[CFrance]

Originally Posted by 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.

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]

Originally Posted by 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.

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]

Originally Posted by CFrance

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]

Originally Posted by Mikeod

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]

Originally Posted by CFrance

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:

[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........

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]

Originally Posted by Halibut

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]

Originally Posted by 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.

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.