our lives, so nothing has changed.

After you see your doctor, what else is so important? Ice cream bingo?

CFrance is making the point that as retirees, most of our lives have already been lived, so the remaining years are even more valuable.
Ice cream bingo? I assume you're trying to be funny?
CFrance is more likely to be playing pickleball than ice cream bingo.

[sunnyatlast]

Maybe this can be understood, written by a primary care physician:

"Today’s article addresses a common complaint about physicians.

“Freewheel” responded to a previous article by writing the following, “you will not make me wait more than 10 minutes. My time is important, too.”

One of the most common complaints I hear is “I waited over an hour to see you!” Waiting for an appointment, particularly when you are sick, is frustrating. Once you have that appointment, waiting for a doc who is running 1 hour behind provokes anger.

Meeting patients’ expectations for timely appointments during which their needs are fulfilled is almost impossible. I have to admit, my approach for the last 28 years is brilliant. When my doors open in the morning, we will see you on a first come first serve basis. You don’t have to call to be seen. And, when I come into your exam room, I am on time. (I do make a few appointments for wellness care).

As a patient, it is critical for you to understand why your doc is never on time. Here’s my typical day. I get up at 5:30am to get to the hospital at 6:30am. If all goes well and my patients don’t have any medical crisis, I get to the office on time. On a bad day, Mr. “MI” decides to drop his blood pressure, stop breathing and “code”. I can’t tell Mr. “MI” that he’s not scheduled for a “code” situation; I have to do what I have to do.

I’m lucky, Mr. MI recovers quickly and I get to the office only 15 minutes late. However, I’m behind schedule. For the sake of this article, assume I make appointments like most docs. I walk into Mrs. Ulcer’s room 15 minutes late. I apologize. Mrs. Ulcer is scheduled for a 15 minute appointment for stomach pain. She is 42 years old and has been having intermittent stomach pain for 3 months. When she scheduled the appointment, she told my staff she thinks she has an ulcer. At 2 am, she developed a fever (103 degrees) and severe pain.

Mrs. Ulcer does not have an ulcer. She has an infected gallbladder. Mrs. Ulcer needs surgery. She is alone in the office and can’t drive to the hospital. I call the paramedics, the ER, and the surgeon. I’m now an hour behind.

I apologize to the next 4 patients for being late. They are relatively easy and I’m now 1 hour and 15 minutes late. I walk into Mr. Aged’s room. He has a 15 minute appointment to follow up on his diabetes. Mr. Aged is sitting with Mrs. Aged; she appears concerned. There is a faint smell of urine in the room. Mrs. Aged says, “His blood sugars have been high over the last 2 weeks. He’s more forgetful than usual, stumbling a lot and dropping things.” Mr. Aged’s 15 minute appointment takes 45 minutes. Mr. Aged is on his way to the hospital. He’s had a stroke.

I’m 2 1/2 hours behind, I have to go to the bathroom, my patients are mad, and they are taking it out on my staff. I value their time, but I value their health more.…….."

Stewart Segal is a family physician who blogs at:
Live Wellthy (Blog) Live Wellthy - (http://livewellthy.org)

To further understand the situation, read "The Electronic Medical Record" on his blog page linked here in the previous sentence.

[dillywho]

Maybe this can be understood, written by a primary care physician:

"Today�s article addresses a common complaint about physicians.

�Freewheel� responded to a previous article by writing the following, �you will not make me wait more than 10 minutes. My time is important, too.�

One of the most common complaints I hear is �I waited over an hour to see you!� Waiting for an appointment, particularly when you are sick, is frustrating. Once you have that appointment, waiting for a doc who is running 1 hour behind provokes anger.

Meeting patients� expectations for timely appointments during which their needs are fulfilled is almost impossible. I have to admit, my approach for the last 28 years is brilliant. When my doors open in the morning, we will see you on a first come first serve basis. You don�t have to call to be seen. And, when I come into your exam room, I am on time. (I do make a few appointments for wellness care).

As a patient, it is critical for you to understand why your doc is never on time. Here�s my typical day. I get up at 5:30am to get to the hospital at 6:30am. If all goes well and my patients don�t have any medical crisis, I get to the office on time. On a bad day, Mr. �MI� decides to drop his blood pressure, stop breathing and �code�. I can�t tell Mr. �MI� that he�s not scheduled for a �code� situation; I have to do what I have to do.

I�m lucky, Mr. MI recovers quickly and I get to the office only 15 minutes late. However, I�m behind schedule. For the sake of this article, assume I make appointments like most docs. I walk into Mrs. Ulcer�s room 15 minutes late. I apologize. Mrs. Ulcer is scheduled for a 15 minute appointment for stomach pain. She is 42 years old and has been having intermittent stomach pain for 3 months. When she scheduled the appointment, she told my staff she thinks she has an ulcer. At 2 am, she developed a fever (103 degrees) and severe pain.

