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Posted: 8/3/2005 7:26:29 PM EDT
[Last Edit: 8/3/2005 7:28:36 PM EDT by PeteCO]
and the general attitude seems to be that of "fuck you, you WILL wait and like it"?

If ANY other business made customers wait the way the healthcare industry does, they'd be out of business in a heartbeat. I can understand a periodic wait, but you fucking wait in the waiting room, then get to go into the room where you see the doc.....and wait some more. If you need an x-ray or something you fucking wait in about 3 different places. This never changes - you ALWAYS wait fucking forever.

When I was in IT I did some work at hospitals and the staff NEVER wanted to collect metrics on scheduling or how long people were having to wait. I just think they don't give a fuck. The process could be improved, but it sucks. And even little things take forever - my wife is pregnant and they left the room for her to change back into her clothes after an exam - alas, we had to wait 20 fucking minutes! I could have sewn her a set of clothes in 20 minutes.

The costs I am ok with, the weird and convoluted billing I am ok with, but waiting pisses me off. I was threatened ONCE when I told the nurse I was leaving (for an important meeting) after waiting forever, that I would have to pay for the appointment if I left. Once.

Don't healthcare professionals know or care how fucking arrogant it makes them look? It's just taken for granted that I have 45 fucking minutes to wait to see the doctor for 5 minutes.
Link Posted: 8/3/2005 7:29:44 PM EDT
I've gotten up and walked out of doctor's offices and dentist's offices on several occasions already. Once I feel I've waited an unreasonable length of time, I just blow my stack and bolt.
I think anything more than 30minutes wait is completely rude on behalf of the doctor's office.

WTF is an appointment for ?
Link Posted: 8/3/2005 7:33:16 PM EDT

Originally Posted By Dragracer_Art:
I've gotten up and walked out of doctor's offices and dentist's offices on several occasions already. Once I feel I've waited an unreasonable length of time, I just blow my stack and bolt.
I think anything more than 30minutes wait is completely rude on behalf of the doctor's office.

WTF is an appointment for ?



Exactly. Many of these shitholes like to have a policy that if you are late at all, even by 5 minutes, you "lose your turn". Luckily I've not had to deal with that, or the result might have made CNN.
Link Posted: 8/3/2005 7:35:32 PM EDT
It depends really.

If my doctor has rounds at the hospital and is delayed or an emergency comes up , I don't have a problem with it.
I just want to know.
It pisses me of when I have an appointment and my doctor isn't under the roof and I don't know it.

They know me pretty well by now and I get a call and ask if I can wait or if I want to come in later.
Link Posted: 8/3/2005 7:38:34 PM EDT

Originally Posted By krpind:
It depends really.

If my doctor has rounds at the hospital and is delayed or an emergency comes up , I don't have a problem with it.
I just want to know.
It pisses me of when I have an appointment and my doctor isn't under the roof and I don't know it.

They know me pretty well by now and I get a call and ask if I can wait or if I want to come in later.



That's my gripe - if the Dr has an emergency, FUCKING CALL ME so I know. Just like I would do if I had a client on the way and had to leave.

Link Posted: 8/3/2005 7:38:55 PM EDT
you need to understand, docs need to see 4-6 patients an hour on average, but if just one patient takes an extra 15 minutes longer, that can mess everything up. Then another takes an extra 5-10 minutes, all that can add up.
Link Posted: 8/3/2005 7:39:07 PM EDT
That is why I get the first appointment. Most of the time the doc and I go in at the same time or I go in before him.
Link Posted: 8/3/2005 7:39:14 PM EDT
About half of the time I dont wait at all... I get my magazine, find a good arcticle and before I get past the first line I have to go get poked and prodded. Bastards!


Link Posted: 8/3/2005 7:43:19 PM EDT

Originally Posted By armoredsaint:
you need to understand, docs need to see 4-6 patients an hour on average, but if just one patient takes an extra 15 minutes longer, that can mess everything up. Then another takes an extra 5-10 minutes, all that can add up.



I have run into this bullshit numerous times right when the place opens, and there are 10 of us already waiting.

Time studies, planning, and good operations management could lessen this problem, but no one seems to give a fuck. If I have a client appointment, and continually show up late because "other clients took longer than anticipated" I'd be promptly fired. Seems that healthcare is the only place where this bullshit is tolerated, at least to the blatant extent that it exists.
Link Posted: 8/3/2005 7:45:04 PM EDT
Because your time is not as expensive as theirs
Link Posted: 8/3/2005 7:45:44 PM EDT

Originally Posted By PeteCO:
Just like I would do if I had a client on the way and had to leave.




Exactly.....I told my doctor while in the Examination room that my time was just as important to me as his and his staffs was to them.

I have been treated like royalty ever since.
Link Posted: 8/3/2005 7:46:43 PM EDT
[Last Edit: 8/3/2005 7:47:31 PM EDT by PeteCO]

Originally Posted By Wash-Ar15:
Because your time is not as expensive as theirs



I make quite a bit more than my GP does. If I got pissed, left, and they send me a bill for thier time, I would probably invoice them for mine......

Again, if I told my customers "hey, I have a business to run and my overhead costs are hefty, so shut the fuck up and wait" I'd be out of business.
Link Posted: 8/3/2005 7:46:55 PM EDT
How many times a day do you think some little old lady who made a 15min appt decides, at the end of her visit, that now is the time to tell the doc about the 4 medical problems she is really there for? Or maybe she just doesn't want to leave. Or maybe her husband died 6 months ago, her family deserted her and she just wants some one to talk to.

