Wednesday, January 19, 2011

Pain In The Foot

There's gotta be a better way to run a business.

Yesterday, I went for a follow-up appointment with my orthopedist about the achilles tendon injury I've been recovering from for several months. After wearing a boot for 10 weeks and working with a physical therapist for two months, I'm finally at the point where I'm walking again without a limp, and can get back out on the tennis court soon. I'm looking forward to playing again, even if I don't get back to the three-times-a-week schedule I'd had for the previous decade.

So, this office visit was just to check with the doctor, report on my progress, see if she had any medical objection to my running around, etc. The appointment was for 11am, and I showed up a few minutes early. Figured I'd be out of there by 11:30am at the latest.

I knew I was in trouble when I saw about 100 people in the waiting room. My orthopedist is part of a large practice with several doctors, so I'm used to seeing a bunch of people there, but this was the largest group I'd ever had to navigate. When I got to the appointment desk to check in, I asked the receptionist how far behind my doctor was running, and she said, "About 25-30 minutes."

I grimaced. I'd brought a couple of newspapers because I knew there would be a wait, but I didn't expect it to be that long. And it wasn't -- it was longer.

After an hour, I'd had enough. I went back up to the desk, where a different receptionist asked which doctor I was seeing. When I told her, she looked surprised and said, "Oh, I didn't think she was seeing any more patients today." That's not what I wanted to hear.

She called back to the doctor's assistant, who said the doctor was still busy with other patients, but that I'd be next. I told the receptionist I knew what that really meant -- that I'd be the next patient brought back to an examination room, but that it would still be at least a half-hour before the doctor came in and spent five minutes with me.

I couldn't wait around, as I had a radio show to do. The receptionist asked if I wanted to reschedule, but not wanting to go through all of this again, I told her to just cancel the appointment -- and be sure not to bill me for the privilege of sitting in the waiting room for over an hour.

They obviously have a thriving practice and a community with a huge need for their services, but there has to be a better system. I know that these (and other) physicians are triple-booking the time slots so they can squeeze in as many patients as possible, and that the staff is constantly moving people in and out and the doctor is trying to get to everyone with all due haste while still offering valuable medical advice. Different patients have different needs that take different amounts of time for the doctor to deal with, and there are going to be backups in the course of any business day. But this office had only been open since 9am, and by 11am, just two hours later, they were more than an hour behind.

That kind of scheduling nightmare is not an anomaly -- it goes on every day in medical practices across the country. It is simply untenable to have patients come in at the pre-arranged time yet have no idea when they'll receive treatment. Granted, this wasn't an emergency room (which often has similar crowds and its own problems), but it's not like we have all day to wait.

At a certain point, someone on the staff has to decide that they've reached the maximum number of patients that can reasonably be seen in one day. If any other business treated customers this way, they'd lose those customers. Ask any salesman how his day would go if he were consistently an hour late to every appointment -- think he'd sell anything?

Here's an idea. In this digital age, in a practice as busy and modern as this one, it shouldn't be hard to install a communications system that notifies patients when the doctor is running late. Kinda like the airlines' flight-status notifications -- they have your phone number and an automated system calls or texts you when they're running behind. With the patient notification system, we'd find out a couple of hours ahead of time and, perhaps, be able to adjust our schedule to get there closer to when the doctor could actually see us. Or, we could call the office to reschedule. That wouldn't solve the problem, but it might loosen up the logjam of people in the waiting room.

On the other hand, this could all be a plot by the pharmaceutical companies that make hypertension medicine -- it's a very effective way to raise the blood pressure of a large group of people at the same time.

There was some good news. I ran out of there with no pain.