this post was submitted on 11 Mar 2024
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Airports work like this. You arrive two hours before takeoff only to find out like half an hour before takeoff that the flight is delayed because there's no plane.
Our patient visits are set as 15 minute slots standard.
This isn’t enough time to practice good medicine for anything much more than something like a flu or strep throat. How does one squeeze in an entire rooming process followed by a solid HPI, physical, poc testing and then plan review with pt in 15 minutes?
They don’t.
But with how medicine works (in the US) it’s the how clinics make enough money to stay open.
For clarity: I work at a Federally Qualified Health Center, not a for profit clinic.
But with how medicine works (in the US) it’s the how clinics make enough money to stay open.
This is the truth. PCP offices in particular have razor-thin margins and insurance reimbursement goes down every year while supply, fixed, and staff costs go up every year. This is an insurance industry and healthcare system problem. Your doctors' offices are just doing everything they can to stay open.
Fortunately CMS is rethinking the role of primary care and realizing we can save money if we're able to provide high quality preventive care like we're supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.
The best way to fix this is to cancel the appointment if they make you wait. If enough people did this the clinic loses money which should cause change. Unfortunately, patients are largely a captive clientele, having already waited months and canceled work and with few if any alternative providers.
The next best thing is much more realistic. Plaster the internet with reviews complaining of the wait. If your doctor (or more likely your doctor's employer) does not respect your time, let everyone know.
Many of the other comments are also correct. I have worked in clinics in government, military, academic centers, venture capital, physician owned, and even free community health centers, all in the USA. Doctors running late is going to happen. I've kept patients waiting while in the operating room, while telling someone they have cancer or are losing a limb, and by my burnt out underpaid government scheduler incompetently overbooking. I will also tell you that when I have at least a little control over my own schedule, I've never made a patient wait an hour, even with the above happening. It can be done, it just isn't because for decades timeliness has not been a financial incentive.
Make it one. Name and shame on google, yelp, zoc doc, wherever. Do it gracefully and sensitively, recognizing that there is a high chance the delay is not the doctor or nurse's fault. Done right, you'll do them a favor when their employer feels the sting of lost patients.