“Why do doctors always keep me waiting?” a relative asked me recently. Foolishly, I started in on the myriad reasons why appointment times begin the day as mere suggestions and wind up as elusive desires by 3 p.m. And then I started explaining about the insurance mill that has to be cranked up, and how each claim must be fed in and cooked for an indeterminate amount of time that requires all the smelling, sifting, stirring, and sipping of craft beer, without any of the satisfaction, requiring a staff roughly equivalent to a Kardashian’s makeup posse, to move all these bits of parasitic data from one virtual bin to another. I explained that doctors often get calls from the ER, urgent pharmacy questions, “oh by the way” patient problems snuck in past the 15-minute visit slot, and of course the server going down, halting the whole assembly line until the IT wizard arrives. Nope, the relative didn’t want to hear it, she just wanted to tell me how awful, disrespectful, and lunch delaying the whole mess is, and of course she is right. But that doesn’t make this mess an easy mess.
In fact it stinks worse than that C. Diff sample forgotten in the patient bathroom over the weekend. I happened across a Business Insider article called “Why your doctor always keeps you waiting“, which handles the question nicely. It’s very realistic, and by the time you have read through the author’s morning of primary care, you will get the gut-knot feeling of having slogged through it with her. The author adequately demonstrates that traditional primary care docs are undervalued, and underpaid, for a variety of reasons, and promises to offer some solutions in her follow up article. She does wonder whether a system works that crams patients into 15-minute slots in order to pay the bills.
One approach of course, might be to free up some time and lower the overhead. Ignoring regulations that make your office more expensive might be a good reason to quit dealing third-party insurance, government or private. Releasing your billing manager and coding human resources into the economic stream might be tough, but aren’t they getting expensive? How much are you paying the IT guy for ICD updates every 6 months? Seeing fewer patients per day, with more scheduling flexibility would have to improve one’s ability to give comprehensive care. A friend of mine who went “cash-only” in 2002 (at $35 per visit) had one staff member, and bragged that he never had a patient wait more than 20 minutes.
It will be interesting to read this article’s follow-up solutions, but I’ll be skeptical if they don’t include steps to permanently take back control of her practice and her customer relations.