I called my doctor today. Well, I called her office, of course. I needed an appointment to see her this week. First available appointment was next Friday (11 days). “Okay,” I thought, settling, “That will do.”
But forgive me, let me rewind. The receptionist asked me for my medical record number. Before my name. It was the first question he had for me upon answering the call. When I didn’t have it, he started with my first and last name along with my birth date. We found my record without trouble. But he noticed it had been 5 years since I’d been in. This brought trouble.
I said, “I’ve been having babies, so my OB has been doing my preventative care,” to which he said nothing. “Well,” he said, “I’ll have to e-mail the doctor. She’ll need to agree to see you since it’s been so long.” It gets worse: “It’s going to be another week until we know,” he said. “She’s on Spring Break this week, so it may not be until next week that you hear if you can get in. Unless she is checking e-mail while away.”
Oh, I hope she’s not checking e-mail on Spring Break. Really. But,
Fired from her practice for not coming in? “Expiring” from a physician’s practice? This is a new one for me. I certainly hope my patients don’t fall off my list after a certain point. I’ll ask tomorrow…
There are a lot of things wrong with health care.
“Okay,” I said, muzzling myself, trying desperately not to mention that I was a doctor, too. That I had her e-mail myself and could write/beg her to take me back in. “Let’s grab that appointment then, so I don’t lose the opportunity to see her next Friday. If need be, you can cancel it.”
I mentioned that by the time she returned from vacation, got through her E-mail, responded to his request, allowing him to call me back to schedule an appointment, the Friday opening would surely be gone. “Not necessarily,” he replied. This is when I dropped the dreaded I’m-a-doctor-I-get-how-this works-way-too-well bomb: “In my practice it would be.”
Health care isn’t supposed to feel like this. As a doctor I never want my patients to feel like they can’t access me, that they “expire” when absent from the office, or that they are an e-mail decision away from being in or out of the fold of care. I don’t want them to feel like their medical record number usurps their name. I should never need to mention I’m a doctor when scheduling an appointment. This shouldn’t be about privilege or “working the system.” This distance, this divorce, this space that exists (and seems to grow) between doctors and patients, it ultimately hurts us. In our efforts to reform health, and in our efforts to partner and participate in preserving health… This crack/divide/space is why I get phone calls every single week from relatives, old friends, new friends, friends of friends, and fellow physicians asking for medical advice. It is simply too challenging to reach our own providers, our doctors–our partners in health. Easier to phone a friend.
We must make this better.
Tell me what has worked for you and your family when scheduling appointments? What works for access to your doctor? Tell me what doesn’t…
This example highlights the benefit of we physicians getting stuck on the other side from time to time, on a Monday phone call, going nowhere.
Monday Phone Call
I called my doctor today. Well, I called her office, of course. I needed an appointment to see her this week. First available appointment was next Friday (11 days). “Okay,” I thought, settling, “That will do.”
I think I can guess the (world class, award winning) medical system that employs your doctor. Unfortunately, we’ve had to change Drs in cases where the bureaucratic crud was too much to bare. Friendly, helpful receptionists. Knowledgeable and responsive nurses. Effective procedures for scheduling appointments, maintaining records…. It all factors in your experience. I’m certain there’s a practice where Skippy the Receptionist would have said, “Dr Swanson congrats on the birth of your babies. I’m sure Dr X would be pleased to see you on Friday. Do you want to be on a wait list for an earlier appt? Are there records we need to transfer from your OBs office?” Our best experiences have been with Dr owned and operated private practices. There are 2 specialists who work out of hospital-run clinics that we work with because their specialties aren’t available in private practice in my area. In these two cases, things work because there is a 1-1 Dr/nurse ratio and you get a direct # to call your Dr’s nurse.
If my guess is incorrect and your Dr is part of a private practice, do her a favor and have her fire Skippy the Receptionist.
Donna Skwiat says
I currently have the same issue. I like my doctors but I cannot get thru to them or get any to return phone call. The receptionists are the problem. I only call when it’s serious. I have a chronic & serious healthcare issue that went months without diagnosis because of this shoddy treatment. The latest issue was being put on an antibiotic by the specialist and he said to phone him for any issues at all. After 6 days I was worse and not responding. The receptionist told me on a Monday morning that he could not be reached all week and I should go to a walk in clinic. I have few choices in my small town and feel neglected and trapped.
