this post was submitted on 11 Mar 2024
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I feel a lot of appointment-based businesses are like this. They're trying to slot in as many services into one day as they can. Them making you wait is acceptable because they're with another customer (Though I'm sure they wanna wrap it up with them quickly too). You making them wait is unacceptable because that'll throw off their carefully timed appointment schedule.
It ain't great but that's the bitch of this damned money world huh
Them making you wait is also often a consequence of earlier patients showing up late or an appointment requiring more time than expected.
The options to solve it are less patients per day, but that leads to even longer delays before you even get to your appointment date, OR more professional staff in the office....but that would cut into profits of the people in charge so is immediately off the table in this damned money world.
In an ER, that's understandable, but in a general doctor's office there's no reason that Docs should extend one patient's appointment time just because they ended up late:
"Oh, you scheduled a 30 minute consultation because of a sore knee but now you're asking for an ENT referral and blood work? You'll have to schedule another appointment to go over that, we're only covering what you told us the other day."
You think someone should be penalised by having their diabetes review cut short because the traffic from their minimum wage job was unexpectedly slow?
Hyperbolic, made up scenario, but yeah pretty much. You get the time slot you scheduled and you should be held responsible for using it. Most offices ask you to check in at least a half hour early for a reason.
I could just as easily switch that around and ask if you believe some poor guy who finally got an extended lunch break from his minimum wage warehouse job should be fired because he had to wait an hour at the doctor's office because some rich white lady spent 30 minutes past her appointment arguing about essential oils. Painting is pretty easy when it's all black and white.
Half an hour early? That feels excessive. At my GPs it's 10 minutes early
That sounds like an employment rights issue. Here we get as much time as required for health appointments.
OK cool don't care and that didn't even address half of my comment
Hyperbole indeed.
What about the 25 other patients who do not have a really, really important diabetes consultation, but a head cold or are just alone and need to talk?*
What about that one person who had their really, really important diabetes consultation at 6pm but was told to come back another day two hours later at 8pm once the other appointments were all stretched out ad infinitum, but can't return anytime soon due to their boss not giving them any time off in their minimum wage job, who then DIES of diabetes? Come on, let's not resort to hyperbole and made up scenarios - improvements are possible, and we should aim for those.
*Loneliness, in particular in elderly patients, is a real problem which I'm not trying to downplay. This needs to be solved, too.
It's a hypothetical scenario. Penalising people for being late or for missing appointments has a higher adverse effect for people in poverty or with disabilities without actually addressing the cause. It's why doctors in the UK are generally against introducing fines for missed appointments.
We need more capacity, yes.
If the commenter you're responding to is from the US then no. We have privately owned for profit hospitals and often they're the only option in ones area.
People always get called out for assuming everything is about the US but Europeans do it just as much lol
There aren't very many hospitals or medical facilities owned by municipalities anymore. Most are either owned and operated by a private hospital network, or operate under a private trust.
The hospital I work at used to be owned by the state via the university, but our governor literally gave the campus away to a private trust that operates for profit. Super fun times.
I think we may be talking about two different countries....
Ahh, yep. Definitely different countries.
Quite a few doctor’s offices are owned or ran by a management group, partly to share or reduce their costs due to bureaucratic insurance companies and HIPAA compliance. Those same management groups use the doctors like a cash cow and attempt to shovel as many patients at them as they can because a venture fund is running the group behind the scenes.
That's a funny name for an urgent care place, from the english "drop in appointment."
I hear you, I just thought it was a funny name from my American perspective. Du lutger dritgodt.
But the question I ask myself everytime is : how carefully timed is it really, if everyone has to wait so much ?
Dunno bout your PCP's office, but I know some hospital workers and it seems like there's a lotta time waiting for transport because they're understaffed, underpaid. Also, lotta piss and shit related delays. Sometimes those compound.
Believe it or not, lotsa "customers" in hospitals aren't, like, operating at peak efficiency. So there's a lotta small delays that occur for normal consequences of that. A fifteen minute delay here because a patient can't move very quickly. A ten minute delay as a patient thinks they have to pee but no one can find a bed pan and they can't use a toilet. Then they don't have to pee. A thirty minute delay because they can't find the right kind of stretcher for a particular patient. An hour delay because, while you were scheduled to get your outpatient test done at 4 P.M. sharp, someone else from the Emergency Room needed that sort of test done ASAP.
When that happens frequently, not scheduling time for it is shitty scheduling.
This is a different kind of issue, one I think a lotta people would be more familiar with. Management setting unrealistic goals and targets. Yes, those kinds of delays are so common they should be baked into the time expectations. However, that would result in fewer billable services forecasted per period. That bad. Want more money. While doctors offices should be immune to that kind of shitty behavior, they are still ultimately business and thus they gotta operate with that forever growing, profit forward behavior.
If it’s so carefully timed, why is it ok for them to mess up the timing? I’m a paying customer and I have shit to do, too. Maybe it’s not true in the case of doctors, but for other businesses, the only reason you’re able to have this business is because I’m here, paying money.
You hit the nail on the head there. Other businesses exist because they won your business in competition with other businesses. A doctor’s office exists because they got permission from the state to operate.
The incentive structure is different, leading to different strategies being used to stay open
In the US at least you could easily find a different doctor, unless you live in a rural area with no other doctors in it
I left two different practices because of schedule fiascos and stuck with the 3rd because they never make me wait.
Because life is unpredictable. They can't know in advance if they're going to have delays, so sometimes you just have to deal with it. This goes for any appointment based service.
But should the same courtesy and understanding be extended to the customer?
Yes, which is part of why they end up running late.
I imagine it's unlikely the doctor's office "messed up the timing" such that the doctor isn't doing work and simply making you wait for funsies, but rather the patient before you needed an unanticipated amount of extra time for one thing or another. This is "acceptable" to the business as the doctor is still performing a billable service. It's not preferable, as it would be better if the doctor was performing MORE billable services per day, but acceptable. In hospitals, the number of services performed per day can be used as a KPI, for example. It's "unacceptable" to have the doctor waiting around not performing billable services as that doesn't make money.
If they're messing up the schedule in a way that you both have to wait and no one is performing a billable service, something has seriously gone wrong.
I started to just leave when this happen. There are a lot of good people who follow the schedule properly, i take my business to them instead.
This isn’t a result of money. It’s a result of having insufficient medical providers and them therefore being guaranteed business no matter how much they suck at customer service.
If money were the most powerful thing in medicine, new players would enter the market given its ridiculous revenue levels, and those new players would introduce competition and suddenly medical providers would be facing a world where their flow of customers is not guaranteed, and they would have to learn to respect and be grateful for their customers.
That’s how it would work if it were actually a “money world”. But medicine doesn’t run on money. It runs on government permission to exist, and that permission is always kept below demand levels, meaning once a provider gets a spot they don’t have to worry about someone else taking it.
Because money is fickle. To get money to come your way you need to provide good service consistently. If you stop, the money stops coming.
But a government license to operate is not fickle. Nobody can take that from you merely by offering better service. A government license to operate, in a market with severely limited supply, is a license to treat your customers like shit and see them crawling back for more.
This is the first I've ever heard of this. Got anywhere I can read more about it? Sounds uncompetitive if not outright corrupt.