Or maybe the third patient of the day is having an MI or needs an admit for some other reason. Involves lots of attn from all the staff, several phonecalls, talking to the EMTs, etc.

Or maybe you have a full slate and a family of 3 is acutely ill and needs to be seen. Tell 'em to screw off?

I know it sucks to have to wait but it is not like any other business. Sorry.
Link Posted: 8/3/2005 7:46:57 PM EDT

Originally Posted By Wash-Ar15:
Because your time is not as expensive as theirs



You would be wrong about that!
Link Posted: 8/3/2005 7:47:40 PM EDT
[Last Edit: 8/3/2005 7:50:48 PM EDT by Wash-Ar15]
yea but ya can'tSo we wait like all the other fools
Link Posted: 8/3/2005 7:47:42 PM EDT
Link Posted: 8/3/2005 7:56:15 PM EDT
[Last Edit: 8/3/2005 7:58:57 PM EDT by PeteCO]

Originally Posted By Rebel_Marine:
How many times a day do you think some little old lady who made a 15min appt decides, at the end of her visit, that now is the time to tell the doc about the 4 medical problems she is really there for? Or maybe she just doesn't want to leave. Or maybe her husband died 6 months ago, her family deserted her and she just wants some one to talk to.

Or maybe the third patient of the day is having an MI or needs an admit for some other reason. Involves lots of attn from all the staff, several phonecalls, talking to the EMTs, etc.

Or maybe you have a full slate and a family of 3 is acutely ill and needs to be seen. Tell 'em to screw off?

I know it sucks to have to wait but it is not like any other business. Sorry.



Sorry, that's what phones are for - CALL ME. I have had important shit come up too, and I either end my appointment with my client anyway, or I fucking call my next client and tell them an emergency came up.

And for the third time, my experience with this industry has demonstrated that they couldn't care less about wait times - no metrics are collected, no attempt is made at improving efficiency. Why? Because people accept it for some unknown reason and therefore it doesn't affect the bottom line.

Re-read my posts above - I have had long wait times even at the beginning of the day, which is an indication that they are overbooking. If a 30 minute wait builds up EVERY damn day, you'd think that would be an indication that an adjustment should be made, that they should widen the gaps at least just a bit.

I think part of the problem w/ healthcare stems from the fact that there are so many doctors in it - don't laugh....what I mean by this is that most doctors will have a great grasp of medicine but a poor grasp of operations/business. The problem is they don't realize it. I used to have alot of engineers that started their own businesses as clients. Some of these guys were fantastically well educated, and as a result assumed that the successful management of a business was pathetically easy to learn and/or intuitive - most of them went bankrupt, maintaining their arrogance to the bitter end. As a generalization, I find that engineers and doctors make the worst business managers. I'm just surprised that there aren't any/more "efficiency experts" that consult to hospitals or clinics.
Link Posted: 8/3/2005 7:58:05 PM EDT
If it makes you feel any better, I hate waiting also. It's tough when the shoe is on the other foot every now and then. I really try to keep on schedule, and I really try to give every patient my best, and those two goals often conflict. Between emergencies, paperwork for every single patient, done right after the visit, to the telephone, and delays and lab tests, and radiographs, and all the other stuff we have to due to run a quality office, it's hard to stay fully on-time, all the time.

Others have commented that the first appointment of the day is best, I generally agree. We try to call ASAP if we know that we are behind, and you can call us too to check if we are delayed before you leave the house. Almost all offices do, and rightly so.

I don't know if this will make you feel better or worse, but there are lots of offices that will see you on-time every time, with coffee in the reception room, and any amount of relaxed consultation time and discussion, but they will not take insurance, you will pay up-front, and it's not cheap either.

The system is broken, we all know it, and it's going to get worse before it gets better.

I'll apologize to you for all the guys who never did. I'm sorry we're behind schedule.

fish
Link Posted: 8/3/2005 7:58:36 PM EDT
They do it because they don't want any down time. They'd rather have you bottle necked badly into the waiting room so that they can keep the physicians busy constantly.

They have an advantage in that they know YOU need them. Most will just sit and wait so they don't have to be hassled on another day (easier to tell your boss that you had to wait in a dr's office, I'm sure they will know how that works, then to say "I need another part of a day off now".) It's just easier to wait another 40 minutes then to have to take more time to find a new doctor and to make another appointment and go there.

I have walked out and went somewhere else 3 times with the healthcare industry and I'm only 20. I was waiting so long one time that I was about to miss class and left the office and I did get a small bill for a "processing fee". Meaning the cost it took them to put my file back on the shelves. It was about $30!

Since I did miss half a class I sent them a bill for $45, as I figure thats what the time was as a portion of my tuition. They then sent me a cancelled invoice notice. I guess they got the picture.

I went somewhere else anyway.
Link Posted: 8/3/2005 8:01:45 PM EDT

Originally Posted By fish223:
If it makes you feel any better, I hate waiting also. It's tough when the shoe is on the other foot every now and then. I really try to keep on schedule, and I really try to give every patient my best, and those two goals often conflict. Between emergencies, paperwork for every single patient, done right after the visit, to the telephone, and delays and lab tests, and radiographs, and all the other stuff we have to due to run a quality office, it's hard to stay fully on-time, all the time.

Others have commented that the first appointment of the day is best, I generally agree. We try to call ASAP if we know that we are behind, and you can call us too to check if we are delayed before you leave the house. Almost all offices do, and rightly so.

