Definition of Insanity

Delayed schedule. Irritated patients. Late workdays. Costly overtime. Disgruntled staff. Stress... You don’t have to be Sherlock Holmes to figure out that something is wrong. All these signs are the classic symptoms of poor scheduling, but that’s only one diagnosis. And sure, patients expectbackups… occasionally. However, when waiting becomes a repeat performance, with no effort to fix it, all that good customer service your practice offers to romance your patients goes out the door, along with the patient. Is there a reason for this? Of course there is. Things don’t just happen in a vacuum… they are the byproduct of our actions. Doctors say they want more efficiency in the office. However, without the willingness to embrace change when fundamental management remedies are suggested, it continues to be the same-ole, same-ole. (Re-enter delayed schedule. Irritated patients. Late workdays. Costly overtime. Disgruntled staff. STRESS.) I believe Einstein said it best. “Insanity: doing the same thing over and over again and expecting different results.”So why is it, that despite the fact that everyone (staff, patients, doctor) benefits from an on-time schedule, worthwhile solutions are glazed over with excuses and the bad habits continue to (ineffectively) run these practices?  

It’s impossible to summarize all the reasons why medical offices keep patients waiting in a one-page blog (there are many!), but since treating (unscheduled) multiple conditions is one of the biggest culprits, it gets top billing. Now, before you get defensive and go all “I do it because I care about my patients”on me, understand that this is not about caring for your patient. Of course you care. No one is disputing that. There is an effective way to handle this scenario and a not so effective way and unfortunately, more often, the not so effective way dictates protocol. What I mean by that is making exceptions for one person usually has a trickle-down effect. While it’s nice to make that “caring” exception for a patient, it is unfair to the others who are on time, also needing care and left sitting in the reception room, AKA “the waiting room”.

I’m confused by this “extra care” because I can tell you that (unless time allows), my dentist sticks to the one tooth I was scheduled for. Not two teeth and not, “Oh, BTW can I get a cleaning while I’m here?”Do I think he’s a bad dentist because he didn’t alter his schedule for me? And would I even consider going to another dentist for that reason? No, because the expectations for this appointment were met. I was taken promptly, received the attention and care I was scheduled for, the patient’s appointment before me did not spill over into mine and I left on time. If I had an additional problem that needed to be addressed, it really should have been MY responsibility to call in advance, explain it to the receptionist and have my appointment expanded or rescheduled if need be to allow time to treat multiple conditions. At the very least, I should expect to make the new, painful condition my priority at this visit and schedule another to replace my original appointment.

Of course emergencies do occur and must be addressed immediately, but not every (unscheduled) event treated as an emergency, really is…an emergency. Naturally, if time allows, special attention can be given to non-emergent conditions as well, however it’s important in this instance, to educate the patient that this may not always be the case or they will come to expect it every time.

Here’s the misconception. Blowing holes in your schedule for one or more patients doesn’t make you a hero, a better doctor, more likely to increase revenue or retain a patient. So, in order to keep flow in tact (and truly keep everyone happy), it’s sensible to hear and examine the patient’s new complaint and treat if it’s emergent or if time really does permit. Otherwise give them a patient-based response; “It’s nothing serious, Mrs. Jones but I’m glad you brought this to my attention. Here’s what we will do today to make you comfortable…I want you to take note of how that feels over the next couple days/week and before you leave today, see Sally at the front desk and have her schedule you for a visit so that we can give you the proper amount of time to follow up and more comprehensively exam and treat it.”

There is no denying that good customer service and patient care is what we all strive for, but not if it means stepping on one patient’s toes to accommodate another’s. Patients want to know that everyone is treated fairly and given the same respect. Again, there are many reasons why a schedule can take a nosedive and as I said at the onset, this is only one; a problematicone that has proven to cause unnecessary disruption. If you commit to making an effort to fix one problem at a time, I promise you…things will improve.