Your appointment is only 10 minutes long... - page 4

My mother does not like going to the doctor so to get her there is a big ordeal. She had had a bunch of little things that should have been seen by a doctor but she puts it off. When she started... Read More

  1. by   texas_lvn
    Quote from bluesnurse

    Add the fact that my clinical time is limited by the need to spend hours on the phone getting preauths for procedures and medication, or trying to give recaps by phone to family members who are concerned about what transpired at the appointment but not concerned enough come along.

    Some providers and practices handle it better than others, but unless you are blessed with the resources to pay for concierge care (I am not), this is the system we have. Most of us are doing our best.
    And after I have spent 2 hours plus getting that precious RQI and the pt decides not to even show up or answer our calls to reschedule and I have to spend an addition 7 dollars to send a certified letter to said non-compliant pt because they refuse to answer or return my call, only to have them show up in 2-4 weeks with the same problem!!!:angryfire:angryfire:angryfire
  2. by   texas_lvn
    Quote from qt2168
    So do you guys think I should just let it go and in the future mabye just book double appointments or do you feel like writing a letter to this NP would actually make a diffrence for one of her patients in the future? Thanks for all the input btw its really helping me and seeing it from the point of view of someone working in the setting helps. Still a bit angry tho.
    With all that I have said, I agree that your voice should be heard. I think you need to address this in a formal, professional letter. There is no reason why someone should be rude. But also, please be considerate in your letter. Let someone else read it before you send it, or write it and then a few hours later read it and edit it so that you don't come across as (can think of a good word) lol, but that you get your point across that you expect more, the rude behavior was unnecessary and that in the future you will book double appointments. So you have a complaint and a resolution. It will have the provider understand that you are not attacking her (as you feel she did you) and let her know that you do want to keep this professional relationship. If she is rude again, Id be gone like donkey kong........

    Cant remember....was this your moms first visit? How long have you had a professional relationship with this provider? That may make a difference.

    Good Luck!
  3. by   texas_lvn
    Quote from chenoaspirit
    And also, if a patient doesnt have the time to list all their complaints, how can any MD properly diagnose. Some disease processes present with multiple symptoms and unless the MD knows all of them, he/she can not possibly diagnose accurately.
    If they are completely different areas like a hurt ankle from a fall 6 months ago, clogged ears for the past 2 months, and wanting an std check, I don't even think House can have a diagnosis where those would be related. LOL
  4. by   Daytonite
    Change doctors. Your mother knows these people don't care about her. If your mother belongs to an HMO write a letter of complaint along with a demand for a change to a different primary care doctor with the reasons you describe above (you did a pretty good job describing them).

    I take a piece of paper to each doctor I visit that I print out from my computer that has the date and a list of my current medications with a list at the bottom of issues they need to know or I want to discuss with them. I leave this paper with them and almost every doc puts this paper in my chart. I also keep them in a file on my computer so I can pull them up at any time.
    Last edit by Daytonite on Jul 4, '09
  5. by   boggle
    A very interesting discussion here! I totally understand the frustration with the "running a business" end of medical care, especially for running an office. If reimbursements keep getting cut, the rush will only get worse.

    Still, I think you have to remember the patient here. Their needs are physical and emotional and usually intertwined.

    I've been in the health care field forever and still get tongue tied and nervous in the physicians office. Don't rush me. Help me please.

    Going to a physician/ NP is very stressful for many people. Many are unsure about what's going on with their bodies, scared, embarrassed, not sure if they are being a bother or will be judged weak or stupid so may have put off coming till little things become big things........ Then there is the financial/ time toll to just get to the appointment. Should I miss a day of work for this problem?....will I miss picking up the kids?...... you get the idea here.

    I don't have an answer to this problem, but feel rushed appointments will only lead to more complex illness/problems to be treated on the next appointment.
  6. by   qt2168
    Cant remember....was this your moms first visit? How long have you had a professional relationship with this provider? That may make a difference.