Dr.Wendy, i was aghast at this appointment fiasco. You were the victim of a dysfunctional system. And, sorry to say, that is why some will wait and seek care in the ED when conditions escalate. The current increase in small private practice outside of the usual venue is a welcome relief from this type of large anonymous clinic. Email access is to enhance the patient doctor relationship, not hinder it. Of course, I would be an expired patient in a nano second. There are others, we have choice. And no, i have never been treated like that before….makes me wonder how a system could be closing the open door on others, just for being untimely…Hardly the answer to access. Take your records and move it all, for your health. Now onto your usual good day.
Danielle Jones says
I’ve never experienced anything like that (blatantly being disrespected) when scheduling an appointment.
I did, however, call in January to schedule a March/April yearly appt with a new Ob/Gyn and get told that the next appt available for new patients was in February…of 2012!! 13 months later. How does that even happen?
I couldn’t be more frustrated with the system! As a mother of a child with food allergies, going to a multi doctor facility is a headache enough. We have a primary, but more often than not they are not available and we must see a doctor with no clue of what we have been dealing with the last 12 months!
I would LOVE a recommendation of an outstanding pedi on the north end!!
Unfortunately over the past 4 years I’ve been a the doctor’s office over 100 times. It boggles my mind when I’m still asked for my id; even when I just saw the same receptionist the day before, and the day before that and so on. To some extent I “get it” they’re trying to show consistency, it’s routine, it’s protocol. But really?! What a waste of time and it makes me feel like a piece of meat not a person.
One thing I do love…is email! I can email my doctor (as well as my son’s) any time I’m thinking of a question and they can get back to me at their convenience (which sometimes has been at night or on the weekend). I also use this for scheduling appointments. It’s certainly not for urgent matters but for those questions that I remember at odd hours when the house is finally quiet or that have a flexible time frame it’s great. And although it’s just through cyberspace it does help me feel so much more connected to my doctors.
Oh dear. You must be a patient an HMO
I remember when I worked as a patient care representative at an HMO when I was in school. It was very frustrating. There were a bunch of us in a room together with switchboards – all very nice women answering the phones and a couple nurses (who were also very nice) on hand for taking patient calls with questions. The doctors I met too were very nice and professional and cared about their patients.
The problem was, all of our hands were tied. If it was upsetting for those of us who just sat at the switchboards, I can’t even imagine how frustrating it was for the doctors. We had to put people’s health on the line to follow protocol and I don’t know how many times I had to say that the person just couldn’t have an appointment because of red tape of some sort of another.
Thankfully, there are practices (like where our family doctor is) that they ask your name first and it is small enough they even know you by name – or at least recognize your name even if you only go in once a year for an annual physical. But we have extremely good insurance through my husband’s extremely good job. Ours is a rarity these days I fear.
I’ve thought a lot about the health care problem in our country and what to do about it. I don’t want our bumbling government to be in charge of health care – especially if it is based on an HMO plan like I hear the national healthcare plan would be. So what is the answer? Sometimes I think about starting a truly non-profit insurance company that would become large enough to put pressure on the big insurance companies so that they’d have to get it together and find a way to not make it so hard for people to have good health care. But I don’t really know anything about the insurance industry so that sounds too big for me to take on alone. So, I continue to ponder it and hope someday I – or someone – will come up with a really productive solution.
As a pediatric subspecialist in an academic setting, I often think about this from the physician side of things too as I have parents telling me it is difficult to reach me and very difficult to get in to see me. On one hand, I am booked up weeks in advance so that unless I overbook (very difficult to do in my very space limited practice) I can’t necessarily see patients on an urgent basis. Additionally, the nature of my practice is that I do spend a lot of time looking after the inpatient service and performing procedures which takes away from potential clinic time. That all might be expected since I am technically a consultant, however I find that patients still want me to find time for them, time that I cannot figure out how to provide. They are coming to me because they have a problem that can’t/won’t be managed by their primary care doctor and even though I try to give recommendations, communicate with their primary physician and send the patients back to their doctor, they continue to return to me and express disappointment when they cannot get in touch with me. My general recommendation is to see their doctor, have him/her contact me with their assessment and I will make a plan with them together but that is not very satisfying for all involved. Our practice has systems in place to deal with this. We have nurses employed to handle the phone calls, we have fellows who can evaluate patients in the ED if that is what is needed and we are always receptive to phone calls from physicians with concerns about patients that we see. Yet still, these complaints about access bother me.
