Chronically late patients... - pg.2 | allnurses

Chronically late patients... - page 2

How do you all handle late patients? I work in a peds clinic where there are a fair amount of chronically late patients, not 5 minutes late, but more like 15-20 minutes late. They never apologize, or... Read More

  1. Visit  AQEELSMOM profile page
    0
    Whats so hard with saying with a smile, "Hey there, i see you're running late! Your appointment time was at x oclock! You know, I want to be able to provide you with the best care that I can, so next time try to come at your appointment time so we don't have to feel rushed, because there are people coming right after you", and then pat them on the back and guide them to where they have to be. I do this all the time and have no problem with latecomers anymore.
  2. Visit  grownuprosie profile page
    1
    As a front office receptionist of 4 years, some of the comments here are like nails on a chalk board to my ears! LOL!


    A few misconceptions to clear up:

    The doctor is usually late, so i should be too. With the exception of a physician new to practice who does not have their time management skills yet, the reason for them being late is probably not under their control. Urgent and late pts make the rest of the pts late. If you use this logic you are part of the problem, not the solution.

    The Front office should be able to tell me how late the doctor is running when I call ahead of time.
    You can see the look foreboding come across my face when pts ask this over the phone. Why? Because if i admit that we are late, they will come in late. Nine times out of ten, we are caught up by the time their appointment comes around and they are no where to be found, making us behind again. They come in 20 minutes late claiming that we told them it was ok. If i tell them we are on time, and something urgent comes up or a pt ahead of them comes in late and makes us late, they will throw a tantrum. I have seen adults kick the wall and scream because, "I lied to them." That is why I made it a personal policy not to answer that question. It always ends poorly. "I do not anticipate the dr to be running behind for your appointment, we encourage you to arrive at your scheduled time of 0000.", is all you are going to get out of me.
    amoLucia likes this.
  3. Visit  SHGR profile page
    1
    Quote from grownuprosie
    Because if i admit that we are late, they will come in late. Nine times out of ten, we are caught up by the time their appointment comes around and they are no where to be found, making us behind again. They come in 20 minutes late claiming that we told them it was ok....
    So true! I never tell people about the grace period, and chronic latecomers I give a fake earlier time to, as one poster mentioned in this thread (and yes, my mom does that to me too!)

    For our clientele, I'd prefer to do away with specific appointment times whatsoever, but that would be a whole 'nother thread.
    grownuprosie likes this.
  4. Visit  wooh profile page
    4
    Quote from grownuprosie
    The doctor is usually late, so i should be too. With the exception of a physician new to practice who does not have their time management skills yet, the reason for them being late is probably not under their control. Urgent and late pts make the rest of the pts late. If you use this logic you are part of the problem, not the solution.
    Well it's not my fault that traffic was bad. But you expect me to plan a bit more time for the drive. Just in case right?
    Well that's what the office needs to do. Plan a bit more time for the urgent and late patients. Just in case. If you aren't doing that. YOU are the problem. (the system at the office, not this poster in particular)
  5. Visit  JZ_RN profile page
    1
    There should be a late policy, but then again, if they have to wait when they show up on time... I see both sides.


    I'd make them wait an irritating amount of time one day, then go in and say, oh, sorry I'm running a little behind, we both know how rude it is to be late, I apologize...maybe they'll get the picture.
    Last edit by JZ_RN on Jun 6, '12
    grownuprosie likes this.
  6. Visit  tigerlogic profile page
    1
    I can't stand being late as it seems disrespectful. I'm almost always early. Except for doctor's appointments. They always make me wait in the lobby and then when I've found an article in an old magazine that's kinda interesting they move me to a room where I wait. I feel that's part of the proccess and they are dealing with all sorts of things. However, it doesn't motivate me to show up early and I show up on time purely out of habit.

    If people are late why can't you just send someone else in out of order? Motivate people to be early/on time. My accupuncturist always gets me in early when I'm early or I can have a cup of their expensive tea while I'm waiting.
    wooh likes this.
  7. Visit  NurseTrishaH profile page
    1
    I dealt with a lot of this when I worked in a Family Practice Clinic. Here is how I ran my ship: Appt times were every 15 minutes with a 5 minute grace period. For instance, if the 0900 pt didn't show up until 0907, they could either reschedule or wait to be seen during a break (but no guarantee when that will be). Some people didn't care, and would wait because it got them out of work for several hours. Others would get irritated, saying that they waste time waiting for the doc. Most finally understood why the doc is running late when I would lay it out for them. Show them that if they are 7 minutes late, that puts the doc 7 minutes behind. The next late person might add on another 8 minutes, so now the doc is running 15 minutes behind. It all adds up. Also some pts make an appt for something little, like refill of allergy meds, but then bring up on the way out the door "oh, hey, doc, sometimes I get chest pain. Is that OK?" which creates a whole mess of testing, checking, etc that eats up more time. Rarely is it entirely the doc's fault for running behind - it is patients who don't see the whole picture of how a clinic runs.
    JZ_RN likes this.
  8. Visit  grownuprosie profile page
    0
    Quote from wooh
    Well it's not my fault that traffic was bad. But you expect me to plan a bit more time for the drive. Just in case right?
    Well that's what the office needs to do. Plan a bit more time for the urgent and late patients. Just in case. If you aren't doing that. YOU are the problem. (the system at the office, not this poster in particular)
    Ha, I don't think you are attacking me personally. No worries. I do disagree with you though.

