Why does your doctor run behind?

We’ve all been there, waiting for the doctor even after showing up on time for our appointment.  It’s even worse when you are waiting with cranky kids.  So what is your doctor is doing anyway?

(Disclaimer: This post is in no way intended to whine about my chosen career path as I love what I do. It is also in no way intended to discourage patients from calling or making requests from the doctor, as we do understand that is our responsibility. It’s intention is to provide better understanding so that everyone is on the same page.)

The Ideal Situation

In a perfect world, a doctor’s day might go something like this:

• Every patient arrives early to be checked in by the front desk and the nurse so that they are in the room at their appointment time
• Every patient’s complaint takes only the time allotted by their appointment slot
• Every doctor’s day is scheduled so that there is plenty of time to catch up on charting, call patients who have questions, approve medication refills and speak to specialists
• Every day has extra hours built-in to have meetings and perform administrative duties

The Real Situation

The fact is, things happen.  Patients run late for a variety of reasons, especially when kids are involved.  Furthermore, doctors run late because some patients require more time if they are sicker or have chronic problems.  Emergencies do arise, even in the pediatrician’s office.  We also do our best to accommodate every patient which may mean a double-booked schedule during high demand times like winter.  Occasionally, doctors have to speak to specialists about patients who are either waiting in the office or who have abnormal tests.  Finally, let’s not forgot that many patients wish to speak to the doctor on the phone while patients are waiting to be seen.  On top of all of this, doctors have to chart efficiently about every patient visit and make sure that all of the past history and medications are accurate and up to date, as well as all lab/x-ray results reviewed.  They also may have administrative responsibilities that take up their time during the day, including school forms and medication refills.

Many doctors are also involved in the business aspect of their practice. There may be meetings, phone calls or other tasks required of them during the day that take their time.

What can you do to help?

It can be hard to wait, especially with antsy children along for the ride. Click here for tips on preparing your child for their doctor’s visit.  To help keep things running smoothly, here are some pointers that your doctor will really appreciate and will help keep him/her running on time:

• Arrive 15 minutes early with accurate insurance information, any outside records and your child’s immunization record.
• Check MyChart and fill out well check questionnaires ahead of time.
• Avoid asking your doctor questions about siblings who do not have an appointment. It’s best to call ahead if you want a sibling to be seen.
• Be aware that you may be asked to make a return or follow-up appointment if your doctor can not address every non-acute issue at one time.
• Be prepared with school forms at the time of your appointment.
• Give your doctor plenty of notice for medication refills.

One last reminder…doctors are people too

Don’t forget that your doctor doesn’t want to run behind any more than you want to wait for 30 minutes or more to be seen.  We stress about running on time as much as we stress about giving good care.  Many times we save all of the busy work until the end of the day just so that we can keep our flow running smoothly.  Yes this means you may not get a call back until 5:30 or 6:00 in the evening, but it also means we aren’t getting home to our families until much later than we want to.  So, be patient, remember the pointers above, and know that, as with all patients, you are getting 100% of our undivided attention when we are in the room with you…which may be why you waited so long.

Addendum:

Since publishing this post my office has grown, my doctors are busier and the demands of practice are even greater. I have noticed more and more ways in which patients and doctors can partner so that the patient’s needs are met and the doctor’s schedule and day continue to run smoothly. Here are a few more pointers, including some policy items specific to Children’s Primary Care Medical Group.

• Utilize Nurse Triage. Nurse triage is a wonderful service, at no cost to the patient, that provides evidence-based and protocol-driven advice to parents while I am not available. They are available during office hours while I am seeing patients, as well as overnight and weekends. If your question is something only I can answer, by all means give me a call or use MyChart (below). Just keep in mind that I may not be able to get back to you until either lunchtime or at the end of the day.
• Patient Portal Policy: At CPCMG we use MyChart which is a great way to access your child’s chart, request appointments and medication refills, and send messages to your doctor. I love it and it’s an easy way for me to get back to you at a time that’s convenient. We do have a disclaimer that states the doctor has up to 72 hours to respond. This means that urgent matters, especially at night, should be addressed by calling nurse triage or (during the day) making an appointment. The doctor does not receive a notification about the message when we are away from the computer, we only see the message when we are logged into the system. Therefore, if you have an urgent matter, it is better to call.
• Walk in appointments: In my office we have a walk in hour from 8-9 every morning Monday through Friday. If a patient walks in later than that, we do our best to accommodate them. However, it is best to call and schedule an appointment so that everyone can be seen in a relatively timely fashion. We even request that you call on Saturdays as our hours are by appointment only. We do not have blocks of time set aside on Saturdays for walk in appointments. Finally, please (begging) don’t walk in at 5 (or 12 noon on Saturday). We really want to take care of your child and will probably fit your child in to be seen, however this can be a stress on our doctors and staff who are not only busy finishing up the day but may have to make personal sacrifices in order to stay.
• Results, forms and refills: Please do your best to give us a 72 hour turn around time for all refills and forms. The reason being that doing both requires a careful chart review. Some refills may not be appropriate, a dose may need to be changed or the child may need to be seen. Furthermore, sports clearance requires that we confirm the child does not have any risk factors. Also, our results reporting policy states that abnormal results should be called as soon as possible to the patient, so if something needs to be addressed we will be calling. Normal results will be reported to you within 72-96 hours but you will probably hear from us within 24 hours. If you don’t hear from us until after hours or the next day, your results are likely normal and non-urgent. Often times I will have one of my assistants call in normal results or send them on MyChart, so check those messages if you get an email from me. One of the reasons we take time from seeing patients during the day is to address abnormal results, which may mean referrals, ordering medications and discussing the next steps with families, so please be patient with us if you are waiting in the office.

Overall, the biggest joy in practicing pediatrics is spending time with the patients. Unfortunately, that comes with all of these other demands. So, let’s work together to make sure everyone gets what they need and our days run smoothly.