Your appointment is only 10 minutes long...

Di Deanna · Jul 3, 2009

wow, that seems to be the norm. i'm looking forward to replies on this thread because i have also failed to get a lot of health concerns off my chest because the doc is glaring a new hole in my forehead and trying to rush me out of there.

NurseTrishaH · Jul 3, 2009

I work in a busy family practice clinic, and it's completely true. Pt appointments are every 15 minutes for us - leaving 5 minutes for vitals, medication reconciliation, etc from the tech/nurse, then the provider has 10 minutes for the pt assessment, diagnosis, education, and treatment. That's it. So when people show up with a laundry list of problems, that 10 minutes turns into 15, 20, 25, etc. Guess what happens. Now all appointments for the rest of the day are at least 5-10 minutes late. Add it up, and that is where 1 hour waits come from.

Right now I work for a doc that drives me nuts. He allows the lists of little things. Yesterday he was 2 HOURS behind schedule for no good reason. And as always, the nurse (me) gets chewed out by patients, families, and the head honcos who have to deal with pt complaints. The doc never hears how angry the pts are because as soon as they see him, their demeanor changes. (ok rant over).

Long story short, when you go to your primary care provider, you need to understand that they have time limits. The 98347598347 tiny little things will have to be dealt with in separate appointments - so narrow it down to 2 major pressing issues like numbness in hand and refill of synthroid. Or shoulder pain + allergy sx. Yes it was a little rude for the NP to tell your mom she only has 10 minutes, but nobody is sweet as pie all the time. It's life.

oramar · Jul 3, 2009

That is interesting, I didn't know anyone else has had that problem. Up until recently all my personal experiences with NPs have been wonderful, when I went in with one chief complaint. I was also quite upset when the same thing you report happened with my 85 year old mom. I actually went there twice with my mom just to make sure I wasn't imagining things, she was given the "bums rush". I don't think those quick clinics are set up for people with multiple problems. I won't go into details about why but for a three month period my mom did not have an attending. Unfortunately she did not stop being elderly and frail and needed checked. By now I have her switched to another doctor and things are going swimmingly. By the way, her insurance company actually pays more for a first visit because they know it will take more time, this new doc spent nearly an hour with her getting to know her. The next couple of visits went very smooth because we had that long first assessment.

Whispera, MSN, RN · Jul 3, 2009

I used to work in a doctor's office where patients were scheduled 3 per 15 minutes (in case someone was a no-show). It was a nightmare!

Silverdragon102, BSN · Jul 3, 2009

I know it can be hard but having worked in a doctor's surgery in the UK when there are time restraints it is hard to look at a list of problems, however there is a way to explain to a patient without coming across abruptly like this. We used to know which patients would be the ones with a list of 'problems' and it would be stressed to them at the time of making the appointment that it was for 10 mins and if they had a couple of items to discuss to think which ones was the most important. If they wasn't know to come with a long list but started talking about several things we would to a certain degree talk to them but there was a limit and if it went beyond that it was explained that being late for this appointment would be affecting other appointments and have a knock on effect and could they make another appointment

I found with adequate explanation the patients in most cases was OK about this and things was sorted. I, as a practice nurse, many times see the doctors advise them to come and chat to me and I would do what I could to help and the doctors would make sure I was aware they was coming to see me and for a lot of stuff I was able to help and any issues was able to sort out or discuss with doctor/NP and arrange a more suitable time if they had to go back and see them

CarsonsMommy · Jul 3, 2009

:igtsyt: If a patient comes in and takes more than 10 minutes, and it is a trend that is happening in the doctors office. Maybe they should look into changing there policy instead of trying to be money greedy. Isn't that what you pay for? This absolutely frustrates me, this is not how it should be. The doctors or NP should be caring instead of trying to just take the money from people that don't have it. Who cares if they have a list, that is what THEY are paying for.

And for someone trying to make everyone think that is ok for a doctor or NP to say that that there time was up., shame on you!

:twocents:

Silverdragon102, BSN · Jul 3, 2009

:igtsyt: If a patient comes in and takes more than 10 minutes, and it is a trend that is happening in the doctors office. Maybe they should look into changing there policy instead of trying to be money greedy. Isn't that what you pay for? This absolutely frustrates me, this is not how it should be. The doctors or NP should be caring instead of trying to just take the money from people that don't have it. Who cares if they have a list, that is what THEY are paying for.
And for someone trying to make everyone think that is ok for a doctor or NP to say that that there time was up., shame on you!

But you also have to be realistic in looking at allocating time for an appointment. If the doctor or NP has a 3 hour appointment slot in the morning and 3 hours in the afternoon (just for figures) and you allocate 15 mins per appointment then you are looking at 12 patients each clinic, 24 patients a day but the demand may be 40 people ring up for an appointment how are you going to work especially if people take more than allocated time.