I offer this not as an explanation nor as a solution, only that I can sense the frustration that exists. Seeing resentful patients or handling phone calls from them is not very pleasant. I wish there were a way to ameliorate these types of situations. I also feel frustrated that it is more difficult but do not have a way to offer the access that seems to be desired. There are a limited number of people who do what I do and many patients with need. I cannot be the primary care provider for these patients and yet that seems to be what is expected by some of them. I empathize with your predicament and wish that it was an isolated incident, unfortunately, I think it is the norm. .
Sorry to hear about the bureaucratic health care system where you are trying to get your health care but suggest that since you are a sophisticated consumer that you look to a place like The Polyclinic First Hill Partnership in Health program. Some of the benefits include same day, longer appointments, streamlined registration and check in and other non covered services for a nominal monthly fee. Call 206-860-4466 if you want further help.
Wendy Sue Swanson, MD says
Thanks, John. Although your comment reads a bit like an advertisement, I approved and published it as you bring up something that likely demands an entire post, but I’ll give it some time here…
Part of me never wants to join a medical group that is “concierge” because it represents classism in medicine. Part of me does, because I want to be able to communicate my health needs and access my physician.
Ultimately, I want to believe that the system can works as well for me ( a doctor) as it does for anybody else (those that don’t have the resources or schooling to understand how to advocate in health).
But I have hesitated over the last few years multiple times because of the challenges that I (like so many others) encounter in my own care, the care for my children, and the care for my mom.
The story I shared yesterday is common. Not because groups don’t want to provide exceptional access, it’s just difficult to do so. Particularly with reimbursement lowering and reimbursement ultimately being based in production. I know you know this…
But concierge or pay-out-of-pocket-for-better-access practices portend an ominious future. One where the wealthy get efficient, speedy care and the poor do not. And I’m terrified to contribute to widening that divide.
What do you think?
Wendy Sue Swanson, MD says
Thanks for your comment. I know the frustration exists in my own practice, too (about getting in) and I’m a generalist where there are plenty of other people around who could solve their problem. We all like having relationships with one doc, just as your patients do. Even though I am that primary care doc you mention, my panel of patients is not always able to get appointments they when they would like and at the speed that they would like. Or they feel they are given a “run-around.” Or they feel they are triaged in a way they shouldn’t be. I hear about this every day. I try to pass on comments/complaints to our practice manage and reception lead as I see fit. I REALLY DO WANT THIS TO WORK for my patients. We do everything we can to improve it. We have a walk-in clinic open 7 days a week until 8pm so that patients can always be seen same day, even when I’m booked. But that isn’t perfect for everyone of course, either.
We’ll also never please everyone, unfortunately. It reminds me of my reaction to a great commentary about waiting for results in Sunday’s NYT. https://www.nytimes.com/2011/04/17/magazine/mag-17lives-t.html?_r=1&ref=magazine where a patient detailed how he adored how when there was bad news to share, the doc entered the room and said it off the bat before even saying hello! But made me think, I can imagine another/different patient complaining about the same interaction…
Unfortunately, we can’t have entire open access like we’d like and remain profitable enough to pay the bills in this climate of health care. It’s exactly why I believe more and more in prepaid integrated systems that have financial incentives to mobilize prevention efforts and maximize online communication so that families can communicate but don’t always have to come in…right now, we do all sort of communication online and out of the office that isn’t reiumbursed. We do it for free because we should, but it takes a toll. And for clinics it’s costly and difficult to do and ultimately just taxes the primary care docs more and more…
I read the last 3 problems as different from the original post. In an urgent care situation, one has to have reasonable expectations about their doctor’s availabilty. I only get to see my kids ped for checkups, with at least 4 wks lead time. Over 4.5 yrs I’ve come to know a handful of docs I can rely on in her practice, and 2 to avoid. Sure it would be a wonderful warm fuzzy if she dx’d every ear infection. But she misses the ear infections and gets to talk about how they are growing. It’s still a satisfying relationship. She does a bang-up job communicating with the GI dr, allergist, audiologist.
