How to sabotage a doctor’s appointment

by Diana E. Lee

None of us really wants to sabotage a doctor’s appointment through our own behavior. But it’s easy to do just that by not paying attention to the factors within our control that affect the quality of our appointments.

These are some behaviors to avoid at all costs:

1. Show up late for appointments. It’s an unfortunate fact that sometimes our doctors keep us waiting. But it doesn’t do any good to do the same and be late for our appointments. Keeping them waiting leaves you very little time for an already short appointment and takes away the doctor and staff’s ability to provide good care. Not to mention that it’s completely rude. Make your care a priority and be on time.

2. Come unprepared. Being prepared for your appointment just makes sense. What questions have been on your mind? How have your medications and other treatments been working? Are you experiencing side effects or do you have other concerns? Have you heard about a newer medication or treatment? Being a partner in your own care is key to making the most of your health. Your doctor can only do so much without your cooperation and coming prepared to your appointments is a big part of that.

3. Don’t tell the staff how your medications or other treatments have changed since your last appointment. If you see other doctors you must assume it is your responsibility to keep the others informed about medication and treatment changes. Some doctors and their staffs are great about keeping everyone on your team in the loop, but this is rare. It’s in your best interest to come to each appointment prepared to help the staff update your file with the latest information.

4. Don’t ask questions.
Asking questions is imperative! Try to come with a list of questions already prepared, but also be ready to ask on the spot questions about new medications or treatments or other issues that occur to you during the appointment.

5. Leave your cell phone ringer on, take calls or text during your appointment. Let’s face it: This behavior is not only distracting to you and your doctor, it’s flat out rude. Why sabotage your relationship with your doctor by being rude? You’re also wasting your limited time with your doctor if you’re not fully presenting and paying attention. If you have an emergency just tell the staff up front.

Diana E. Lee is a chronic migraine patient who blogs at Somebody Heal Me.

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  • http://secondbasedispatch.com Jackie Fox

    What’s that saying about common sense? It’s not all that common? Great tips here for all patients.

  • http://Www.drmartinyoung.com Martin Young

    Funny thing is I was writing a post titled ten things to keep your doctor happy. I am one. I should know.

    Truth is that it’s better to see a doctor who is not running late, tired, stressed, kept in the dark – all the things you mention.

    And my top five on the list were exactly the same as yours. Bravo!! I could never have said it better!!

  • family practitioner

    Others:
    1. Not respecting the reason for the appointment. If the appointment was made for a cough, for example, do not come with a long list of other things you think should be addressed, or at least respect the doctor telling you to schedule another appointment.

    2. Piggybacking. If the appointment is for one child, for example, don’t ask the doctor to check the other child. If the appointment is for your spouse, don’t ask the doctor to address concerns you may have for yourself.

  • Michelle

    Unfortunately it’s always the doctors doing these things and sabotaging the appointment (and causing more harm than good, usually).

  • Truga

    I am a 70 yr old retired internist physician with multiple medical problems after having a massive heart attack in 2006 (cardiac arrest; pacemaker; chronic heart failure). I make an appointment for the first one in the afternoon and, even at that, my internist is almost always 1/2 hr late. He gives me 5 min to talk; 5 min for him to talk; 5 min for him to enter info into the computer. Then there is a knock at the door and he abruptly gets us and, without saying anything further, just walks out of the office. I just sit there like a dummy. I go to the front desk and I’m told that the visit today is $195 cash (“We no longer take Medicare”). I refuse to pay and tell them to bill Medicare/Blue Cross. That’s too much money for a 15 min office visit, which he wants to do every month. Most other doctors in town are doing the same thing.

    • buzzkillersmith

      Doctor, I wish to apologize to you for my unspeakably rude colleagues. No one should be treated that way. And as for the computer entry complaint–amen to that.

    • Fam Med Doc

      Dear esteemed collegue,

      Congrats on surviving your MI. I wish you the best in future health.

      Comments:
      If your doc is already late at the beginning of the afternoon, and this is typical, that’s an inefficient, & disrespectful MD. Occasionally late, ok, that happens. Always late, at the beginning of the afternoon. Unacceptable. He is trying to squeeze a 10 hr day into an eight hour day.

      A 15 min appointment isn’t…too…bad. I do agree it feels a bit shorter than it should be. But not every primary care doc schedules a 15 min follow-up appt. ALL follow-ups in my office are 20 minutes. If someone comes in with an uncomplicated sore throat, it’s viral, not prescriptions are written, it may only take 10 min & I get to move on to the next task/patient, but s/he was still originally given a 20 min apt. Inn primary care, 20 min are usually needed.

