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Late for Appointments


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My logic is this:

If the clinicians are consistently running behind schedule, forcing people who show up on time to wait...then how could they turn this around and blame late patients?  If the "rule" is that patients are on time for their appointments, so too should the clinicians be on time.  And it they're runing late, then patients shouldn't be penalized for running late either.  Seems ommon sense to me.

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My logic is this:

If the clinicians are consistently running behind schedule, forcing people who show up on time to wait...then how could they turn this around and blame late patients?  If the "rule" is that patients are on time for their appointments, so too should the clinicians be on time.  And it they're runing late, then patients shouldn't be penalized for running late either.  Seems ommon sense to me.

But what if clinicians are running late because patients are late?  All it takes is one late patient to throw off a schedule.  That patients shows up 10 minutes late, demands to be seen, and every patient after is subsequently pushed back.  If the clinician doesn't see that late patient bc it keeps them on track to see all of the ones that are actually on time....1 unhappy patient vs 10 unhappy ones....that seems like common sense to me.  I'm sure they run late for many reasons, but in this case...it's easy to fix the problem.

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But what if clinicians are running late because patients are late?  All it takes is one late patient to throw off a schedule.  That patients shows up 10 minutes late, demands to be seen, and [...]

[...] is politely rescheduled into a later appointment, same day if possible, and given discharge paperwork immediately if they throw an inappropriate fit about the previously communicated late arrival policy. At least, that's how it ought to work.

 

Sometimes, I think we (medicine/FP in general) are too busy chasing revenue to look at the consequences of taking poorly behaved patients.  Read JMJ's posts about limiting his practice and the benefits that's brought--or rather, the headaches that it has eliminated.

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My logic is this:

If the clinicians are consistently running behind schedule, forcing people who show up on time to wait...then how could they turn this around and blame late patients?  If the "rule" is that patients are on time for their appointments, so too should the clinicians be on time.  And it they're runing late, then patients shouldn't be penalized for running late either.  Seems ommon sense to me.

 

I agree. I have worked in several practices where the patient's time was irrelevant to the provider, which I don't agree with. I worked with one neurologist that always came to work 45 minutes to 1 hour after the scheduled time for his first patient.  However, in a fair system, there should be exceptions. As stated by others, the primary reason that I don't accommodate late patients is that it will make me late for the next patient. If a late patient has a reasonable explanation,  like one was late because the ferry had to  stop to allow a pod of Orca's pass and I was able to verify that, I will work them in.  In the same token, on the rare occasion that I have an emergency, where a patient is worked in, in a 20-minute slot, and she tells me that she is going to kill herself. That can take more than 20 minutes to deal with.  I will explain to the next few patients, "I am really sorry that I am running late. We had an emergency with a patient that needed time. I think you will understand."  

 

I have seen too many practices run chronically late because they are not realistic about the schedule. My first practice was always 2 hours late by the end of the day. The reason was, they were trying to cram in 20-30-minute appointments into 15-minute slots.  I told them to switch to 20-30-minute appointment slots and they said they could not afford to do that. But that was reality anyway.

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[...] is politely rescheduled into a later appointment, same day if possible, and given discharge paperwork immediately if they throw an inappropriate fit about the previously communicated late arrival policy. At least, that's how it ought to work.

 

Sometimes, I think we (medicine/FP in general) are too busy chasing revenue to look at the consequences of taking poorly behaved patients.  Read JMJ's posts about limiting his practice and the benefits that's brought--or rather, the headaches that it has eliminated.

Agreed.  Consequences should apply to the late patient as to avoid making all other patients wait instead of trucking along the schedule and pushing everyone back.  In a perfect world...

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I have seen too many practices run chronically late because they are not realistic about the schedule. My first practice was always 2 hours late by the end of the day. The reason was, they were trying to cram in 20-30-minute appointments into 15-minute slots.  I told them to switch to 20-30-minute appointment slots and they said they could not afford to do that. But that was reality anyway.

Yes, these structural issues are SO REAL.  If patients were products in an assembly line rather than real people, then scheduling them for precise 15-minute time increments and packing 20 of them per day, expecting all of them to show up on time, might be a reasonable thing to expect.  But patients are people, and some are more complicated than others and require more time.  I'm not suggesting that patient's should be seen no matter how late they arrive, or that we can ask & expect nothing of them.  Of course there should be reasonable expectations for on-time arrival, but incorporating some flex time into the day might be a good idea in order to accomodate the inevitable complication.  But flex time is unrealistic, or so it appears, in a setting where maximizing # of patients per day on the assembly line is the only way to stay solvent.  Ah, capitalism and it's greedy, efficiency-driven principles...

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