Sunday, April 14, 2013

Waiting times...


No one likes to wait at the doctor's office.

We don't want patients to have to wait.

We want to get home to our families at a decent hour each day.

wait, doctor's office, appointment, urgent care, waiting time


Thankfully our waiting room doesn't usually fill up as above. (This is a screen shot from our Harlem Shake video.) Since our move to our new location, we have fewer people showing up late ~ amazing what a convenient and open parking lot can do ~ and this has contributed to our being on time more often.

Unfortunately there are always things that can come up unexpectedly in our schedules. We can be running right on time, but one patient is all it takes to fall behind. Please be patient! Remember that if it is your child that needs the extra time, we will take that time. We do respect your time and know that it is important, so our office will also accommodate patients as needed. If one provider is running behind, another will offer to see your child if that will help everyone be seen more quickly.

If it is important to you to have less of a wait time, avoid late morning or late afternoon appointments (more time for us to get caught up in something), and avoid busy Mondays and Fridays, as well as the day before and after holidays.

What makes the wait so long in the first place and what do we do to prevent long waits?

  • Sick kids. Most of our “sick” appointments are fairly quick visits, and are scheduled as such. Children who are truly sick and require more time (breathing treatments, stitches, admission to the hospital, sending for x-ray, or watching as they sip fluids over a few hours) back us up. They take extra provider and nursing time and may tie up a room for several hours, limiting the available rooms for other patients. Please understand that this may happen any time, and even an otherwise low patient volume day can be consumed by one sick child. Most importantly, if it is your child, we will spend the required time to adequately treat him/her. If one provider is backed up, we will attempt to have another provider help out.
  • “Oh, by the way…” This is a common phrase in any doctor’s office. When you have an appointment for one thing, but bring several concerns, the visit runs long. Scheduling experts recommend putting off all non-urgent and non-related things for future appointments, but we realize that families have limited days off to bring in their children. We try to help by addressing many of the concerns so you do not have to return. Sometimes it is not appropriate to tackle too many issues (none will be covered adequately if too many are attempted) and we will ask that you schedule another appointment. Things that go together, such as cold, cough and earache are easily addressed at one visit. It is not possible to discuss chronic headaches, warts, asthma, and other complaints when a simple "sore throat" appointment was scheduled. This also applies to the list of questions and concerns parents bring to well visits. A well visit is designed to address safety, growth, nutrition, development, and other specific topics. Saving up a year's worth of concerns to discuss at that one appointment is not wise. It does not allow time to devote to each issue appropriately. We ask that you come in for separate visits as needed and not wait to discuss everything at one visit.
  • Siblings. Many times each day our providers are asked to “just take a look” at brother or sister. This innocent question seems to only take a few minutes, but these minutes add up by the end of the day. Since we will see all sick children on a same-day basis, please check in each child you want checked or discussed. If you just want to discuss another child without an appointment, call the nurse line or e-mail your provider through our web portal.
  • Sometimes we joke that the bus just stopped by. There’s no one in the waiting room, then suddenly the waiting room is full of people. If someone's late to an appointment, someone else right on time, and someone early, then it gets backed up. Please be on time for appointments whenever possible and call if you will be more than a few minutes late. We understand that sometimes there is unexpected traffic or a child pukes during the drive, so we will always attempt to fit people in who missed their appointment time, but realize that it makes others wait. Do not schedule an appointment if you know you will be late. It’s amazing how often we hear, “It always takes so long to get from work to daycare and then to your office.” If it always happens, why not adjust your travel time to be at the office on time?
  • We will see your sick child the same day during business hours. It is easy to pre-schedule well visits and follow up appointments, but it is difficult to anticipate how many kids will be sick on any given day. We track visit numbers by time of year, but there is variability. Our providers have more well visit openings in their schedules and fewer sick slots during the summer, but more sick visit openings and fewer well visit appointments during the winter. Call early in the day if you want to schedule with a particular provider. If a schedule is full, we do not "overbook" a provider. 
  • Inappropriately scheduled appointments. It is difficult for our schedulers to know exactly how long an appointment will run, but they do attempt to schedule based on the concerns of the caller scheduling. For instance, a sick visit with ear ache, cough, or sore throat is typically well covered in 10-15 minutes, and is scheduled as such. If the child is actually wheezing and in need of breathing treatments, this becomes a long appointment where the provider will need to assess the child several times. Understandably the child needs this attention, but was not scheduled for a long visit, so other patients will end up waiting longer. Please attempt to be clear with your concerns when scheduling to allow proper time allotment for your appointment. 
  • Insurance information and other “bookkeeping” issues. Please be ready with all current insurance information as you check in. If you have not filled in a Patient Information Sheet in the past 12 months, you will be asked to provide a new form. Filling this out at home is easier for most parents. You can print out and fill in our Patient Information Form ahead of time if you prefer. For all new patients and existing patients with insurance changes, our receptionists may need to call the insurance company to verify information, so please arrive 10-15 minutes early. Have your co pay ready. Again, it is amazing how many people have to run back to the car because they leave their wallet there. (Never a good idea, by the way... thieves love wallets in cars!)
  • Physical forms. Often high school age kids come in for sport and camp physicals without the required form filled in. The form MUST be completed before the provider can sign it. Many of these forms are detailed and take time to fill out. Please fill out your forms before coming to the office. If you do not have a form, click here.
  • Behavior. Some parents spend an extraordinary amount of time disciplining their children in our office. Often it is the sibling of the child with the appointment, not even the child being seen. We know that all children are rowdy sometimes, but it makes the visit long if we have to repeat what is said multiple times because the parent was distracted by the child, or if we have to wait for the parent to calm the child down. Bringing only the child(ren) with appointments helps this situation. If a child resists being weighed and measured, it takes the nurse longer to get him ready and the next patient might be ready before you, meaning you might end up waiting longer for the provider. If the child fights an exam (very common between 12 and 36 months) it takes longer to adequately evaluate the child and extends the provider time in the room, making the next patient wait longer. We expect and understand this, but it still adds time to our day, and if we have several of these children in a row, it slows us down. 
  • Walk-ins. We offer an urgent care walk-in clinic daily. We staff this based on time of year and expected volume of patients. Obviously without scheduled appointments, this is at best an educated guess. Try arriving before the last 30 minutes of walk-in, as this is the busiest time. It usually has fairly short waiting times and you don't need to spend time calling to schedule then waiting for your appointment. (A benefit to our walk in clinic versus another clinic around town is that we have your child's records and the visit will be added to your child's permanent health record. We know you and your family. By seeing us, you help us keep current in your child's health.)