      The knock on the door is rude. My staff know do NOT bug me when I am in the exam room w a patient unless it’s ABSOLUTELY necessary. That happens bout every 2-3 months.

      In regard to not accepting Medicare. Well, that’s where I agree w him. The pay & hassle from Medicare, from all the insurance companies sucks, so going cash only is fantastic. I wish more doctors did it where I live & I would most certainly do it to, too. Right now if I did, I would lose my patients.

      But overall, it sounds like you are unhappy w your current doctor. By all means, change doctors. If someone is expected to pay $195 for a MD visit, that patient entitled to an AMAZING visit. For my cash pay patients, I charge $100. And I make it worth their while. But I’m confused. You wrote that your doctors staff inform you they no longer accept Medicare, yet you tell them to bill them. So, do you get a free visit?

      Regards

      • Truga

        M.D. billed M-Care/BC for 99215 and was paid $124.41. Saw cardiac N.P. yesterday (very satisfied; 1/2 hr, which included an exam; billed 99214 and will be paid $97.05). Will get new cardiac pacemaker next week.

        • http://Www.twitter.com/alicearobertson Alice

          I am glad you shared..and agree with you…I think doctor’s images are hurt terribly by their colleagues bad behavior. Yet…I cannot help but notice that other doctors here will take your complaint as more weighty than those of us who are mere patients. The truth seems more valuable when “MD” is attached to it….this means it is vital you speak out because your voice is more helpful to patients because some doctors fluff us off.

  • soloFP

    I stay usually on time or within 10 minutes of the scheduled visits. I make sure to mingle same day visits in the schedule for acute concerns and for catch up time. After practicing around 10 years, I have learned not to address more than the chief complaint, unless it is an urgent concerns. It is appropriate to schedule the patient for a follow up visit in 1-2 weeks for the routine concerns.

    Adding on a second person for an acute sinus infection or simply uti is easy enough to do with electronic records, as not pulling a chart saves a lot of time. If you don’t add on the person, then the person likely will give the $60 visit to an acute care clinic.

    That said, ways to sabotage or upset the doctor include: coming in for a + strept and then asking to have your spouse or another kid simply get called in antibiotics; rescheduling your visit so that you have one day of meds left, with your insurance allowing a local 10 day supply and then needing a mail order supply on 15 or more meds; insisting on brand name meds instead of generic that all require Tier 3 or nonformulary prior auth; wanting to MRI your entire back and thinking that can be done with a simple prior auth; showing up with a 2 page typed list of concerns and expecting all of them to addressed in 15-25 minutes; bringing in 12 pages of FMLA and disability forms and wanting them done for free at what was supposed to be a 15 min visit; not having active insurance; not having the copay or payment for overdue deductibles.

  • Pinky

    I agree with the article. I am a patient with some severe problems caused by a violent crime several years ago. I have a great deal of experience with the health care system, with mostly good results.

    I do have some suggestions from the patient’s viewpoint that may help the medical profession:

    Don’t ask me a question and not wait for an answer before launching into another question.

    Don’t look at your watch if my answer is more than two sentences long.

    Don’t allow your cell phone to ring every two minutes, look at it each time and even answer the phone during a visit. (This happened to me during an introductory visit with a psychiatrist who was charging me $420 hr., I only saw him for less than 15 minutes of that hour – it was my last visit with him.) This not being rude advice should also apply to the patient.

    Don’t have your receptionist ask what the patient’s medical problem is. My reason to see a physician is between the physician / nurse, not everyone in the waiting area.

    Don’t hire staff with a need for ‘power games’, I have had trouble with some staff people who thought they were imbued with some imaginary power because they were working for a physician. If a staff person is not civil, they will drive patients away. Firm and businesslike is good, but staff should also be kind and helpful.

    If the physician’s staff knows she/he will be late, advise the patients waiting to see her/him. If the wait is unusually long and the patients find out the information was kept from them, they will consider it the same as a lie.

    Do the quick glance of the chart outside the door, not while you are talking to the patient. Humans do not multi task, it is a myth.

    Don’t be cheap. Install a handicapped door if your specialty concerns people who might be handicapped. Do not hire relatives for staff. Treat your staff right so they stay with you, if the faces of the staff are new every time I visit (I am required to see many physicians at one to three month intervals) I will lose confidence in your ability to interact with people and patients.

    In spite of my suggestions above, my involvement with medical personnel has overall been outstanding.