Lee, I’ve been waiting to see my son’s GI dr since November. He had 6 bouts of gastroenteritis in 5 weeks. He has a dx. We have a care plan. We know most triggers. We have a letter to for physicians who might treat him that explains what to do just-in-case. When I called the nurse at the GI clinic, I was tired, concerned there was some other illness at play. So the nurse was going to fit me in during the Drs lunch break on a procedure day. But I had to decline. My ped had tested to various pathogens. Long term I need to understand if we are looking at celiac or colitis. But there wasn’t anything he could actually *do* in that visit. We just had to weather things with pedialyte as usual. It’s hard as a parent to not to crave the extra expert support from a specialist. I’ve come to accept the ED as a filter. If my kid is stable, then I have to accept there aren’t any quick diagnoses or cures.
Chandra F. says
I can tell you for sure what doesn’t work at my PCP. The receptionist at my doctor doesn’t answer the phone, ever. Not in the 5-6 years that I have been seeing this doctor can I ever remember calling and having somebody answer the phone. Instead, I have to call, leave a voicemail telling why I want to call and wait patiently for her to return my call. This wait is rarely (if ever) shorter than 45 minutes. So, what typically happens is that I will call her on my lunch break or in the morning before I start classes (I’m a student) or in between meetings, and she calls me back when I am (a) in a lecture (b) in a small group session or (c) in an area with zero cell phone signal. So she calls, I’m busy and miss the call, she won’t call back so I have to call and leave a message AGAIN and inevitably this phone tag continues 2 or 3 times. The worst part is that their office hours are just that – normal business office hours from 8:30 – 4:30, so when the receptionist is working, I am also busy. This clearly must be the case for the majority of people who call her office. I will never understand why it is acceptable for somebody who’s primary job is to handle phone calls to never be available on the phone, yet patients are expected to drop everything during their workday to answer the phone when the receptionist finally gets around to returning a call. I also had the bright idea to call in the evening to have a message waiting in her voicemail queue when she got to the office in the morning, that way she would see it and call me bright and early before I am in class. Nope, no luck, she simply does not answer voicemails left during non business hours. That means that her voicemail exists simply so she can screen callers. That to me is unacceptable, and I have been seconds away from leaving that office and finding a new doctor multiple times. The only reason I ever change my mind is that I love my PCP, I just hate the receptionist. It gets to the point where I will be months behind schedule on my yearly visit simply because I avoid the prospect of dealing with her office staff.
Chandra F. says
Oh, and I was too worked up with my complaining to talk about what I think should be more easily available in today’s medical system: the ability to schedule appointments and ask simple questions via email. My PCP’s office won’t allow this for privacy reasons. This is is so frustrating because I would gladly sign a waiver if that meant I could schedule appointments and ask quick health related questions without having to deal with the receptionist (see above). This is something that I desperately hope they incorporate into the system by the time I graduate from residency. I would much rather be able to take 5 minutes out of my day to answer a parent’s simple question about whether or not a child is “old enough” to sit facing front in a car seat (for example) than have them make uneducated decisions simply because they can’t afford the time or money to come into the office to ask that question.
The thing that drives me up the wall with the physicians I’ve seen and see is this attitude of, “Oh, you’ll be LUCKY if we deign to see you and you’ll come in when I SAY you can come in.”
The model is all wrong and the relationship from top to bottom in almost every practice is structured as teacher-student: These are the rules and you’ll follow them or you’ll be punished in the form of a refusal to help solve your problem.
What so many doctors, nurses, medical receptionists, etc do not seem to understand is that this is a customer service business at its core. It is a vendor-client relationship where patients pay money (lots of good money!) for a service and we can take our money (and insurance cards) elsewhere if the service we receive isn’t up to par.
