Chronically late patients... - page 3

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 acknowledge that they are... Read More

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    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.

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    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.
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    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.
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    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.
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    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.
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    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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    The central problem here is that the MDs don't really mind if the patients come in late. Every doctor I've worked with placed a premium value on their lunch time and wanted to leave on time to go home. Thus they were our allies in keeping the flow going and generally would be very peeved at the latecomers for throwing a monkey wrench into the whole business. If someone did that more than twice they would refuse to see them.

    You could tell them to come in 15 minutes earlier than their actual appointment time. You can see all the patients who come on time first, but this usually only works if the doctor agrees -- because the habitually late people don't like to be kept waiting too long.

    For well-baby check-ups you can call them to remind them the night before or to make sure they plan on coming in for their appointment early on the same day. If they forgot or lost track of time then you know ahead of time you have an extra 15 minutes to work with. I know it isn't our job to be somebody's nanny but the anxiety of waiting for people to saunter in whenever they feel like it is too much for me even if everyone else is fine with it!

    For sick kids you really do need to see them. Most parents of sick kids bring them in pretty promptly if they get a same-day appointment in the clinics I've worked in. I feel your pain!
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    when I was seeing my OB-GYN for my pregnanacies he always scheduled all appointments for the morning at 1030. He saw you first come, first served, so-t0-speak! That meant there was 10-15 pregnanat women aiting from 10-12 or later to be seen. UGH!!!!
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    I have always had to sign a contract stating that I was charged a fee if I was more than x late. After 3 times I was fired from the service.
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    Haha, do we work in the same office OP? I agree and tardiness is my biggest pet peeve, as are chronic "no-showers". Only 1 of the doctors has a policy on tardiness, and you know what? ALL of his patients come on time. Patients tend to take advantage, and then leave negative reviews on why the doctor is running so late, or why they have to wait so long...ahhh!
    Last edit by PlumeriaSun on Jun 14, '12 : Reason: grammar

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