Mrs. Ulcer does not have an ulcer. She has an infected gallbladder. Mrs. Ulcer needs surgery. She is alone in the office and can�t drive to the hospital. I call the paramedics, the ER, and the surgeon. I�m now an hour behind.

I apologize to the next 4 patients for being late. They are relatively easy and I�m now 1 hour and 15 minutes late. I walk into Mr. Aged�s room. He has a 15 minute appointment to follow up on his diabetes. Mr. Aged is sitting with Mrs. Aged; she appears concerned. There is a faint smell of urine in the room. Mrs. Aged says, �His blood sugars have been high over the last 2 weeks. He�s more forgetful than usual, stumbling a lot and dropping things.� Mr. Aged�s 15 minute appointment takes 45 minutes. Mr. Aged is on his way to the hospital. He�s had a stroke.

I�m 2 1/2 hours behind, I have to go to the bathroom, my patients are mad, and they are taking it out on my staff. I value their time, but I value their health more.��.."

Stewart Segal is a family physician who blogs at:
Live Wellthy (Blog) Live Wellthy - (http://livewellthy.org)

To further understand the situation, read "The Electronic Medical Record" on his blog page linked here in the previous sentence.



THANK YOU. And I especially like your statement, which I think sums up what everyone should EXPECT from their physicians: "I value their time, but I value their health more........"

As I said earlier, I will gladly wait whatever length of time is necessary for caring and competent care.

In the past, there have been too many complaints about 'sorry medical care in TV'. As a matter of fact, they continue to come up. Which is it? Do you want "great care" or do you want "hurry up because I have better things to do care". From where I sit, you can't have both.

[CFrance]

CFrance is making the point that as retirees, most of our lives have already been lived, so the remaining years are even more valuable.
Ice cream bingo? I assume you're trying to be funny?
CFrance is more likely to be playing pickleball than ice cream bingo.
Thank you, Bare. You understood exactly what I meant. I was definitely not being literal.

And I don't have the slightest idea whatever the hell ice cream bingo is.

Anyone who thinks we should wait forever for quality care should visit my dentist in Bushnell. The best quality of care I have ever received from a dentist, and I have yet to have a wait. And these people will fit me in and will stay open late in case anyone calls in with an absess or a broken tooth at their closing time.

They run a thriving, busy practice, and they don't overbook, so nobody waits. Likewise my University of Michigan doctors, and my doctor here in TV. Every doctor's day is not full of emergencies and people with gall bladder problems who can't drive themselves to the hospital.

[Bonanza]

This entire thread got me to thinking. Many doctors require you to cancel an appointment at least 24 hours in advance or else you will be billed for the appointment. Then on the other hand, if you are required to wait longer than 15 or 20 minutes to be seen, it's just too bad.

Why do we permit this? Is it because doctors think they're God and can get away with overbooking on an ongoing basis, or is it because we, the patients, are just plain stupid?

Thankfully and luckily my internist has never kept me waiting more than five minutes or so, after my weight, blood pressure, etc., was taken. I agree that if a doctor doesn't have enough respect for his patients to schedule properly and take them on time, they are the ones who need to be penalized by having patients walk out. I agree that an emergency is an exception, but other than that, I'm all for walking out so the doctor will get the message loud and clear.

[Halibut]

deleted

[Walter123]

This entire thread got me to thinking. Many doctors require you to cancel an appointment at least 24 hours in advance or else you will be billed for the appointment. Then on the other hand, if you are required to wait longer than 15 or 20 minutes to be seen, it's just too bad.

Why do we permit this? Is it because doctors think they're God and can get away with overbooking on an ongoing basis, or is it because we, the patients, are just plain stupid?

Thankfully and luckily my internist has never kept me waiting more than five minutes or so, after my weight, blood pressure, etc., was taken. I agree that if a doctor doesn't have enough respect for his patients to schedule properly and take them on time, they are the ones who need to be penalized by having patients walk out. I agree that an emergency is an exception, but other than that, I'm all for walking out so the doctor will get the message loud and clear.

You left out social conditioning and I don't think that doctors think they are god, we do that ourselves.

[CFrance]

You left out social conditioning and I don't think that doctors think they are god, we do that ourselves.
I agree with you. But I would add from personal experience (not here) that their staff frequently thinks they're God and treats the patients/customers like cattle.

Which is why in MI we took our healthcare 3 hours away to a teaching hospital.