Except…the regulations and nature of how we access and pay for this care makes it far more trouble than it’s worth. We can’t get our medical records for free in Texas unless we have them sent to another doctor and it can take up to 2 or 3 weeks, which is beyond stupid. There’s tremendous “start up” cost to changing practices in the form of filling out releases and information requests plus the standard 10+ day wait for an opening for a new patient – JUST TO SEE if you like the new doctor. So many doctors don’t do informational appointments or put enough quality information on their websites (likely in the name of liability) so that patients can make educated decisions on who they choose to see. It’s a weird game of hunt and peck where the physician always gets paid and the patient *sometimes* gets what she needs.
I wish that the front office staff were smart. I wish that when i asked for information to be faxed to me in advance, that they’d take the time to actually fax me the CURRENT forms and then keep track of them until I arrive so I’m not asked to fill out the same freaking forms again. (True story.) I wish they approached making an appointment as a simple service they’re happy to provide for me, rather than a dramatic inconvenience or a task so burdened with rules that it’s impossible to fulfill. (The LATEST I have is a 2p that day. Take it or leave it.)
More importantly than all of that though, I wish doctors would allow patients direct access to tools. The category is firmly stuck in 1995 when it comes to record-keeping and client management. Get rid of these bozos who lack basic phone skills and turn off so many patients and PUT IT ALL ON THE INTERNET. Make the calendar publicly available for booking (similar to OpenTable). Disclose policies online. Make forms printable PDFs. (It’s entirely unfair to have a patient legally agree to certain things on the fly without prior review.) Publish a patient care philosophy. In short, SELL ME. Tell me why choosing this practice is a good idea and how you’re going to make my life easier. Earn my money. Act like it’s valuable to you.
And then? Thank me for my business. Make it easy for me to make my next appointment. Send me a Happy Birthday email. Congratulate me when I lose weight or hit a health goal. Stop acting like you have ten million better things to do than pay attention to me. If you have to disappear for ten minutes, tell me in advance so I’m not sitting in a room wondering when in the hell someone is coming back. Because really, I think that’s what a huge issue is: So many patients feel like they are de-prioritized and unimportant to EVERYONE in the office and that’s just wrong.
I wrote a novel. SORRY!
One last note: The practice where I have been treated the best, the most professionally and the kindest? Was my infertility clinic. I can’t help but think it has something to do with the fact that they deal primarily in cash and measurable results and they know exactly what sort of customer service business they’re in. They have to provide quality care, set reasonable expectations and fulfill on them or their clients will walk away.
I suppose I see this as a patient issue as much as a doctor/practice issue. If more patients were as discriminating and didn’t put up with being treated poorly then practices would have to change their model/behavior to retain clients.
The fault lies with both, but is greatly exacerbated by how we pay for these services. If everyone had to pay cash, things would be entirely different from a customer service standpoint and THAT is the part that makes me crazy. There are so many people that refuse to acknowledge that indirect costs are actually real costs. UGH.
I have to know, and it wasn’t in the post – did telling him that you are a doctor get you in?
Wendy Sue Swanson, MD says
No, telling him I was a doctor and understood the system didn’t help. Or maybe it did, who knows, because
…..drumroll, the receptionist called today fortuitiously while I was at my desk between seeing patients.
THE BAD NEWS: my doctor checks her e-mail on vacation
THE GOOD NEWS: she has accepted me back into the practice. I have an appointment next week.
I had something similar happen to me. Ever since I was 9 I had seen a certain doctor. I moved away for college, but my parents and sister continued to see him. When I moved back and scheduled an appointment the receptionist refused to schedule me because I had been away too long! She claimed she would talk to my doctor about it, but I know she never did because my mom followed up with him about it the next time she was there.
Anyway, I soon moved again and it was ridiculously hard to find a primary care physician. The wait lists to get into see one were ridiculous. For awhile I thought we found one, until one day my husband went in for an afternoon appointment and they told him it had been canceled. Upon questioning he found out that it had been canceled in the morning and no one had called to tell him. And they couldn’t give him a good reason for why no one told him. He took off personal time from work to make the appointment! They couldn’t even give a reason for why he hadn’t been called.
We finally found an experimental clinic that works like an ER and private practice. Extended hours and weekends, with the ability to schedule appointments with the same doctor and convenience to see another one if it’s an emergency and s/he isn’t in. It’s worked out well thus far.