Believe me I know emergencies happen and appointments can and do run over but there still has to be some structure and time allocation.

Lovely_RN, MSN · Jul 3, 2009

Went in for my 35 week prenatal visit and Group B strep test. I arrived on time at 10am and left at almost noon. I spent an hour in the waiting room before I was taken to an exam room where I had my vitals and FHR checked by a medical assistant. Then I spent another hour dozing on the exam table until the doc came in got the culture, briefly palpated my abdomen, and asked me how I was feeling. I think I spent a total of 10 minutes being seen between the MA and the doc. When I had my last child I saw a different provider and I switched because I had the same experience. Now I know that this is typical. I think it has something to do with the skyrocketing malpractice rates. Providers have to cram in as many visits as possible to keep the bills paid these days. Also forget about seeing the same doc at each prenatal visit unless you like to wait and wait and wait. These days you get seen by whatever NP, PA, or Doc that is available.

It's so different from when I had my first child almost 17 years ago. I meet the three docs of the practice but I was seen by only one. The visits were much longer back then and I actually had a rapport with the doc.

I have also had this same experience with my PCP. They really do not have the time to address each minor problem, rather they want to hear about the major ones and have you come in for additional visits to address the other concerns. I feel that it's almost impossible to get great care these days because everything is a patch up job and providers don't have the time to address the patient as a whole.

I also had a recent experience where I threatened to call the department of health on a doc. I needed to get a physical for my job and my regular doc was on vacation. The replacement didn't know I was a nurse and tried to get away with filling out my paperwork without doing any sort of physical examination. No physical assessment was done, no vital signs were taken, not even my weight and height. He did not do the hearing test or eye exam that was required. The only thing that was done was blood drawing for titers and a PPD implant. When I confronted him about it he tried to play it off and say that since I was pregnant that I didn't need a thorough exam because he was sure my OB/GYN was following my care. Yep this is the state of health care right now and if your not proactive or knowledgeable the chances of you getting the shaft are pretty high and I have what is considered good insurance. I can't imagine what the un-insured or people on medicaid are getting as care. :uhoh3:

pers · Jul 3, 2009

I've never run into this myself but agree that NP could have dealt with your mom better. I'm assuming this isn't a clinic but a primary care office? I understand they have time limits but unless they told her when she made the appt that it was only 10 minutes long it's not really fair to push her out the door because she's got more issues than they can handle in 10 minutes. Personally I'd call and speak to the NP about it and if I still wasn't satisfied I'd change providers since the vote that counts most is the one you make with your wallet.

In the future, I'd recommend you let them know she has several things going on and may need a little more time with the Dr/NP when making the appt.

xoemmylouox, ASN, RN · Jul 3, 2009

In the pediatric office I work in we treat all patients the same regardless of insurance. We also do our best to address all issues but the same person who wants to talk for a half an hour will throw a fit if they have to wait 15 minutes past their appt time. In our office we schedule 3 every 15 minutes just to try to meet the demand, but there are always pts we cannot see. I think it goes both ways. You want to talk to your doctor for a half an hour, but then you don't want to wait 15 minutes whils someone else does. I am constantly yelled at by our patients parents for waiting. Believe me in our office we understand your time is just as important as ours. We don't like to be behind either. I don't like staying late, I want to go home to my family. So next time have a little patience and understanding. We can only do so much!

CoffeeRTC, BSN, RN · Jul 3, 2009

Wow....I totally understand the fact that the docs or NP need to see that many people and to be quick about it, but is that the patient's fault?

NO...For some older people or just busy people getting to a doctor appt is rough. Telling them they might need 3 different appts just to get to discuss the issues (that may be interrelatted anyway) is obsurd and not practical.

One of my last OB appts was rushed. The doc came in the room to listen to the baby hr and the nurse came in and kind took over for him (first time meeting the doc and he seemed like a talker and started telling a joke) nurse took over and started looking at him and handing him the doppler etc. I was barely sitting up from that and she was helping me off the table and ripping the paper off of it to change it. SRSLY, barely off of the table. (picture big pregnant women getting up from laying down) The she was opening the door trying to usher him out be for he could say anything.

The entire appt took less than 5 minutes (being a 5th time mom..I really didn't need much longer than that, except to meet the doc that could be delivering my baby) BUT....it was just the way it was done.

I had a feeling this doc gets behind in the appts and the nurse was trying too keep him on track...he seemed nice and willing to spend the extra time with his patients....BUT...the system wouldn't let him. At least I understand that, but I'm sure the average non person doesn't.