Irritated about making an appt.

Nurse Ratched, RN · Feb 25, 2003

I can see where you would be upset. It's frustrating when you feel like someone is "gatekeeping" a little too enthusiastically . I frequently arrange appts for our patients. Our scheduling software actually budgets a certain amount of time based on the general nature of the problem (to hopefully avoid backups.) If the patient has multiple concerns, then we again allot more time for that. So when I inquire about the problem, it's for that reason, as well as to see if the doctor can assist without needing to see the patient (uncomplicated prescription refills and the like.) I agree that the receptionist shouldn't be offering nursing or medical advice.

We do also offer an option "unspecified" so if the problem is not on our list, or the patient simply doesn't want to say, then they can.

As nurses, we don't typically spend any more time at the doctor's office than we absolutely have to, so I know when you do finally break down and go you just want the appointment without the inquisition lol.

ShandyLynnRN, BSN, RN · Feb 25, 2003

I have had a problem with this also! Last year I wanted to see my GP reguarding depression/anxiety,.... when the receptionist asked why I wanted to be seen, I told her it was personal, and she kept prying.... said she HAD to have SOME reason to put down for time constraints. So I told her I would need 30 min visit. Not good enough. Finally I just told her I had insomnia.

I complained about it to the doc, and she told me that it had to do with medicare regs, and billing... she said something to the effect that if they put down that someone was being seen for one problem, and then they billed for 3 diagnoses, then they could be fined for fraud or something like that.

It sounded like a crock to me, and I told her that!

I run into this in my new state as well...

I wonder what the receptionist would say if when she asked someone that, they said "well I've got this discharge coming from 'down there' that smells like a dead rat"....

itsme · Feb 25, 2003

Shady lynn you are sooo funny!! I almost spit my coffee reading that!! I think I will make the dead rat appt just for s&g!!! (shyts & giggles)!! Maybe I will wait until friday just before the clinic closes though, just to top off her week!!! then monday I can call and cancel and tell her it went from dead rat stench to spring time lilac!!!!!!!!

SmilingBluEyes · Feb 25, 2003

I would be upset too, but usually I answer in general terms if I don't want some receptionist to know my personal reasons why I need an appt. I swear, people get ruder by the day; no phone presence in most of them anymore. Sometimes, they could get a bit more if they just tried being "nice"!!!!

ERNurse752, RN · Feb 25, 2003

"I have sex for crack, and I think I got the drip..."

Seriously...I don't like it either, especially b/c at my PCP's office, I went to high school with one of the receptionists, and one of the other office people is the mom of one of my high school friends. Ick.

hiccup...hippa...hiccup...

(currently flying high on Imitrex and coffee...I take no responsibility for anything I post today!)

boggle, ASN, RN · Feb 25, 2003

I so agree with you ITSME.

Actually, If I only need the appointment for a sinus infection or something basic (meaning I can probably diagnose myself thank you, just can't write my own prescription), then I don't mind telling the receptionist. Anything beyond that, I'd rather not discuss with the receptionist.

Since my doc's office is in the building attached to my workplace, I often go in in person to make appointments. Guess I feel I get more respect with a little face-to-face, eye contact interaction.

One wonderful thing about HIPPA is that this office won' t have you discussing problems, appointments, treatments, phone number, shoe size, etc through the little window in the waiting room. I have always hated hearing everyone else's private information as I sat waiting for my appointment. I have always refused to discuss anything that way, and have insisted they let me in to their reception office before disclosing any info.

eltrip · Feb 25, 2003

Originally posted by ShandyLynnRN
I wonder what the receptionist would say if when she asked someone that, they said "well I've got this discharge coming from 'down there' that smells like a dead rat"....

I'd love to hear the reaction to that one! Fortunately, I've not encountered that one. However, I frequently caution patients that when they call their Dr.'s office to ask to speak with either an LPN or an RN, & to not share their medical issues with whoever just happens to answer the phone. Educating patients...it's a good thing!

ERNurse752, RN · Feb 25, 2003

Originally posted by eltrip
Educating patients...it's a good thing!

Knowledge is power!

sjoe · Feb 25, 2003

Ratched writes: "Our scheduling software actually budgets a certain amount of time based on the general nature of the problem (to hopefully avoid backups.) If the patient has multiple concerns, then we again allot more time for that. So when I inquire about the problem, it's for that reason, as well as to see if the doctor can assist without needing to see the patient (uncomplicated prescription refills and the like.) I agree that the receptionist shouldn't be offering nursing or medical advice."

Right. Much of this is automated, and the receptionist has to click on certain symptoms and complaints on the screen in order for the appointment to be scheduled (having worked as an advice and appointments nurse myself for one intolerable year).

And the doc is right as well. What happens during an audit by an insurance carrier, Medicare, etc. when an appointment has been made for an ingrown toenail, and there are three different procedures done, and a referral or two? It does look like fraud, and the clinic is now stuck with an additional pile of paperwork to complete in order to get properly reimbursed for its work.

Of course, the receptionist is way out of line, pretending to be able to offer medical advice, and the clinic should be informed of that (in writing) in no uncertain terms. Additionally, as you mention, NO patient should have to be concerned about confidentiality when contacting his/her clinic or doc. HIPPA will NOT change people with loose lips, of course. The biggest problem seems to be that these people simply have not been adequately trained on the subject, IMHO.

If I were the calling patient and thought the reception either would not understand the problem or I simply did not want to discuss it with him/her, I'd request to speak to an LVN or RN and I would not take "no" for an answer.

PowerPuffGirl · Feb 25, 2003

I hate this, too, and keep running into it.

Reminds me of the time I was waiting for an Rx refill at the drug store, and this sweet little old lady whispered a question to the pharmacist's assistant, who bellowed, "Hey, Susan, where do we keep the fleet enemas? The lady in the red blouse couldn't find them!!!"

KRVRN, BSN, RN · Feb 25, 2003

Sometimes you can get by the receptionist by using the medical term rather than a more common layperson term.

Dyspareunia, for instance. Who would want to tell the window peon the layperson term for that?