I don't know if this will make you feel better or worse, but there are lots of offices that will see you on-time every time, with coffee in the reception room, and any amount of relaxed consultation time and discussion, but they will not take insurance, you will pay up-front, and it's not cheap either.

The system is broken, we all know it, and it's going to get worse before it gets better.

I'll apologize to you for all the guys who never did. I'm sorry we're behind schedule.

fish



Oh believe me, I know some of the challenges facing healthcare right now, especially with the way insurance companies have attempted to second-guess physicians. I feel for you guys. I just hate the excessive waiting. My general rule is that 15 minutes is fine, and I'll wait up a half hour before I get shitty. I don't blame the physicians but rather the management of the clinic/hospital.
Link Posted: 8/3/2005 8:08:08 PM EDT
[Last Edit: 8/3/2005 8:11:20 PM EDT by topknot]

Originally Posted By PeteCO:

Originally Posted By Dragracer_Art:
I've gotten up and walked out of doctor's offices and dentist's offices on several occasions already. Once I feel I've waited an unreasonable length of time, I just blow my stack and bolt.
I think anything more than 30minutes wait is completely rude on behalf of the doctor's office.

WTF is an appointment for ?



Exactly. Many of these shitholes like to have a policy that if you are late at all, even by 5 minutes, you "lose your turn". Luckily I've not had to deal with that, or the result might have made CNN.



Ah so we get to the crux of the story. You were late for your appointment? Show up on time and you might get seen (if I read that right). One late person causes a domino effect that lasts through the day.

Also, if you display the attitude that you have in this thread where I work, I would show you the door.

Courtesy works both ways.

ps - I realize that you are probably just needing to vent a bit. Also, I don't appreciate waiting for LONG periods with no update or reason. Communication would go a long ways in many offices.
Link Posted: 8/3/2005 8:08:38 PM EDT

Originally Posted By PeteCO:

Originally Posted By Rebel_Marine:
How many times a day do you think some little old lady who made a 15min appt decides, at the end of her visit, that now is the time to tell the doc about the 4 medical problems she is really there for? Or maybe she just doesn't want to leave. Or maybe her husband died 6 months ago, her family deserted her and she just wants some one to talk to.

Or maybe the third patient of the day is having an MI or needs an admit for some other reason. Involves lots of attn from all the staff, several phonecalls, talking to the EMTs, etc.

Or maybe you have a full slate and a family of 3 is acutely ill and needs to be seen. Tell 'em to screw off?

I know it sucks to have to wait but it is not like any other business. Sorry.



Sorry, that's what phones are for - CALL ME. I have had important shit come up too, and I either end my appointment with my client anyway, or I fucking call my next client and tell them an emergency came up.

And for the third time, my experience with this industry has demonstrated that they couldn't care less about wait times - no metrics are collected, no attempt is made at improving efficiency. Why? Because people accept it for some unknown reason and therefore it doesn't affect the bottom line.

Re-read my posts above - I have had long wait times even at the beginning of the day, which is an indication that they are overbooking. If a 30 minute wait builds up EVERY damn day, you'd think that would be an indication that an adjustment should be made, that they should widen the gaps at least just a bit.

I think part of the problem w/ healthcare stems from the fact that there are so many doctors in it - don't laugh....what I mean by this is that most doctors will have a great grasp of medicine but a poor grasp of operations/business. The problem is they don't realize it. I used to have alot of engineers that started their own businesses as clients. Some of these guys were fantastically well educated, and as a result assumed that the successful management of a business was pathetically easy to learn and/or intuitive - most of them went bankrupt, maintaining their arrogance to the bitter end. As a generalization, I find that engineers and doctors make the worst business managers. I'm just surprised that there aren't any/more "efficiency experts" that consult to hospitals or clinics.



It is kind of ironic... "efficiency experts" (otherwise known as managed care) are one of the causes of delays. Docs nowdays have to see a lot of patients to make money.. this means tight schedules. Like Armoredsaint said, healthcare sometimes can't be provided in the time anticipated. Also, no flame intended, but I daresay that most folks agree that a physicians' time is worth more than almost any businessmans' time.
Link Posted: 8/3/2005 8:13:04 PM EDT
[Last Edit: 8/3/2005 8:16:39 PM EDT by PeteCO]

Originally Posted By topknot:
Ah so we get to the crux of the story. You were late for your appointment. Show up on time and you might get seen.



Random assumptions make you look like an idiot. I have never been late for an appointment. My gripe is my excessive wait at the OB/GYN yesterday.


One late person causes a domino effect that lasts through the day.


It doesn't have to be that way - tell them to reschedule. Why allow one late patient ruin shit for others? More incompetent management?


Also, if you display the attitude that you have in this thread where I work, I would show you the door.


Attitude? I am the fucking customer. ANY other business would not get away with that bullshit.


Courtesy works both ways.


If you learn some reading comprehension you'd see that this is the point of my whole thread.
Link Posted: 8/3/2005 8:16:24 PM EDT

Originally Posted By PeteCO:

Originally Posted By Rebel_Marine:
How many times a day do you think some little old lady who made a 15min appt decides, at the end of her visit, that now is the time to tell the doc about the 4 medical problems she is really there for? Or maybe she just doesn't want to leave. Or maybe her husband died 6 months ago, her family deserted her and she just wants some one to talk to.

