May 2005 – One of many posts lamenting what the death of primary care means:
No one wants to wait two weeks to see a doctor. In fact, no one wants to wait an hour in my waiting room. People are much more concerned about getting things done on demand, and they have difficulty finding a primary care doctor who will see them promptly.
Related posts:
- How retail clinics will harm primary care and the public good
- When primary care refuses to accept Medicare
- Primary care in Massachusetts
- Will the lack of primary care doctors make universal coverage useless?
- Free health care: "People do not realize how much they pay for it in taxes"
- What to look for in a primary care job
- Should primary care doctors embrace retail clinics?
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{ 19 comments }
Well…ultimately, all of these issues come down to one thing, money.
In this town we have two large clinic associations affiliated with two large non-profit hospitals. Both clinics recently built for-profit surgicenters that pull business away from the hospitals. The benefit for the clinics is that they can refuse the patients on Medicaid and Medicare or without insurance. The hospitals’ ERs obviously cannot, and are justifiably concerned that losing business to the surgicenters will further strain their finances, while the surgicenters “cherry pick” only those patients who can pay per their demands.
I suppose there’s a way to twist this and make it the patients’ fault, but that will be a stretch. Blame insurance providers, blame poor compensation from government programs, blame plain and simple greed…but when the medical profession begins consciously sabotaging ERs for its own profit, we’re all in some deep doo-doo.
Considerably off-topic, yes.
It is about time. Why continued overpaying for a job that could be done by a NP and a computer? This change would have occurred a long time ago if not for the power of Al Quida in America (AMA).
“In fact, no one wants to wait an hour in my waiting room.”
Obviously, I do not mind waiting in a doctor’s office if the doctor is working me into the schedule. I do, however, object to waiting an hour if I have an appointment — especially when the staff has booked several patients at the SAME TIME. I have to take leave from work to go to the doctor’s office, but I’m lucky to have leave to take. Millions of people work hourly jobs and give up pay during that time they are waiting. I’ve noticed a lot of lawyer-bashing on this website (lawyers who are representing litigious-minded clients who came to THEM); but it’s ok for arrogant doctors to keep patients waiting — and waiting– and waiting? I’m not talking about when there’s an emergency the doctor has to handle, I’m talking when it’s every dang-blasted time you go to a doctor’s office.
One of these days, I’m going to run for president on the following common sense platform: (1) reducing fees for ATM machines, and (2) making doctors reduce their fees based on the time the patient waits in the ##)*@!&*( waiting room.
“One of these days, I’m going to run for president on the following common sense platform: (1) reducing fees for ATM machines, and (2) making doctors reduce their fees based on the time the patient waits in the ##)*@!&*( waiting room.”
I hope you win. Really.
Believe me, when you see the fee I’ll charge for the appointment that is guaranteed never to be delayed, believe you me, I’ll make sure to be on time. And you’ll be on time with my payment, too. Right on time.
And I’ll be whistling all the way to that ATM you’re promising.
Your response shows the arrogance I have come to expect from many (but certainly not all) physicians. Your response indicates you don’t even expect to be on time.
“Believe me, when you see the fee I’ll charge for the appointment that is guaranteed never to be delayed, believe you me, I’ll make sure to be on time. And you’ll be on time with my payment, too. Right on time.”
I don’t think my message implied I expect that an appointment is “guaranteed never to be delayed.” I’m not talking about a delay; I’m talking about always having to wait an hour or more in a doctor’s office, especially when the doctor’s staff has signed up several people for the same time slot. And I would think any reasonable person could imply by my saying “waiting — and waiting — and waiting” that I’m talking about A LONG WAIT. (What’s the point in having an appointment? Appointment means “An arrangement to do something or meet someone at a particular time and place.” Let’s just stop calling them appointments; let’s call them approximations. “Hello, I’d like to have an approximation of when I can see Dr. X.”) Or better yet, how about giving patients those buzzers they provide at restaurants — maybe I could at least walk around the block and get some exercise or do something else useful.
Obviously, your time is far more valuable than mine; as you have so stated, to be allowed your extremely valuable time at a pre-arranged slot will cost me far more than if I have to wait until your schedule REALLY allows.
And you have no earthly idea how or when I pay my physicians. Yet, it’s easy to make the generalization that I fall into a category of patients who do not pay on a timely basis.
On a favorable note, my two primary (and long-time) physicians are great, are generally on schedule, and provide sufficient time to fully discuss my issues with them. for some reason, the overbooking and lengthy waits seem more likely to occur with specialists.
i’ve posted on this before, but if you go to my blog (yes its a poor neglected blog) but in the archives i explain how i’ll charge $20/15 min cash (no ins excepted) and make 200K a year. Thats a win for the pts and a win for the docs. With lower prices and greater quality than this nurse-clinics, we can revive primary care. oh, and yes i’ll be on time, i respect my patients too much to waste their time
“i’ve posted on this before, but if you go to my blog (yes its a poor neglected blog) but in the archives i explain how i’ll charge $20/15 min cash (no ins excepted) and make 200K a year.”
$20 x 4 appts/hour x 8 hours/day x 5 days/week x 52 weeks per year = 166,400 (and that is not counting in vacation and overhead)
You know, part of the problem is that you are so incredibly arrogant that you really believe you are the only people in the world who have jobs that matter. In the real world(the one you’re not a part of) people work everyday all day long. If they have a doctor appt. they must try and do it on a lunch hour, take the day off, use vacation or holiday time, etc. Whatever option we use, almost everyone loses money for a doctor appt.
When “YOUR STAFF” gives us an appointment time based on YOUR schedule, tell us why we shouldn’t expect to have that appointment within a resonable time? By making an appointment and giving us a card with a date and time on it you have said “This is the day and time I can see you” That card does not say “show up at 1:00 pm and be seen sometime before 5:00pm.”