[Villages PL]

I agree with you. But I would add from personal experience (not here) that their staff frequently thinks they're God and treats the patients/customers like cattle.

Which is why in MI we took our healthcare 3 hours away to a teaching hospital.

Based on what you just said happens in MI, it seems to be about the same everywhere. Which suggests it's a natural, unavoidable consequence of operating a private medical practice where unpredictable things happen to upset scheduling.

I think the only time it doesn't happen is when a doctor sets up a new practice and doesn't yet have a lot of patients. Or else a patient gets lucky and shows up on a day when nothing unusual happens to upset the doctor's schedule. So then the patient goes around telling others that his doctor doesn't overbook, when actually it was just the luck of the draw.

[CFrance]

Based on what you just said happens in MI, it seems to be about the same everywhere. Which suggests it's a natural, unavoidable consequence of operating a private medical practice where unpredictable things happen to upset scheduling.

I think the only time it doesn't happen is when a doctor sets up a new practice and doesn't yet have a lot of patients. Or else a patient gets lucky and shows up on a day when nothing unusual happens to upset the doctor's schedule. So then the patient goes around telling others that his doctor doesn't overbook, when actually it was just the luck of the draw.
Well I've been awful darn lucky the last two years with the two doctors and one dentist I've been seeing, plus the PT.

Of practices in MI--one local and four at U of M (primary, gastro, and two others related to a one-timeillness)--all of whom have been in business for decades, only one overbooked, the local one. Which is why I switched.

So I disagree with you. I've had plenty of experience with well-established practices.

[Villages PL]

Well I've been awful darn lucky the last two years with the two doctors and one dentist I've been seeing, plus the PT.

I agree with you! You've been awful darn lucky the last two years with your two doctors and one dentist. Two years may not represent a lot of appointments, So it could very well have been luck.

With me it's been a mixed bag. In the beginning I didn't have to wait at all. Then sometimes I waited 5, 10 or 15 minutes. On two occasions I waited one hour. That was for my primary doctor. I'm not about to dump a doctor because of two unfortunate episodes. Another doctor would likely be the same and I'd be hopscotching around from doctor to doctor, to prove what? How important I am?

The dentist I go to now in The Villages hasn't been a problem, at least so far. The previous dentist did keep me waiting a few times. The difference may be because of the cost. Who knows? The dentist where I waited the most had discounted rates, even though the hygienist was very good in my opinion. (When she left, I left.)

[dillywho]

Why will people here wait often times an hour or hours to eat at a particular restaurant but are not willing to wait for something as important as their health? Makes no sense to me.

As for traveling several miles away to see a doctor because you don't have to wait or wait as long, at least when you are waiting here you are not spending "valuable time" on the road getting there, to say nothing of the gas getting there and back. And, if you get caught in traffic and are late either direction..........

Just sayin'.

[sunnyatlast]

"Why will people here wait often times an hour or hours to eat at a particular restaurant but are not willing to wait for something as important as their health?"


Because:

there's a bar and alcohol at the restaurants, but doctor's offices don't have that.

[Happydaz]

Why will people here wait often times an hour or hours to eat at a particular restaurant but are not willing to wait for something as important as their health? Makes no sense to me.

As for traveling several miles away to see a doctor because you don't have to wait or wait as long, at least when you are waiting here you are not spending "valuable time" on the road getting there, to say nothing of the gas getting there and back. And, if you get caught in traffic and are late either direction..........

Just sayin'.

Some thoughtful comments! I, personally, would rather wait a while for a particular doctor I think is competent then get in quickly with a doctor I wasn't familiar with. Doctors sometimes get behind due to situations out of their control. I don't mind waiting an hour or so if there is a good reason. The contractor, doctor, dentist, etc., who is very busy is often in high demand for a reason. They are good! Who am I to expect people to jump when I walk in. I think it is another example of the demanding attitude that begins to creep in as we age. Let's face it we're retired. What is the big deal, especially if you are pleased with your care. Relax, bring a book, do some reading, maybe some knitting. Just don't just stare at the wall and grind your teeth because a doctor gets behind and sees you an hour after you were scheduled..

[Shimpy]

I once had an appointment for an ear doctor (about 1970) that I picked out of a phone book after experiencing very bad hearing following a shooting experience where I forgot to wear hearing protection. Setting in the waiting room I noticed I was the only one there and they took me right away, (15 minutes early). When in the examining room I notice all his equipment which is usually stainless steel was painted over with what looked liked a paint brush in green paint. The doctor took a probe out of a container and looked into my ear then put it back into the same container with all the other probes. I couldn't wait to get out of there.
Sometimes it's nice to know your doctor is busy because he is good.