Or maybe the third patient of the day is having an MI or needs an admit for some other reason. Involves lots of attn from all the staff, several phonecalls, talking to the EMTs, etc.

Or maybe you have a full slate and a family of 3 is acutely ill and needs to be seen. Tell 'em to screw off?

I know it sucks to have to wait but it is not like any other business. Sorry.



Sorry, that's what phones are for - CALL ME. I have had important shit come up too, and I either end my appointment with my client anyway, or I fucking call my next client and tell them an emergency came up.



Sometimes that's possible sometimes shit just happens.


And for the third time, my experience with this industry has demonstrated that they couldn't care less about wait times


Not that we don't care, just out of our control sometimes.
Nor do I have time to apologize to everyone I see for the rest of the day.
And as has been pointed out, the world of corporate medicine is one big shit sandwich for docs. We have little or no say over staff, HR handles that , no control over booking, and even less control over some of the nutbake patients we get. For instance, our clinic does over 50% uninsured(free) and medical assistance. Further, the patients I see couldn't care less about everyone else waiting.

I got sick of the scheduled appt bit myself and that was one reason I went into urgent care but sometimes I see people immediately, when it's busy, you wait. If you show up like everyone else 30 minutes before closing, you are going to wait. I know that doesn't fit your situation but you get the picture.

How much more staff do you think we will need if we are going to call every patient on the schedule, every time something happens to get further behind somedays?
Hell, just finding some people is next to impossible. You ought to see it, everyday I have several patients we try to contact for lab results and the phone number they give us is totally bogus. After several attempts we get someone who doesn't even know them, or are told they used to live next door and the people are pissed that they keep giving out their number for info, including their drug dealer. So then we have to send out a letter. A week later they get their results--sometimes. Every-fucking-day.


Re-read my posts above - I have had long wait times even at the beginning of the day, which is an indication that they are overbooking.


No, it's an indication that someone in the hospital was having serious problems when your doc did his AM rounds.


If a 30 minute wait builds up EVERY damn day, you'd think that would be an indication that an adjustment should be made, that they should widen the gaps at least just a bit.


If you ever own a medical corporation give me a call. I want to work for you.


I think part of the problem w/ healthcare stems from the fact that there are so many doctors in it - don't laugh....what I mean by this is that most doctors will have a great grasp of medicine but a poor grasp of operations/business. The problem is they don't realize it. I used to have alot of engineers that started their own businesses as clients. Some of these guys were fantastically well educated, and as a result assumed that the successful management of a business was pathetically easy to learn and/or intuitive - most of them went bankrupt, maintaining their arrogance to the bitter end. As a generalization, I find that engineers and doctors make the worst business managers. I'm just surprised that there aren't any/more "efficiency experts" that consult to hospitals or clinics.


There are.
They are having a negative impact on patient care.

When you come in having your MI, you can expect to be cared for and have lots of attention from the ENTIRE staff while others wait. Same goes for when you are seriously ill or some member of the family is. Hopefully, they'll squeeze you in. Otherwise what's the point.
Link Posted: 8/3/2005 8:18:20 PM EDT
i always stay and wait it out. why, because its SNAFU!!!

Link Posted: 8/3/2005 8:18:23 PM EDT
[Last Edit: 8/3/2005 8:20:09 PM EDT by fish223]

Originally Posted By PeteCO:

My gripe is my excessive wait at the OB/GYN yesterday.



Are you sure you were in the right place?
Link Posted: 8/3/2005 8:21:14 PM EDT

Originally Posted By fish223:

Originally Posted By PeteCO:

My gripe is my excessive wait at the OB/GYN yesterday.



Are you sure you were in the right place?



Yes, I was there to have my prostate looked at.......
Link Posted: 8/3/2005 8:21:40 PM EDT

Originally Posted By PeteCO:

Originally Posted By topknot:
One late person causes a domino effect that lasts through the day.



It doesn't have to be that way - tell them to reschedule. Why allow one late patient ruin shit for others? More incompetent management?



I tried that one day several years ago as people were getting pissed about the waits. I hardly saw anyone.



Also, if you display the attitude that you have in this thread where I work, I would show you the door.


Attitude? I am the fucking customer. ANY other business would not get away with that bullshit.



LMFAO.
You must not get out much.

Link Posted: 8/3/2005 8:23:06 PM EDT


As an established patient, your visit is going to net him 30-40 bucks after the "negotiated" discounts the insurance company rammed down his throat. Sitting around to find out if your wife needs 90 seconds to change or 15 minutes? He doesn't have time and will see another patient while she is getting out of the paper gown and back into clothes.

Ever wonder why plastic surgeons have nice offices with free cokes, coffee and snacks? Patients pay retail for their services.

You want to be seen on time? You make more $$ than the doc and your time is more valuable? Fine, then pay to go to the head of the line.

Find a solo doc and send your him a letter and say "Hey doc, we are both busy and I really need to be seen and get back to work. How about a little agreement on the side.? If you will see me within 5 minutes of my appointment, I'll be happy to pay in cash the difference in the "negotiated" discount my insurance pays you and what you actually charge. For example, instead of the $36 bucks Aetna sends you for a $75 dollar bill, I'll give you the $39 difference.

You won't wait anymore.


Insurance companies reimburse physicians at WalMart rates. Why do you expect Nordstrom service??? Most physicians have kept the quality of care as high as they can, but the days of the squeeze on the "rich" doctors with no consequences is about over.