    This was not my mothers first visit to this NP she was actually there 6 months ago for major depression (which took me forever to get her to go in the first place) I dont have a professional relationship with this provider either. We will definitly not be going back and I am going to take the advice and write a letter and have someone else read it also. thanks for the help guys!
  7. by   texas_lvn
    Quote from Daytonite
    I take a piece of paper to each doctor I visit that I print out from my computer that has the date and a list of my current medications with a list at the bottom of issues they need to know or I want to discuss with them. I leave this paper with them and almost every doc puts this paper in my chart. I also keep them in a file on my computer so I can pull them up at any time.
    Thank you Thank you Thank you!!!!!!!!!!! This is a very good idea and I wish more people would do this!!!!
  8. by   NurseKitten
    My best friend went to my OB-GYN when she got pregnant, on my recommendation. She miscarried at 5 weeks, and went that afternoon. Imagine my rage when the CNM did her exam, VERY brusquely with unnecessary physical roughness, and didn't even tell her she was sorry for her loss.

    This was the same CNM that had done my pap 2 months earlier, and didn't say hello, or anything else, just SHOVED a speculum....well, you know where.

    Me and doc had a chat. Don't know if what I said had anything to do with it, but this CNM doesn't work there anymore. Thank God.

    Complain. Advocate for your patients - in this case, your mother. Advocate and don't take no for an answer. There are MANY providers out there who are VERY good and would LOVE the opportunity to care for her.
  9. by   NurseTrishaH
    Quote from texas_lvn
    If they are completely different areas like a hurt ankle from a fall 6 months ago, clogged ears for the past 2 months, and wanting an std check, I don't even think House can have a diagnosis where those would be related. LOL
    Exactly. As the nurse, I will listen to the entire list to make sure there isn't something really important or related to the chief complaint. A sinus infection might be related to issue #8, teeth pain. So yeah, that is OK to bring up. But when a pt's CC is shoulder pain r/t fall in basketball last week, then how does that related to the plantar's wart present for 6 months, and the prematutre ejaculation, and the dry skin, and male pattern baldness, and everything under the sun??? we should address all those issues in one appointment? HOW???

    The clinic I work in is on an Air Force Base. So the office visits are FREE. People do not have to take unpaid time off to go to the doctor. The supervisor had to allow medical appointments. Non working spouses with children have 3 options for childcare if they don't want to bring the kids along. So, there is no excuse to not come back later.

    If it's the first time I see a patient and they have a list, I explain the time constraints (never had a complaint about me being rude). Most people have no idea, and that's OK. I help them go over the list and narrow it down, and immediately book them another appointment or 2 to address the other problems. It is a problem when it's a repeat offender with a shopping list. They know better, yet think the world revolves around them, and that we don't have any other patients to help. Sound familiar? Just like the people constantly on the call bell. Same mentality.

    You say you don't want to be rushed in an appointment. You say you shouldn't have to wait long in the waiting room. BUT, you also don't want to pay extra money. What is your suggestion, then?
  10. by   nursel56
    Quote from texas_lvn
    If they are completely different areas like a hurt ankle from a fall 6 months ago, clogged ears for the past 2 months, and wanting an std check, I don't even think House can have a diagnosis where those would be related. LOL

    :chuckle:chuckle

    OP, I would agree that a letter pointing out how you and your mother were upset by her communication style (rude) would be a good idea. I know that for me, if I'm still disturbed by something after a few days to think about it, I need to address it.
    Last edit by nursel56 on Jul 5, '09
  11. by   qt2168
    Does anyone have any ideas on how I could word this letter?
  12. by   ghillbert
    My doctor's office lets you make extended appointments if required.
  13. by   Katie82
    This issue is a classic example of attempting to charge the maximum allowed in return for the minimum amount of effort. I worked as a Practice Administrator for several years for a large Healthcare System. I was always under pressure from above to insure that my docs saw 22 - 25 patients a day while delivering above-grade customer service. Impossible. Don't blame the providers, they hate it too. I finally left that job because I felt I was being forced to place the corporate need above the patient. I am now a Case Manager and advocate for the very patient that I delivered care to. Two of my tasks are Utilization Review and QA. I monitor my patient's claims data for compliance and am always amazed how a system can get away with charging for a Level IV Office Visit (30 min. 2-problem focus) for every single 10 minute patient they see. I don't blame the healthcare systems, however. PCP practices receive the lowest reimbursement in the feeding scale, and are the costliest to run. Healthcare reform needs to focus on recruiting more docs to Family Medicine and paying them better.

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