What can you do to help?

  • Try to be on time. If you will be late, please call. Your appointment might only be set for 15 minutes, so arriving just 10 minutes late nearly misses it altogether. It is not possible to shorten the actual visit, so we will now run late for everyone else. We may ask people who are late to see another provider to lessen the disruption to others. 
  • Arrive no more than 5 minutes early or warn the staff that you are early. People who arrive early are just as disruptive to a schedule as those who show late. Although you might luck out and show up early when someone else has called that they are running late, but it rarely works that way. Early patients take front office staff and nursing time away from people checking in on time, and may put people scheduled ahead of them back in line. Kids learn early in school "no cuts" and this is the same concept. We attempt to keep track of who is being seen and order them in order of appointments, but some patients show up early and then are upset at the "long" wait time and their kids are out of control in the room from boredom of the extra wait time. 
  • Schedule your appointment appropriately. Scheduling for an earache when you really want to discuss the implications of your divorce on your child's behavior is not appropriate. An earache is a short appointment. Chronic conditions, behavior concerns, and well visits are long visits on the schedule.
  • Be flexible. If the provider you scheduled with is very busy due to unexpected issues and you are offered to see another provider, please consider this option. If you want to see only the person you scheduled with, remember you will wait longer. If another provider has an opening, you will get more prompt (but still great!) care.
  • Avoid scheduling during nap or meal times. Being tired, sick, and hungry makes kids more irritable, can prolong visits due to behavior problems, and makes the visit less valuable due to difficulty holding a conversation, answering questions, and staying on task. (Please avoid giving children snacks in the office. It can be a real problem for others with food allergies.)
  • If you must leave by a specific time, let your nurse know. She might suggest seeing another provider if the one you are seeing is delayed.
  • Bring only the child scheduled for an appointment if possible. This allows the focus to be on your child that is being seen, and not on the fighting and running around that happens with siblings. Also, there is less exposure to the germs in our office, so you don't make a trip back a few days later with a sick sibling!
  • Schedule all children you wish to have seen or discuss.
  • Have your insurance card and co payment ready at check in.
  • Schedule early in the morning or afternoon - less time for us to get hung up with another patient.
  • Bring books or toys (this is a great time for hand held electronics) for your child to stay occupied with during the wait to make it seem shorter for all!