Great post, Dr. Swanson. When I moved across the county I had to get a new GP. For my first appointment I came in 5 minutes late. I was told I would have to reschedule. The receptionist never smiled or said anything kind. When I came in form my rescheduled appointment (10 minutes early) I was directed to the “watiing” area where I sat for over 30 minutes. I went to the receptioinist and informed him that the doctor was late and would have to reschedule. The receptionist told me I would still be billed for the visit. I recommended they not do that and never returned. I did get a bill. I mailed it back with a kind note saying I had never been a patient. Thankfully, I never got another bill. But I did get some junk mail from the clinic promoting a diet product it was selling.
The problem seems to be overload. In the 1980s my general practitioner was always available, 24 hours a day. And getting an appointment the same day was never a problem. But his was a small practice. The modern GP has to carry so many patients to make ends meet while complying with endless regulation….well, both the patient and the doctor must be pretty fed up at this point.
How do we remove the divide/crack as you say? Who or what created the divide? And how can we put the patient and the doctor back together? And, even better, in a new partnership rather than a one-way relationship.
This happened to me just yesterday! I too was under the care of my OB for the last 5 years and when I called to make a routine yearly well woman visit with my primary, I was told it had been 5 years so I would need to be seen as a new patient. Crazy!
Jen B says
I worked at a community health center for a long time, and once patients hadn’t seen us for over 2 years, we certainly didn’t fire them, but we did usually schedule them in a longer “new patient” slot. This often resulted in a longer wait until an appointment was free, but as regular appointment were 15 minutes, the longer appointment time was necessary.
That said, if someone had an urgent issue we would always get them seen by a provider before the “new patient” visit.
Our docs had only a certain number of patients on their “panel” (in the 1000s) and once a doc hit their limit they didn’t take on any new patients. That’s the only reasonable explanation I can think of- your doctor’s panel was closed and you now qualified as a new patient. However, I’m kind of appalled that they didn’t offer you any alternatives, and that the situation wasn’t better explained to you.
Thanks for not pulling the I’m-a-doctor card right off. At the CHC we didn’t see any physicians, since we took Medicaid and uninsured, but occasionally a physician relative would call and try to use their status to change something administrative for the patient. Treating every patient equally and offering equal access is really important, whether they are an unemployed immigrant or a billionaire CEO. (Can you imagine a billionaire CEO waiting for an appointment to see the doctor? Neither can I.)
Honestly, this is where I view medicine as a business, and doctors like any service provider I might hire for something. I am FIERCELY loyal to my pediatrician, who just so happened to be the doctor at the hospital the day my first daughter was born and I love everything about his practice, his staff, and most of all I trust and respect him. I get very sad thinking he might retire before my children are all grown and can’t imagine ever leaving his practice (in fact, it’s an argument I’ve made to my husband for not moving out of state ha! I said “only if Dr. Johnson comes with us!!”)
BUT I have been through 7 OB/GYNs, 4 PCPs, and for my daughter 3 dermatologists and 3 plastic surgeons, my other daughter 2 opthalmologists. Why? Because they made me wait (this morning I had an appointment with a perinatologist just for one test and I was the first patient of the day, he made me wait 1.5 hours before I saw him and didn’t even apologize or offer any explanation – I would never go back to him, but thankfully I don’t have to anyway), or their staff is rude, or the doctors were too inaccessible, or their practice policies turn me off. It IS possible to find great doctors, who are respectful of their patient’s time, who have caring and competent staff, who are available to their patients (I don’t take advantage of it often, but if I want to speak with my pediatrician personally rather than his nurse, I have never had trouble reaching him), and who manage their practices in a reasonable way… sometimes it just takes a little shopping around to find them. We are very happy with our current OB/GYN, pediatric dermatologist, and we have been traveling out of state for almost 6 years to see my daughter’s plastic surgeon – it’s inconvenient but worth it.
I would urge you to find a way to ask your patients about their experience at your own practice, because sadly I think a lot of doctors don’t know what problems their patients face. I had a ridiculous experience with a doctor’s billing company/coder/manager trying to get a diagnosis code changed that was very obviously WRONG and was keeping my insurance company from paying – no one would let me speak with the doctor himself and no one ever communicated with him. I finally strong-armed my way into getting him on the phone, and he was appalled – he had no idea, and agreed that the code needed to be changed, made sure it was, and my insurance paid. Unfortunately, the whole experience was so awful and his staff so rude, that I probably wouldn’t go back to him if I needed a dermatologist again.
