Thursday, February 02, 2006

"You never know what is behind door #2..."

The frustrations of the waiting room, and why doctors are late. Dr. Rod Moser blogs at WebMD:
People are complex. When you schedule a woman for a routine pap smear, this is what you are planning to do. However, when you enter the room, you are faced with a crying, depressed individual in a paper gown. Clearly, a pap smear is not her main issue today. You patiently listen to her version of the divorce and custody issues, and what a bastard her husband is, or how she may lose her job. You wait and you listen. Tactfully, you try and look at your watch, but you always get caught. Sometimes, you will decide to triage - take care of the situational depression first, rescheduled the pap. Sometimes, and more likely, you do both. This is a 45 minute visit (at least).

Out in your waiting room, people are stirring. They are making quick arrangements for people to pick up their kids at school, or cancelling other appointments. They are waiting and people HATE to wait (even though we call it a WAITING ROOM!). And, I understand that they are ticked. I hate to wait, too.

My next patient has been waiting a nearly an hour in the room. I don't want to go in there, but this is my job. My first goal is to defuse the angry. I apologize for the wait, acknowledge their anger for being inconvenienced. 'I am sorry that you had to wait today. I had an unanticipated medical crisis that took more of my time than anticipated. Sometimes, people's medical problems take more than just 15 minutes. I hope that you understand. Someday, YOU will need more time, and I hope the people that have to wait for YOU will be understanding as well. So, how can I help you today?' We both smile, tensions have released, and we complete the visit. As I exit the door, I hear, 'Oh, by the way...'"
(Don't miss the comment thread.)


Blogger Fallen Angels said...

I think our society has gotten to be much to focused on time. We are a clock-watching society, everything revolves around the clock. The !Kung! people (shown in the movie "The Gods Must Be Crazy") have a much better way of spending time with people. If it is a social interaction they approach and talk...NO ONE else approaches the ones talking until they are clearly finished, that would be considered extremely rude. If they need to see the healer, they approach and sit down. They wait. And wait. When it is their turn, someone else waits. They will wait days if need be and not even question the wait, it is obvious to them that someone else had something more pressing than they and the health of the group as a whole is more important than the individual. Of course our society could never be like that, but it does sound nice at times. Personally, I don't mind waiting for my GP or my Pdoc...if they could be on time, they would, they don't want to be stuck at the office after hours any more than I do.


10:28 AM  
Blogger Christi said...

Okay, fine. Doctors get behind due to emergencies. I understand and accept this. But how do you explain this? Several weeks ago, I called my daughter's new pediatrician to schedule a wart removal. I specifically told them I wanted it burned off with the liquid nitrogen. The front office checked, and said that if I didn't mind seeing the NP, I could have an appointment the next day.

I rushed to get there early, because being new to the practice, I knew I was going to have to fill out paperwork. Got that all completed prior to the appointment time and waited to be called back to the exam room. And then waited some more. Several sick babies came in, and they were seen before us. Okay, sick babies. I can deal with that. 45 minutes after our scheduled appointment, we are finally called back. We then proceed to wait for another 1/2 hour. When the NP finally shows up (without an apology for a more than 1 hour wait) she takes a look at my daughter's hand and says "Yep, that's a wart all right," and then proceeds to tell me to use Compound W.

When I asked why she wouldn't burn it off, she glibly told me that they didn't have the liquid nitrogen at this office - only at the old office. Also, she wanted to look at it just to make sure. And when I asked where I could get it done, she said that since I was on an HMO, she would have to write a referral to a dermatologist, but she wouldn't actually do that!

I walked out of there feeling well and truly the only reason she had scheduled the appointment was to get my copay.

I don't think we will be going back.

10:48 AM  
Blogger Kim said...

My previous physician was always notoriously off schedule. So...I would book as the last appointment of the day, take my crochet or the latest book I was reading and relax for the 60-90 minutes it took me to get seen. Heck, it was the only peaceful time I had in the day!

And...he spent just as much time with me as needed.

Also: the last person in the world who is going to complain about a wait time is an ER nurse! We've been there!

10:55 AM  
Blogger boinky said...

Hmmm...sounds like my office...
When you hear all the crap about "computerizing medicine" of the future for "efficiency", it is because people forget that doctors are supposed to be healers...
As for the liquid Nitrogen in the previous comment: the stuff evaporates, and it is embarassing to say: Well, it was here yesterday...

2:44 PM  
Anonymous Anonymous said...

When I go to the doctor's office I expect to wait. However, to the nurse who got me all set up for a pelvic, I appreciate that you want to try and speed things along by having me all ready, but PLEASE make sure the doc is coming in the near future, it gets real drafty.

4:49 PM  
Blogger Christi said...

I guess I did't describe it too well. My bad. W/regard to the liquid nitrogen, they flat out don't offer it.

I wish I had known that before I spent 4 hours (including drive time) dealing with the appointment. She could have told me to try Compound W over the phone. Or, she could have told me that they didn't offer that service, and that I would need a referral to a dermatologist, but that she couldn't give me the referral until she checked it out herself. That wouldn't have thrilled me (I mean come on, its a silly wart, but in these litigious days, I would have understood.)

But I spent about 6 months gently explaining to my daughter what to expect before she would let me make the appointment to have a wart taken care of. And then to get there, wait, and then basically get blown off, well, I was pretty mad.

5:14 PM  
Anonymous Bruce Small said...

I don't mind waiting, because my doc is worth waiting for. What irks me is when the front desk knows perfectly well he is running 2 hours behind schedule and they don't say a word about any delays.

6:17 PM  
Blogger TBTAM said...

Whew! I've never seen a comment thread as long or as spirited as that one over at Dr Moser! Seems like someone touched a nerve!

2:50 PM  

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