The team saw that doctors deliberately schedule appointments in such a way as to benefit them and not their patients. Clinic appointments are made before the physicians are even expected to be ready. Patients arrive way too early and are asked to wait. This ensures that the doctor never runs out of work.
Ironically this has patients waiting more than 30 minutes to see their doctor despite having specific appointment times.
But if you think you can “cheat” the system by arriving later, think again. Patients who do not arrive on time are not accommodated due to their tardiness.
Supposedly this scheduling “mistake” is because some patients do not come on time or take too long in their appointments. To maximize the physician’s productivity and avoid wasting valuable health care resources, clinics compensate by scheduling one or more patients at the same time slot. This naturally becomes a problem when both patients arrive on time.
The researchers at Brock said that better scheduling could eliminate this problem. A simulation test proved that scheduling would be easy if no one was ever late. This, of course, is not reflective of reality. Yet a little foresight and thought could reduce the waiting time of patients. For example, if a patient is habitually late, the clinic could schedule an appointment a little bit earlier in the day.
It’s a slippery slope. In an effort to adjust for consistent lateness, clinics are overscheduling. Their priority, of course, is not the patient’s wellness but how busy the physician will be during the day. If scheduling was done evenly and no patient comes, doctors would routinely run out of patients. What ends up happening is that patients are scheduled to arrive the instant the clinic opens. This means that some patients can wait for hours before being seen.
Researchers have proposed two approaches which they say can reduce waiting times. The first involves placing appointments closer together near the start of and at the end of the work session. Appointments are then spread farther apart in between. The second plan is to ask doctors to place appointments closer together in clusters of two or three, with clusters spread further apart.
The team says that if appointments were scheduled better, doctors would be able to see more patients per day. It’s not exactly efficient to have more patients waiting longer, they say, for only 10 minutes of consultation. What should be done is to adjust time management practices so that patients are immediately seen at the time they are scheduled.
There are also reports that suggest patients are waiting longer because there are fewer general practitioners. Primary care doctors are overburdened with patients. This has occurred because most residents choose to specialize in order to earn more money. It is estimated that only a third of graduating medical students decide to practice general medicine.
Ultimately, the medical industry says that waiting times are an inevitable outcome of doctors working exclusively on a “fee-for-service” basis. Doctors only earn money by seeing more patients. It behooves them to overschedule so that they are assured of a constant stream of patients.
“The painful reality is that the fee-for-service system rewards long waits and overbooking,” concludes the authors of a recent New England Journal of Medicine report. “The system does not reward providers who organize care to reduce waits for all patients, even though that might keep some patients from becoming sicker.”
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