I have written and re-written my response several times. Each time, it turns into a volume and starts sounding like a complaint, when that is not my intention at all. So, I will answer your questions about what works and what doesn’t.
You are aware of the access issues at your own practice. I have had maddening conversations with TEC personnel that echo the one you just described. I could go into details, but it really doesn’t matter. Bottom line: access is a challenge. And yes, the walk-in clinic is always an option, but a two hour wait with two children is a nightmare for me (and everyone else in the waiting room, I’m sure).
What works? Well, if you happen to be in that day, you are amazing about fitting us into your schedule. What doesn’t work? If you aren’t in that day, we are out of luck for being seen that day.
What works? Calling as far in advance as possible for well-child visits.
What works? Asking to talk to a nurse before scheduling an appointment. That’s how we were able to see you that day when Will was sick. You just happened to have an appointment open up while I was on the phone with the nurse (we both laughed when I told her it was a sign of the apocolypse that you actually had an opening). I am not just trying to run-around the receptionist either. Sometimes, I am well and truly on the fence about whether we need to be seen. Most times, the nurse does think we should be seen, but sometimes, they will say that we should take a wait and see approach. Then they put me on the schedule for a day or two later, and if the kid in question is still sick, we can keep that appointment. If not, we cancel it, and hopefully someone else that needs to get in that day can be seen.
What works? The FOLLOW UP PHONE CALL. Two weeks ago, when Will was still very sick the day after you’d seen him, I honestly didn’t know what to do. He was laying on the couch, very listless, very feverish, and just not acting himself. I debated calling into the clinic, but knew they would likely just tell me that he needed to be seen and to take him to the walk in clinic and he was honestly in no shape for that. As I was sitting there, trying to decide what to do. . .
I know I already sent you a twitter message about this, but seriously, it was just so good to hear you, my trusted pediatrician, listen to me describe his behavior and then say, \GO to Children’s.\ Often, as parents, we are nervous to appear overanxious and as if we are wasting the time of the medical professionals. Having you call ahead and pave the way for us was comforting and amazing.
As you know, Will ended up being fine, but I am so glad that we took him in. It was a stressful experience and a difficult weekend. He really took a few more days to really perk up completely. Sunday, he still had a lowgrade fever and wasn’t eating much and I was feeling a bit uncertain and. . .
YOU CALLED. On a weekend. On a SUNDAY. Just to check in. And I know that to you, a doctor who sees HORRIBLE diseases and very sick kids, Will’s virus was no big deal. But to us, it had been a stressful experience and your support made a world of difference. And I hope you know how much it meant to me and our family. Things like that bridges the divide.
I know there is the new Swedish ER in our area. A few weeks ago, one of my friends had an amazing experience there. Part of it had to do with a guaranteed wait time of less than 30 minutes to see a provider. Also, they don’t have waiting rooms, but rather, a patient is roomed immediately. What ultimately made her feel so positive, however, was that the ER doctor called the next day to check up on her kids. See. . . it’s the phone call. It’s that personal touch that makes you feel as if you aren’t just a number and that you are still on your doctor’s mind after you’ve left the office.
I know a busy provider doesn’t always have time to call, and most times, it’s really unnecessary. But a follow up phone call really does make a world of difference in soothing nerves in cases where the diagnosis was uncertain or the child seemed more ill than usual.
Well, my comment still ended up being a novel, but hopefully, it didn’t come across as a complaint. We adore you and know you and your partners are doing the best you can. But the frustration about access is still there and I think opening up the lines of communcation as you have done here is a great step in the right direction. I know that can sometimes open a can of worms, too, but finding out the real problems that your patients are facing might help forge some changes in how access is handled..
Thank you again for doing your best to bridge the gap and for being there for our kids and our family!
Ease of communication is a major reason I like Group Health. There is nothing like being able to request appointments and ask for medical advice/provide requested information over the Internet (and of course it’s a secured connection and database). Obviously, it’s easier for an institution like Group Health to be able to implement this than for a private practice.