Link Posted: 8/3/2005 8:27:42 PM EDT
[Last Edit: 8/3/2005 8:28:06 PM EDT by Bubbatheredneck]

Originally Posted By PeteCO:


Attitude? I am the fucking customer.




Actually, in a business sense, no, your not. Your insurance company is paying, right???

Link Posted: 8/3/2005 8:27:50 PM EDT
Once after showing up twenty minutes early for my apointment I sat in the waiting room for thirtyfive minute. Then I sat in an examination room once for three hours with no pants on, getting increasingly .

Finally I got dressed and started to leave. The nurse asked me where I was going and I don't mind saying I cut loose on her and the doctor for the colossal waist of my time.

Now when I visit the doctor once I am in the examination room, I wait less than fifteen minutes.

Not long ago there was a patient who successfully sued his doctor for time lost in an instance in which the patient only waited 2&1/2 hours. The award was less than $200 dollars but the point is a appointment is a contract of sorts and the patients time has value.
Link Posted: 8/3/2005 8:29:50 PM EDT

Originally Posted By Bubbatheredneck:

Originally Posted By PeteCO:


Attitude? I am the fucking customer.




Actually, in a business sense, no, your not. Your insurance company is paying, right???




Yes and who is paying the insurance premiums and the co-pay? So actually in every sense he is the fucking customer.
Link Posted: 8/3/2005 8:29:55 PM EDT
[Last Edit: 8/3/2005 8:34:20 PM EDT by PeteCO]

Originally Posted By PeteCO:

Originally Posted By fish223:

Originally Posted By PeteCO:

My gripe is my excessive wait at the OB/GYN yesterday.



Are you sure you were in the right place?



Yes, I was there to have my prostate looked at.......



This reminds me of something that maybe you guys can answer: Several years ago I had prostatitis. I had 2 prostate exams. One was "normal" - pull the cheeks apart, lube the finger with K-Y, and stick it in. Fair enough - not my or my doctor's favorite part of the day.

The next time I went, my doctor was on vacation so I saw this indian dude. He lubed up his whole hand with K-Y rather than just the finger. Then, rather than pulling my ass cheek to the side, he worked his hand up and down my asscrack, slowly working his way to my asshole. Once he was there, he slid the finger in. Honestly, I felt a little violated, like it was fucking foreplay or something with him sliding his hand up and down like that.

So serious question - is there a "standard" or commonly accepted way of doing this? I honestly don't think they guy was a pervert or anything, but that it was a matter of technique. I'd rather not have my whole asscrack massaged, and it just seemed too weird to me. Besides it was actually kind of hard to clean up afterward with all that K-Y on my ass, up to my shirt.
Link Posted: 8/3/2005 8:32:13 PM EDT

Originally Posted By sysop:
Once after showing up twenty minutes early for my apointment I sat in the waiting room for thirtyfive minute. Then I sat in an examination room once for three hours with no pants on, getting increasingly .

Finally I got dressed and started to leave. The nurse asked me where I was going and I don't mind saying I cut loose on her and the doctor for the colossal waist of my time.

Now when I visit the doctor once I am in the examination room, I wait less than fifteen minutes.

Not long ago there was a patient who successfully sued his doctor for time lost in an instance in which the patient only waited 2&1/2 hours. The award was less than $200 dollars but the point is a appointment is a contract of sorts and the patients time has value.



That is unfortunate indeed. I won't sugar coat it - mistakes happen, folks do get forgotten from time to time. That is very rare, but when it does happen, it should be made right.

Taking care of sick humans is not a standard enterprise. It is totally dynamic. It takes good communications and understanding on both sides.
Link Posted: 8/3/2005 8:33:16 PM EDT

Originally Posted By PeteCO:

Originally Posted By PeteCO:

Originally Posted By fish223:

Originally Posted By PeteCO:

My gripe is my excessive wait at the OB/GYN yesterday.



Are you sure you were in the right place?



Yes, I was there to have my prostate looked at.......



This reminds me of something that maybe you guys can answer: Several years ago I had prostatitis. I had 2 prostate exams. One was "normal" - pull the cheeks apart, lube the finger with K-Y, and stick it in. Fair enough - not my or my doctor's favorite part of the day.

The next time I went, my doctor was on vacation so I saw this indian dude. He lubed up his whole hand with K-Y rather than just the finger. Then, rather than pulling my ass cheek to the side, he worked his hand up and down my asscrack, slowly working his way to my asshole. Once he was there, he slid the finger in. Honestly, I felt a little violated, like it was fucking foreplay or something with him sliding his hand up and down like that.

So serious question - is there a "standard" or commonly accepted way of doing this? I honestly don't think they guy was a pervert or anything, but that it was a matter of, uh, technique. I'd rather not have my whole asscrack massaged, and it just seemed weird to me. Besides it was seriously kind of hard to clean up afterward with all that K-Y on my ass, up to my shirt. Thoughts?



It'll cost ya.
Make an appointment and make sure you're there a little early.

Link Posted: 8/3/2005 8:34:14 PM EDT

Originally Posted By PeteCO:

Originally Posted By PeteCO:

Originally Posted By fish223:

Originally Posted By PeteCO:

My gripe is my excessive wait at the OB/GYN yesterday.



Are you sure you were in the right place?



Yes, I was there to have my prostate looked at.......



This reminds me of something that maybe you guys can answer: Several years ago I had prostatitis. I had 2 prostate exams. One was "normal" - pull the cheeks apart, lube the finger with K-Y, and stick it in. Fair enough - not my or my doctor's favorite part of the day.

