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Demanding Patients Try Physicians' Patience

By Melissa Young, MD | September 24, 2012

So I recently posted about a woman who wanted to be seen ASAP and tried to pull rank by saying she is a hospital board member. An Internet search has thus far been negative. I did not see anyone with that name or a similar name listed on the hospital website, although I am asking around to verify. Not that it really matters, except that if she really is on the board, I will have to decide whether it is worthwhile to bring it up to other board members. Is it a HIPAA violation if she really isn’t a patient of mine? I know her diagnosis, but that is not pertinent to the discussion.

Anyway, not soon after that conversation, my associate, Dr. F, got an even more bizarre call. Now, I was not part of any of the conversations, so some of the details may have been lost along the way. Mr. X, oh excuse me, Dr. X called and told our receptionist that he is Dr. F’s patient and that he needs an appointment on a specific day because that’s when he is available. Now, he must think we are all pretty stupid because how long do you think it took to figure out he is not, was not, and has never been a patient of the practice? With our EHR: two seconds. So he needs a new patient appointment, for which there is a significant wait, and on the specific date he had in mind, there’s nothing.

(MORE: Balancing Bureaucracy and Patient Care as a Physician)

Well, “Dr.” X (and I have to put that in quotation marks, because there is no way a real doctor, at least not a doctor of medicine would pull, pardon the expression, the crap he tried to pull) therefore had to speak to Dr. F herself. He asked her to see him on said date and when she said she did not have anything available on that date, he asked why she couldn’t see him during her break. How about after hours? How about a Saturday? She stood her ground (good girl) and said no. I told her after the fact she should have used my prepared speech about him arranging child care, transportation, and such. Why not throw in someone to do the laundry, the grocery shopping, and cooking? Because, you know, that is what working moms do after hours and on Saturdays.

How can people even ask such things? It’s not like we don’t have other things to do. We have other patients to see in the office and in the hospital. We have phone calls to make, forms to fill out, stupid prior authorizations, etc. And all these forms from the insurance companies, checking to make sure our diabetics are having their HbA1cs ordered and their eyes examined. Letters saying Mr. So-and-so hasn’t been refilling his statin as often as he is supposed to. And we do have lives outside of work (*gasp*). I know, shocking but true. We have husbands, children, and parents. There are houses to clean, soccer practices to go to, homework to check, and doctors’ visits to go to.

Do people really think we sit around twiddling our thumbs as we wait for their call? Do they think that if they just show up at the door, that we will be sitting on our behinds ready to jump up and see them at them whim? Whole other story.

We have been blessed with a busy practice. I am in no way ungrateful to the doctors and patients who send new patients our way. I know that in a healthcare system where doctors are having to close their doors because they can’t afford to keep them open, that we are very fortunate. But unless we make compromises somewhere (shorter visits, double booking, less comprehensive care, motherless children, unwashed clothes), we can’t see more patients than we already are now.

Find out more about Melissa Young and our other Practice Notes bloggers.

 

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by Melissa Young | October 01, 2012 3:27 PM EDT

HB Davis - "Do Doctors even go to the hospital anymore?" Why, yes. OK, not all. But most do. Especially subspecialists. I suppose internists can have hospitalists see their patients (but that's still a minority), but subspecialty consults have to be done by subspecialists. My associate and I take turns doing rounds in the hospital. There is one local endocrinology practice who are so overwhelmed by their office patients that they have asked another practice to cover for them in the hospital, but otherwise, all the other practices here do inpatient rounds.

by Jason Landry | September 30, 2012 12:38 PM EDT

I agree 100% with the article. I am a solo internist and often run into situations where patients will call to establish care and expect a same day appointment. It is very rare for a MD to have a new patient appointment on the same day and the average wait is usually 3-4 weeks. When patients are told this they often will claim to be a friend of the family, friend of a local MD, will claim that their doctor said they should be seen right away or the ER doctor said that had to been seen within 1-2 days. Most of the time this is not true but some people have no trouble with a small lie, sort of along the lines of the end justifies the means. I have had patients go so far to hang up and call my one of my parents to plead their case. My policy is I am an appointment only practice and do not take walk in's or same day appointments unless an opening is available. This helps me keep on time 90%-95% of the time. I do try to accommodate requests has much of possible but it is not fair for the patients who have scheduled an appointment. If a patient has a problem that is so urgent that they cannot wait till the next available we refer to an urgent care clinic or the ED depending on what is appropriate. By sticking to this rule it has allowed our clinic to stay on time, increased patient satisfaction, and decreased staff stress.

Has far has doctors not going to the hospital I am not sure what this is supposed to mean. I am also outpatient only but do this only to increase the amount of patients I see has an outpatient. So if a MD does not go to the hospital it does not mean he or she has an increase in idle time. I know there are various opinions on handling walk in's and same day appointment so just wanted to give my take. Anyone with different ideas, it would be good to hear about.

by hb Davis | September 28, 2012 2:03 PM EDT

That's all well and good. I could not agree more with 98% of what is said. But really now... Do Doctors even go to the hospital anymore?

More from Melissa Young, MD

In Treating Patients, Too Many Physician Cooks Spoil the Broth

When Physicians Leave: Giving Your Notice of Resignation

Demanding Patients Try Physicians' Patience

Patients, and Physicians, Need to Skip Unnecessary Testing

Only Hire When the Time is Right at Your Medical Practice

When Physicians Are Out, Revenue Also Takes a Vacation

Medical Practice Audits: Preparing for What's to Come

Hobbies: A Great Stress Reliever for Physicians

Dealing with the Absence of a Physician in Private Practice

Should Medical Practice Staff Get Paid When the Office is Closed?

Picking the Right Health Insurance for Medical Practice Staff

An Employee Benefit to Consider for Your Medical Practice

Weighing Employee Benefits for Medical Practice Staff

In Private Practice, There's Very Little 'Off' Time

Retirement Plans for Medical Practice Staff a Great Investment

Patient Satisfaction: You Can't Please Everyone

Dealing with Difficult Patients a Part of the Job as a Physician

Going into Medicine ‘to Help People’ Not a Bad Reason at All

Having Students at My Medical Practice Provides Lessons in Liability

Balancing a Patient’s Request with a Physician’s Ethical Standards

2011: A Year of Milestones at Our Medical Practice

My Medical Practice Christmas Wish List

Common Stereotypes Often Cloud Patients’ Perception of Physicians

Office Manager – a Necessary Expense in a Small Medical Practice?

When Patients Ask About Other Physicians, Answers Are Tough to Find

Appropriate Halloween Costumes at a Physicians Practice

Mommas, Don’t Let Your Babies Grow Up to Be Doctors

In Medicine, Good Peer Interaction Can Be Hard to Diagnose

When Lied to, Physicians Need to Trust Their Gut

The Challenges of Running a Solo Private Practice

Lessons Learned in Running My Private Medical Practice

When Doctor's Get Sick, Patients Should Understand

Medical Practice Staffing: There's No Right Number for All Physicians

Patients Who Damage Property Just Another Part of Private Practice

The Doctor-Patient Relationship Isn't Always Smooth

Is Supreme Court ACA Ruling Best for Physicians, Patients?

Patient Compliance: Why Must It Be So Hard to Follow Doctors' Orders?

No Special Privileges for Patients at My Medical Practice

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Balancing Bureaucracy and Patient Care as a Physician





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