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... Read More

  1. by   nursel56
    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!
  2. by   silverbat
    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!!!!
  3. by   That Guy
    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.
  4. by   PlumeriaSun
    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
  5. by   chrisrn24
    I used to do reception work, and if you were over 1/2 of the time late for your appointment, it was cancelled. So if you had an appointment scheduled 2:00-2:15, if you weren't there by 2:07, it was cancelled.

    Could you also maybe tell reception to push their appointments back? So if they want a 2:00 PM, put them in at 2:15?
  6. by   MrChicagoRN
    We had that if you were more than 15 minutes late, onetime people would be seen first. More than 30 and you may be asked to reschedule.
  7. by   mappers
    I work in an Heme/onc clinic and scheduling is a nightmare for us. I don't know where all our hang-ups are and my job is always at the tail end, so the lateness shows up the worst for us. Our patients usually have several "appointments" not just one. For example, 99% go to lab first, then most see MD, then a lot come back to the infusion area for a treatment or an injection. Some see the Coag nurse or the Social Worker. We also have a CT scanner and a CXR machine they may be scheduled for. Rarely does a patient visit all of these slots, but most have at least two (lab + something else), and often three different stops.

    Now the patient is only see one time on their card. They may not realize they are scheduled in chemo at 10:15, because their card says 9:30 (the lab time.). Now if they get back to our waiting room at 9:45 and have to wait 15 minutes, they'll complain, even though technically, they aren't late for us. (We take patients on a first come first served basis, so if we can take them early we will.)

    Usually I explain to patients that scheduling for us is very complicated, that at most Dr.'s offices, you have one appointment to see the MD only. For us, there are lots of moving parts and there are lots of kinks. The patients usually understand, but not always. And a lot of times they have a right to be mad. We get frustrated as well.

    The coag nurse was telling me about a patient who was always an hour or more late. She finally said something to him about it and suggested he reschedule his appointment times. He said, "Well, it never seems to be a problem, you always get me in", to which she responded, "Well when you show up at 11:45, I don't get a lunch that day.". He rescheduled his appointments. Sometimes, just explaining the issue to the patients is enough.

    Another problem we have is lunch. The chemo area is not supposed to have anyone scheduled between 11:00 and 1:00 because we take lunch. The nurses go to lunch in shifts and give report on their patients to other nurses. It is very difficult to start a patient during lunch in that it is time consuming and doesn't allow for you to do anything else, when you are already responsible for twice as many patients as usual.

    However, if the Dr. sees the patient at 10:45, guess what time they are coming back to see us? Right during lunch. The appt desk will put "sorry, only time for MD" on the memo line, but id doesn't really help, make us feel better.

    It really isn't the appointment desk people's fault, they are just worker bees. The system is just very broken.