The next time I went, my doctor was on vacation so I saw this indian dude. He lubed up his whole hand with K-Y rather than just the finger. Then, rather than pulling my ass cheek to the side, he worked his hand up and down my asscrack, slowly working his way to my asshole. Once he was there, he slid the finger in. Honestly, I felt a little violated, like it was fucking foreplay or something with him sliding his hand up and down like that.

So serious question - is there a "standard" or commonly accepted way of doing this? I honestly don't think they guy was a pervert or anything, but that it was a matter of, uh, technique. I'd rather not have my whole asscrack massaged, and it just seemed weird to me. Besides it was seriously kind of hard to clean up afterward with all that K-Y on my ass, up to my shirt. Thoughts?



Uh, you were violated. That's not a standard digital rectal exam. :)
Link Posted: 8/3/2005 8:35:39 PM EDT

Originally Posted By topknot:

Uh, you were violated. That's not a standard digital rectal exam. :)



You're kidding, right? You think it's because he was maybe educated in India?
Link Posted: 8/3/2005 8:41:27 PM EDT

Originally Posted By PeteCO:

Originally Posted By topknot:

Uh, you were violated. That's not a standard digital rectal exam. :)



You're kidding, right? You think it's because he was maybe educated in India?



Are you sure it was his finger?
Link Posted: 8/3/2005 8:42:53 PM EDT

Originally Posted By sysop:

Originally Posted By Bubbatheredneck:

Originally Posted By PeteCO:


Attitude? I am the fucking customer.




Actually, in a business sense, no, your not. Your insurance company is paying, right???




Yes and who is paying the insurance premiums and the co-pay? So actually in every sense he is the fucking customer.



The "customer" mentality is a big part of what is wrong with medicine. Administration and some patients want to come in and just get what they want like it is a fucking chinese restaurant where you choose one from each column.

A:
Antibiotic of choice

B:
Narcotic or benzo of choice

C:
day off, 3 days off, week off or short term disability. Sometimes they really go for the gusto though, walk in looking just fine, and try to convince you they should be put on SSDI

I ain't a server at Burger King and you don't get it your way. Not necessarily anyhow.

When I see patients they get my attention, my expertise and my advice. I have some people who want me to give them dangerous meds for ridiculous reasons.

It is just not like any other profession. You say we don't know how to run a business and that is true oftentimes but you don't know how to be a doctor.

Link Posted: 8/3/2005 8:45:54 PM EDT

Originally Posted By sysop:

Originally Posted By Bubbatheredneck:

Originally Posted By PeteCO:


Attitude? I am the fucking customer.




Actually, in a business sense, no, your not. Your insurance company is paying, right???




Yes and who is paying the insurance premiums and the co-pay? So actually in every sense he is the fucking customer.



Well, generally, in America, the employer pays the majority of the insurance premium, not the patient. True, the copay is part of it., but the lion's share of medical cost are NOT paid by the receipient of services. That is the problem. If you are directly paying everything changes. Look at plastic surgeons. Totally different experience because there is no question of who is who, and who is paying for what. The opposite end is the medicaid system. Patient pays ZERO. Go to a office that is 90% medicaid patients and see how "on time" and friendly they are.

A big problem is trying to balance the art and calling of being a physician with the economic realities of medicine in 2005. Also, everyone wants their cake and eat it too. When we pay our premiums, we demand cold, business, spreadsheet efficiency. But when we are sick or in the ER or on the phone asking questions, we want the artful, thoughtful caring family doc to spend as much time as needed with us.

I am 100% on your side, even thought I don't think you realize that and I don't think I am conveying it very well. 95% of docs I know are on the patients side and equally, if not moreso, frustrated with the current system rammed down our throats by the .gov and insurance companies.

Link Posted: 8/3/2005 8:47:38 PM EDT

Originally Posted By Rebel_Marine:

The "customer" mentality is a big part of what is wrong with medicine. Administration and some patients want to come in and just get what they want like it is a fucking chinese restaurant where you choose one from each column.

A:
Antibiotic of choice

B:
Narcotic or benzo of choice

C:
day off, 3 days off, week off or short term disability. Sometimes they really go for the gusto though, walk in looking just fine, and try to convince you they should be put on SSDI

I ain't a server at Burger King and you don't get it your way. Not necessarily anyhow.

When I see patients they get my attention, my expertise and my advice. I have some people who want me to give them dangerous meds for ridiculous reasons.

It is just not like any other profession. You say we don't know how to run a business and that is true oftentimes but you don't know how to be a doctor.




Big +1

Link Posted: 8/3/2005 8:48:34 PM EDT
[Last Edit: 8/3/2005 8:50:44 PM EDT by PeteCO]

Originally Posted By Rebel_Marine:

The "customer" mentality is a big part of what is wrong with medicine. Administration and some patients want to come in and just get what they want like it is a fucking chinese restaurant where you choose one from each column.

A:
Antibiotic of choice

B:
Narcotic or benzo of choice

C:
day off, 3 days off, week off or short term disability. Sometimes they really go for the gusto though, walk in looking just fine, and try to convince you they should be put on SSDI

I ain't a server at Burger King and you don't get it your way. Not necessarily anyhow.

When I see patients they get my attention, my expertise and my advice. I have some people who want me to give them dangerous meds for ridiculous reasons.



You're confusing the medical treatment options with business practices.


It is just not like any other profession. You say we don't know how to run a business and that is true oftentimes but you don't know how to be a doctor.