If this seems challenging, try finding a doc who will even CONSIDER seeing your parents on Medicare. Then sit through the appointments once in a while when the only doc in town who would take them talks to them like badly behaved children. I finally found a new doc for my dad but dad won’t change (after a nasty debacle ending in hospitalization and the doc insisting he was in detox when he was dehydrated) because he’s afraid of being dropped by a new doc.
I have to see a breast surgeon by referral by way of a NP at the women’s clinic at the CHC that I go to. I called today and they said they wanted to see me at the next available appointment. . It would have cost me only $25 but I opted for the $80 to see another BS next week when I was told that the next available appointment was in July.
I also wanted to add that at the Community Health Center I go to if you don’t see your provider once a year they “expire” you. You’ll be put on the waiting list to become a new patient. Last time I heard it was about 7 months long.
My daughter has seen you since birth and I couldn’t be happier. Of course, every parent (I would only assume) would like to have access to their childs pediatrician 24/7 but unfortnately it doesn’t work that way.
Thanks for all you do in trying to better not only the healthcare system but views shown in the media.
Here is the linke to the EPI-Pen commercial I saw last month that you were interested in. My apology for being a bit off topic in this topic but I couldn’t find a general area to post so found this one to enter comments.
Chris Richardson says
I have found the only way to get in to see our children’s doctor for sick baby visits is actually to say if they can’t find me an appointment for that day we will have to go to the local Stat Care where appoints aren’t necessary. It’s hard to say that, but the people making the appointments don’t work with you at all until they thing you will go somewhere else! Or, I can have my husband, who is a doctor, call the other doctors directly that always works. I hate to say it, but it is a frustrating thing just to see the doctor!
Melany Richmond says
We’ve had horrible issues with doctors. We used to live in Eastern Washington where there is an actual shortage of practitioners. I kept my OB in Seattle because the local doctors were not accepting patients who weren’t pregnant. I was calling an OB/Gyn about Endometriosis, but they wouldn’t accept me as a patient.
The pediatrician has a 4 month wait. They called with an appointment reminder and I said I’m not sure if that will work, give me a minute to call my husband. She then gave the appointment away, the one I had scheduled 4 months prior.
It is hard to see a doctor and the schedulers appear to be on a power trip. The rumor on the pediatrician in town was the thicker your file was the harder it was to get an appointment, like the scheduler assumed you came in for everything. My son was asthmatic, he came in when he had trouble breathing, but they blocked us from coming in more than once. Then the doctor lectured me for not bringing him in sooner, but it was the scheduler that was the barricade.
Our doctor went “concierge” awhile ago but still saw the regular folks (like me) too. However, there were gradual changes. First there were no more after hours phone to reach the doctor. And now no one answers the phone calls. You leave a message and they call you back several hours later. So sad because we love the doctor…I have to drive a distance to the office but I may have to consider switching practices after so many years. I teach and can’t wait for a phone call…often I can’t take a phone call w hen I have a class so even if they do call back I may not be able to take the call. Email seems like a better way to go than the phone. Very disheartening.
I have been asked on numerous occasions to “pay on my balance” before I am allowed to go back to see my doctor. Let me make it clear – I have NEVER not paid my doctor bill in full. Yet I am treated as if I am trying to take advantage of something. Often I didn’t even know I had a balance! But the worst was the last time I called, after being sick almost non-stop since December, and the scheduler refused to even look at the appointment book before taking a payment!! I have been a patient of this doctor since I was 12 years old (15 years) and used to babysit his kids, yet I am treated as a stranger, or worse, a “problem patient.” Not only that, but about a year ago, my doctor stopped seeing me in person and passed me on to his nurse practitioner. He never asked or told me about this change. He just stopped seeing me. I don’t know what I’ve done – im very respectful of their time (to the point that I sometimes don’t ask questions I wanted to ask because I don’t want to take too long) – to deserve this sort of disrespect. But I’ve decided it’s time for a change. I don’t want to change and am not looking forward to the process, but I’m sick of being treated this way.
top doctors San Antonio says
What a sad experience! We should be able to reach our own providers, our doctors–our partners in health easier.