    In a nut shell, yes, you should make time for the drive and the possibility that traffic or parking is going to make you late. If that is not possible and you are late, do not get upset that you have to wait because the next pt took your place. The vast majority of our pts are seen within ten minutes of their appointment time because we are making an effort to stay on time. We expect that you do too. As far as the offices making time for urgent cases, they do. However, can you tell me exactly how many of Dr. X's pts will fall ill on a particular day? Me neither. We have no choice but to guess based on trends. Sometimes we guess wrong.

    I don't know what kind if nurse you are, but I am sure there is something in your job comparable to this. Have you ever ran late giving meds because a pt held you up? Now imagine if that pt did it on purpose because they felt you would not be on time anyway. it is kind of the same thing.
  9. Visit  wooh profile page
    0
    Quote from grownuprosie

    I don't know what kind if nurse you are, but I am sure there is something in your job comparable to this. Have you ever ran late giving meds because a pt held you up? Now imagine if that pt did it on purpose because they felt you would not be on time anyway. it is kind of the same thing.
    Yeah, but I plan my day to make allowances so that I'm not HABITUALLY late with things. A patient doesn't code everyday. So when one does, that day things will be really behind. And occasional problems are understood if they're explained. My GYN office apparently had a patient go really bad in surgery, which took up two of their GYNs and then they couldn't even have the on call one come to help because she was delivering a baby. They explained, nobody was angry, we all understood that stuff happens. Generally they ran within a 15-20 minute wait. (And it is actually sad THAT kind of wait is considered acceptable. Lucky for me they're doing even better than that the last couple years.) BUT, at a different MD office, when EVERY SINGLE TIME one goes to the office they're running 45+ minutes behind? No matter the time of day you make the appointment? THAT is a failure to plan for the inevitable. And a lack of respect for the patients' time. That's like me saying, "Mapquest says it's a 30 minute drive, so I'll give myself 31 minutes even though I plan to go in the middle of rush hour and know that most days it takes a good 83 minutes to make that trip because I'd rather they wait than I have to wait."
    Late policies are fine. IF your office is run on time. If not, good for the goose IS good for the gander.
  10. Visit  dudette10 profile page
    3
    Here's a possible solution. Sick visits are not scheduled visits at my pediatrician's office. The office has "sick hours" for two hours first thing in the morning and for two hours right after lunch and for three hours on Saturday morning. (The length of time for sick visits may be a seasonal arrangement.) When someone calls in for a sick visit, the sick hours are stated, and the parent chooses morning or afternoon. Because any sick visit I've had with my kids has been quite prompt, I figure the office may avoid too many scheduled well visits during the "sick hours."

    It is made clear that sick visits will be seen by the first available doctor (five doctors in the practice), which may not be the pediatrician the family usually sees for well visits. This is enforced. It's also made clear it's first-come, first-served and scheduled well visit appointments are kept.

    The office itself is separated into a sick side and a well side for infection control, but it serves another purpose: it's also visually clear that someone isn't jumping ahead in line. For example, a well visit may have arrived later, but is seen before a sick child that came in earlier because the well visit was scheduled. Since the waiting room is separated, sick visits don't get in a huff with "Hey, they got to go first!" They already know it's a scheduled well visit because the child came from the "well" side. Anyone on the sick side knows the wait may be longer than a regularly scheduled well visit, and because that's the expectation, people usually don't get upset about it.

    I'm sure there are other policies that the office follows because it has always been fairly prompt.
    Last edit by dudette10 on Jun 7, '12
    sharpeimom, SHGR, and wooh like this.
  11. Visit  grownuprosie profile page
    0
    i think we can agree to disagree. The only thing I would say is that I think all offices should have late policies. Their enforcement OTOH should be done with discretion. If they are 40 minutes behind and you show up 20 min late, you are still waiting 20 min so you should not be subject to it.

    I am assuming the OP runs a fairly tight ship. If she notices pts are late, then she must be on time for it to be affecting her. In this case, I think it is appropriate to enact some kind of documented policy for tardiness. I am assuming that you have the standards down? I.E. telling all pts that they are requested to show up 15 min early. Reminder calls the day before. If there is construction nearby or a parade will be going on, have the front office leave that info on the reminder call so they can plan extra time.
  12. Visit  dudette10 profile page
    1
    If she notices pts are late, then she must be on time for it to be affecting her.
    No doctor's office is 100% on time. Not even my kids' dentist or orthodontist! If the OP's office is scheduling sick visits in the midst of well visits, it can be logically assumed that the office is not on time all the time. C

    linic wait times are not just due to patients being late. Visits run longer than the 15 minutes allotted, docs run behind, etc. The best that any office can hope for is to reduce unanticipated wait times with innovative ideas and a juggling act or two.
    wooh likes this.
  13. Visit  nor902 profile page
    2
    I worked for years in a GYN office. Despite the best efforts of the staff to keep everything running smoothly it rarely happened until we got really strict. We instituted the 15 minute late reschedule appointment. For the first few months it was rough going. In our office patients most of the time try to use us as their primary care with such excuses that they do not like their primary doctors. They would save all their problems up for a year and present them to us at their appointment. We had to put our foot down on this as well. A 15 minute appoitment would easily turn into an hour appt. What a mess. I must say that now since we became stricter we are pretty much on time every day, unless their is an emergency or delivery.
    grownuprosie and wooh like this.


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