I don't have to be a doctor. But every doctor's office is a business. No business can exist without customers.

I'm not accusing physicians themselves of being motherfuckers here, just making some observations about the field.
Link Posted: 8/3/2005 8:59:02 PM EDT

Originally Posted By PeteCO:

Originally Posted By Rebel_Marine:

The "customer" mentality is a big part of what is wrong with medicine. Administration and some patients want to come in and just get what they want like it is a fucking chinese restaurant where you choose one from each column.

A:
Antibiotic of choice

B:
Narcotic or benzo of choice

C:
day off, 3 days off, week off or short term disability. Sometimes they really go for the gusto though, walk in looking just fine, and try to convince you they should be put on SSDI

I ain't a server at Burger King and you don't get it your way. Not necessarily anyhow.

When I see patients they get my attention, my expertise and my advice. I have some people who want me to give them dangerous meds for ridiculous reasons.



You're confusing the medical treatment options with business practices.



Not at all but plenty of admin types and customers do.
It is impossible to keep appointments right on time without just walking out on people. Sometimes I have to. They just won't stop....



It is just not like any other profession. You say we don't know how to run a business and that is true oftentimes but you don't know how to be a doctor.


I don't have to be a doctor.



No you don't, you pay someone else.
You may confuse promptness with a quality physician.
Others with someone who gives them whatever they want.
Still others with whoever kiss their ass the most or make them even more dependent.

I don't really consider any of those qualities of a good physician.


But every doctor's office is a business. No business can exist without customers.


True, very true.
And that is the art of medicine. Combining science, and common sense advice with some people is almost impossible.


I'm not accusing physicians themselves of being motherfuckers here, just making some observations about the field.


Well, we don't really like the rules either. Gov't and insurance companies are the ones that changed 'em and the only way they are going back is if people pay out of pocket for healthcare.
Link Posted: 8/3/2005 8:59:53 PM EDT

Originally Posted By Rebel_Marine:

Originally Posted By sysop:

Yes and who is paying the insurance premiums and the co-pay? So actually in every sense he is the fucking customer.



The "customer" mentality is a big part of what is wrong with medicine. Administration and some patients want to come in and just get what they want like it is a fucking chinese restaurant where you choose one from each column.

A:
Antibiotic of choice

B:
Narcotic or benzo of choice

C:
day off, 3 days off, week off or short term disability. Sometimes they really go for the gusto though, walk in looking just fine, and try to convince you they should be put on SSDI

I ain't a server at Burger King and you don't get it your way. Not necessarily anyhow.

When I see patients they get my attention, my expertise and my advice. I have some people who want me to give them dangerous meds for ridiculous reasons.

It is just not like any other profession. You say we don't know how to run a business and that is true oftentimes but you don't know how to be a doctor.




Well inspite of the problematic patients listed as examples above all that most of us want is to get treated in a timely manner. That was the topic of the thread was it not?

When a patient/customer makes an appointment it is not unreasonable for them to expect too see the doctor in a timely manner unless there are extenuating circumstances and under these circumstances a nurse or staff member should inform the patient/customer giving them the option to either wait or re-schedule the appointent.

I don't recall ever having said I know how to run a business or be a doctor or how your comments in regard to this are even slightly relavent to the conversation.
Link Posted: 8/3/2005 9:03:05 PM EDT

Originally Posted By PeteCO:
But every doctor's office is a business.




Exactly. The problem is when the business aspects collide with the "art" (for lack of a better word) aspects of the practice of medicine.

When a patient calls for an appointment and list the reason as "cough and think I have a sinus infection". You schedule 10 minutes. After talking for 5 or so minutes, you find out they aren't taking their allergy medicine anymore. Why? Well, I forgot. Why? Well, my son was in a tragic accident last week and is the burn unit in a nearby city with 2nd and 3rd degree burns on his face and I have been driving back and forth and i am not sleeping and.......10 minutes of sobbing on your shoulder because they have so much emotion pent up and no where else to let it out.

Do you really want a physician to just "sorry ma'am, gotta move on along...gotta schedule to keep...sorry, ma'am...be sure to take all your meds.....see you in three months...."

The tragedies that occur in peoples's lives daily is the most humbling thing, and will cause you to thank daily God for the little "problems" in your own life that pale in comparison.


Link Posted: 8/3/2005 9:04:54 PM EDT
I can't believe nobody has mentioned this as of yet, but I can tell you for sure this affects the amount of wait time quite possibly more than any other reason mentioned above (I have first hand knowledge of this example):

A busy Internal Medicine office will receive as many as 10 (and sometimes more) pharmaceutical reps per day. Squeeze that into an overbooked schedule (just like airlines overbook) and you're bound to create delays. Drugs reps bring in all kinds of goodies for the doctors and staff, often times including food (breakfast or lunch) which ultimately takes time away from the patients, and few doctor's offices will turn away a drug rep, especially those that take good care of them and their staff.

Now before anyone goes on a tyrade about the pharmaceutical industry, there are many benefits these drug reps provide to physicians that equate to better patient care including physician and nurse education as well as the free samples patients often times are sent home with. Not all physicians have a lot of time to constantly stay abreast of all the current medical trends in the pharmaceutical industry, and much of what the physicians learn about the medicines they prescribe is from information that is provided by the drug companies. All this information that is provided is also tightly regulated by the FDA, so ultimately, clinical data prevails when it comes to physician's prescribing choices.