All you can see consistently is your self serving issues with it. You don’t see that we also have lives, that we are missing work and losing money. You couldn’t care less about that. It is always only about YOU!
You better wise up or all your patients will be going to the walk ins.
“You better wise up or all your patients will be going to the walk ins.”
I’ll be there to meet you. Have your credit card ready. You can leave the insurance card at home. You won’t be needing it.
“”Obviously, your time is far more valuable than mine; as you have so stated, to be allowed your extremely valuable time at a pre-arranged slot will cost me far more than if I have to wait until your schedule REALLY allows. “
Apparently so. You seem to have lots of time for your gassy and plaintive posts, caps and all.
“Anonymous said…”
“‘Obviously, your time is far more valuable than mine; as you have so stated, to be allowed your extremely valuable time at a pre-arranged slot will cost me far more than if I have to wait until your schedule REALLY allows.’”
“Apparently so. You seem to have lots of time for your gassy and plaintive posts, caps and all.”
……………………………
I didn’t submit the other well-stated post from Anonymous about having to wait for our doctor’s approximations. (”You know, part of the problem is that you are so incredibly arrogant that you really believe you are the only people in the world who have jobs that matter.”) Believe it or not, that was from another person who has also spent significant stretches of time awaiting his/her turn for the (drumroll, please) doctor.
I may very well be gassy, but I won’t be going to the gastroenterologist for relief. My last trip to that hallowed ground resulted in a $450 charge for a 15-minute “approximation,” during which she said I needed to have a colonoscopy and rattled off a memorized speech about its potential problems. It had all of the heartfelt rendering as that from a stewardess who is reciting, “In the event of a crash..etc. etc.”
You just can’t accept criticism from atop your lofty perch.
— Anonymous 1.
” My last trip to that hallowed ground resulted in a $450 charge….”
Come now be honest anon how much of that 450.00 came out of YOUR POCKET.
Be honest now.
Better yet, by how much was that $450.00 “charge” reduced by the insurer’s contract with that doctor?
A $450.00 value, yours for only $59.95, that’s right . . . .
So much for an “approximation”, whatever that is.
“Lofty perch”, what a hoot. You’d think she went to an aviary.
Shall we do a little math for this joker so he realizes how stupid he sounds:
450.00 for 15 minutes for the GI doc
1800.00/hour (X 4pts/hr) for the GI doc
14,400/day (X 8 hrs/day ha ha)
72,000/week (assume 40 hour work week ha ha)
3,456,000.00/year (assuming a one month vacation).
Anybody know a Gi doc just seeing clinic patients making that kind of money? I don’t.
Conclusion: You are a liar.
Right, you would of course conclude I’m a liar rather than take my word that I was charged an exorbitant amount for a brief office visit. I’m not lying; it happened during February of this year.
This doctor did not have to review any previous tests prior to or otherwise in connection with that appointment. She simply talked to me for a few minutes about my very few symptoms, poked on my stomach, and routinely ordered the colonoscopy based on my age, since colonoscopies are now a rite of passage for anyone over 50. Then she recited (and I do mean recited) the risks associated with the procedure. Fifteen minutes. Ok, MAYBE (so sorry for the caps) 20 minutes max. The charge was $450; there was no discount, but yes, insurance did pay however much was allowable. (I can’t tell you the amount insurance allotted for this office visit and for the actual procedure; I only know how much I had to pay out of pocket total.)
What difference does it make how much I had to pay out of pocket anyway? I am lucky enough to have insurance. It was still an exorbitant charge for an appointment which could have been called in. Insurance paid, so everyone paid.
Ok, come on, anything else? Anyone want to address the reason doctors schedule several patients for the same time, allow them to wait in the waiting room, and then stack them up in rooms like planes on a runway? Convince me it’s not because they don’t want to risk having some downtime without a patient waiting (for some undetermined period of time) next in line to see them.
Sorry anon you don’t know how payment works today in medicine. No insurance company would tolerate 450.00 for an office visit. That’s the truth. Or the above anon’s calcuations would be correct and most GI docs make 1/10 (or less)that amount. Why don’t you break out the bill and reread it.
PS: You never mentioned how much you payed. Your typical american answer of “I have insurance” betrays one of the real problems in american medicine. Most americans have no clue (and I mean no clue) how expensive medicine/tests are. Yet they always want the best, newest test right now. Why not, they only pay a fraction of the real price. This system will not continue. In 10 years we will have socialized healthcare and associated rationing. Then you will be really waiting. Just think of your local post office.
The insurance company probably has the doctor by the balls and the agreement (or allowable) is that he gets 125-150 dollars. 10%-20% of that is spent on malpractice premium. Another 50%+ is spent on office overhead. How much does it cost to get a consultation for a plumber or electrician. Not much less.
Well, if I go to a doctor’s office and wait for an unexpected hour, that’s one less hour that I bill.
I’m a highly paid professional. From a national economic standpoint, I think you’d have a VERY VERY hard time arguing (wthout laughing) that my time is best spent in a waiting room.
Would I pay an extra $10/appointment? Sure! Multiple $10 by each appointment, and that’s easily enough to cover extra for a functional secretary who can call people through the day and let them know when the doc is running late.
All I have read is how unhappy or unsatisfied somebody, (pt, staff, and MD), is at md office. I work for one and let me tell you I already know no one is ever going to be pleased. My doc is internal med and the only one in town. He can just make it with the overhead and drives a simple car. Pts are important to us and ofcourse to him but is the doc important to the pts? If someone can find the answer to scheduling hey post it and I promise I will start using it in our practice. I have heard patience is a virtue. Health is alot more vital than time or money. When health runs out is anything going to matter then.
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