    • http://mylansingdoctor.com Omada Idachaba

      Points well noted. Indeed this works both ways. A few comments I have.
      What you are seeing is the life of the time crunched physician who is taking on much more than s/he can satisfactorily handle. Reasons ranging from poor time manangement to the need to cram as many patients in his schedule to meet financial goals. Unfortunately, the patient can easily become the victim.
      Some of the points you made were purely customer service related. Unfortunately, the front office creates one of the first images of the practice. I have had many a new patient tell me that they loved their doctor but hated the staff and so switched to another doctor.
      I believe that if we practice the motto “do unto others what you would like done unto you”, things will be alot smoother and the doctor’s office will be a better place. This applies to medical field and all other areas of life.
      Patients should not feel they have to stay with a physician or provider that is not meeting your needs. For every one that is not, there are many others that can do a great job. I am glad your experience with medical personnel has been outstanding.

    • http://Www.twitter.com/alicearobertson Alice

      Don’t hire staff with a need for ‘power games’, I have had trouble with some staff people who thought they were imbued with some imaginary power because they were working for a physician. [end quote]

      I think some of the employees become highly protective of the doctor’s time (some say they are trained to do this by physicians who are paying them to keep the lesser stuff of their to do list).

      The specialist for my dad read the social workers remarks and asked why I do not call for advice or help with my demented parents. I said I do not like to bother them…he said to just ask for him if the staff has an attitude. Then reminded me that the staff is there to serve me…not vica versa. I doubt I will call…..but his caring counsel was impressive…of course…he felt it was part of his job….yes….he’s a great doctor. He gets it!

  • Melgirl

    How to Sabotage a Patient Appointment

    1. Show up late for appointments – Go ahead and schedule your day to the max…you need to cram in patients to get your reimbursements up. But recognize that my boss expects me to be back at my desk in an hour, or I need to pick up my kids from the bus stop. If you make me wait 20-45 minutes to see you, I will be angry when you walk in the door. I’ll be even angrier if you have a sign posted at your front desk stating that you will charge a $25 fee to patients who show up late. My billable rate is $200+ an hour and one day you might get a bill for making me wait.
    2. Come unprepared – Walk in and glance at the chart to check my name. Hem and haw while you are reading the nurse’s intake notes so you know why I’m there. Don’t bother with the chart. Do you really need to know that this is my third time seeing you about the same unresolved health complaint? I’m happy to feel like a total stranger every single time I visit you.
    3. Don’t tell me anything about my treatment options – Ignore the journals that have been sitting on your desk. Give me counsel based on how you’ve always done things. For example, if I’m pregnant and my baby is breech, don’t utter a word about a the possibility of a version or how the pendulum is swinging on the “cesarean for breech” dictum. But be prepared for me to bring in abstracts and studies that I found on my own in that internet-web-thingy. Try not to act too irritated.
    4. Don’t ask questions – You’ve got 3 more patients to see in the next 20 minutes, so don’t drag it out. Knowing that I just started my first full-time job since I became a mom, or that my dad just died of Lymphoma has no bearing on my weight gain, heart palpitations, or chronic headaches.
    5. Take the opportunity to rant – Please, tell me about how dysfunctional the healthcare system is. Tell me who you think the villains are. Democrats? Republicans? Obama? Pharmaceutical companies? Trial lawyers? Lazy reporters? When you’re done, that’s a good opportunity to tell me how little you’re being reimbursed for the service you are providing me at the moment, and that it’s hardly worth your time. Tell me about your regrets that you didn’t become a lawyer.
    6. Be content living in 1987 – Don’t bother with scanners, email, internet or EHR. After all, I’ve been content with illegible scripts and two trips to CVS for every prescription all my life. And if you’d like to point fingers about why you are still in the stone age, please refer to #5.

  • Vox Rusticus

    “Be content living in 1987 – Don’t bother with scanners, email, internet or EHR.”

    Tell ya what, give me 1987 payments and I will be happy to go buy 2011 EHRs.

  • http://www.neilbaum.com Neil Baum

    Would like to add two additional suggestions on becoming a patient who is the physician’s partner in their healthcare:

    1)It is helpful to arrange to have your tests performed several weeks prior to your scheduled office visit. For example, if you see the doctor once a year for an annual exam, you might request the nurse order your x-rays, routine lab tests (cholesterol, blood count, and PSA test if you are a man over 50 years of age), EKG etc prior to your office visits. Then call the doctor’s office at least a two days before your appointment to make certain that the results are in your chart. Now when you meet with the doctor, he\she can analyze the data at the time of your visit and make the appropriate recommendations. Failure to do so means you will meet with the doctor, then obtain your tests, and wait for weeks to hear from the doctor to review the results on the phone or using E-mail.

    2) It is also helpful for older patients to bring a family member with them at the time of their office visit to help communicate various health issues with the doctor. The family member can also write down the doctor’s recommendations. I also encourage patients to bring a voice recorder or use their iPhones to record my conversation with the patient and they can play it after they have left the office in order to help them recall the suggestions I have provided the patient.