It's a double edged sword, but ultimately, it results in better patient care (allbeit at the expense of yours and the physicians time)
Link Posted: 8/3/2005 9:05:11 PM EDT

Originally Posted By sysop:
When a patient/customer makes an appointment it is not unreasonable for them to expect too see the doctor in a timely manner unless there are extenuating circumstances and under these circumstances a nurse or staff member should inform the patient/customer giving them the option to either wait or re-schedule the appointent.



I agree 100% and try too.


Link Posted: 8/3/2005 9:06:10 PM EDT
[Last Edit: 8/3/2005 9:08:32 PM EDT by PeteCO]


You may confuse promptness with a quality physician.



Promptness is a tenet of any sucessful business. Accuracy in billing, a clean office, polite receptionist, etc are also expected of any entity doing business with the public, regardless of the specific service provided. I know a few attorneys who are slobs but that doesn't excuse them from having a clean and presentable waiting area and consultation room.

That's part of the problem - for example, every consulting engineer has to be a businessman AND an engineer, same goes for every other profession in the world. It just seems that hospital and clinic administration is either incompetent or unable to do anything about the problems, and as far as I am concerned insurance companies can burn in hell for all the problems they have caused.

Reading about a prescription that a doctor has prescribed being declined because some idiot at an insurance company didn't see the need for it is the kind of thing that makes my blood boil. So you see, I really am on your side here.

As for the rest of your post, I agree with you.
Link Posted: 8/3/2005 9:07:49 PM EDT

Originally Posted By niceguymr:
I can't believe nobody has mentioned this as of yet, but I can tell you for sure this affects the amount of wait time quite possibly more than any other reason mentioned above (I have first hand knowledge of this example):

A busy Internal Medicine office will receive as many as 10 (and sometimes more) pharmaceutical reps per day. Squeeze that into an overbooked schedule (just like airlines overbook) and you're bound to create delays. Drugs reps bring in all kinds of goodies for the doctors and staff, often times including food (breakfast or lunch) which ultimately takes time away from the patients, and few doctor's offices will turn away a drug rep, especially those that take good care of them and their staff.

Now before anyone goes on a tyrade about the pharmaceutical industry, there are many benefits these drug reps provide to physicians that equate to better patient care including physician and nurse education as well as the free samples patients often times are sent home with. Not all physicians have a lot of time to constantly stay abreast of all the current medical trends in the pharmaceutical industry, and much of what the physicians learn about the medicines they prescribe is from information that is provided by the drug companies. All this information that is provided is also tightly regulated by the FDA, so ultimately, clinical data prevails when it comes to physician's prescribing choices.

It's a double edged sword, but ultimately, it results in better patient care (allbeit at the expense of yours and the physicians time)




Free drug samples that the doc sends you home with are from the drug reps. Free to you, but he had to pay by listening to a cheesy marketing pitch.

Link Posted: 8/3/2005 9:10:08 PM EDT

Originally Posted By sysop:

Originally Posted By Rebel_Marine:

Originally Posted By sysop:

Yes and who is paying the insurance premiums and the co-pay? So actually in every sense he is the fucking customer.



The "customer" mentality is a big part of what is wrong with medicine. Administration and some patients want to come in and just get what they want like it is a fucking chinese restaurant where you choose one from each column.

A:
Antibiotic of choice

B:
Narcotic or benzo of choice

C:
day off, 3 days off, week off or short term disability. Sometimes they really go for the gusto though, walk in looking just fine, and try to convince you they should be put on SSDI

I ain't a server at Burger King and you don't get it your way. Not necessarily anyhow.

When I see patients they get my attention, my expertise and my advice. I have some people who want me to give them dangerous meds for ridiculous reasons.

It is just not like any other profession. You say we don't know how to run a business and that is true oftentimes but you don't know how to be a doctor.




Well inspite of the problematic patients listed as examples above all that most of us want is to get treated in a timely manner.



I would think the goal would to be appropriate treatment. Of course, you won't mind your doc walking out when you want to discuss something else or he decides you have had an MI? Guess you can call your own ambulance.


That was the topic of the thread was it not?


Like most all threads here people are free to interject what they consider imposrtant points and it is related to the subject at hand. If you don't want to discuss those bring up your own points for discussion and I will either respond or ignore.


When a patient/customer makes an appointment it is not unreasonable for them to expect too see the doctor in a timely manner unless there are extenuating circumstances


There are ALWAYS extenuating circumstances. I don't know what kind of doctors you guys plan on going to but I got a feeling when the S truly HTF that you might wish you had another at the time.


and under these circumstances a nurse or staff member should inform the patient/customer giving them the option to either wait or re-schedule the appointent.


I sure agree with that.
Further, I'd say that on days like that having a patient decide they couldn't wait any longer saved my ass.


I don't recall ever having said I know how to run a business or be a doctor or how your comments in regard to this are even slightly relavent to the conversation.


I see little relevancy to much of anything you've said either regardless of the fact that you bitched about having to wait.
Link Posted: 8/3/2005 9:10:52 PM EDT

Originally Posted By Bubbatheredneck:

Originally Posted By sysop:
When a patient/customer makes an appointment it is not unreasonable for them to expect too see the doctor in a timely manner unless there are extenuating circumstances and under these circumstances a nurse or staff member should inform the patient/customer giving them the option to either wait or re-schedule the appointent.



I agree 100% and try too.





Indeed and judging from the posts in this thread I can only say that I am glad that Rebel_Marine is not my Primary Care Physician. He appears to have issues.
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