Tuesday, June 09, 2009

Who's waiting?

E-patient Dave referred me to this article in USA Today, entitled "Wait times to see doctor getting longer." The title says it all, but here's an excerpt:

The survey found that, on average, wait times have increased by 8.6 days per city. Boston had the longest wait, averaging 49.6 days.

But, now look at this marvelous contrast in our hospital, where we have made a concerted effort to reduce wait times. Over one year, the average wait time for all of our medicine clinics has dropped from 13 days to 4.4 days. (The figures are based on a sample of mystery shopping calls.)

Our goal is for all clinics to be under three days. Right now, 6 have been meeting that goal. Another six are in the 3-5 day range. Two are in the 5-10 day range, and one is greater than that. In these last three cases, the reason is that we have doctor vacancies that are being filled in July.

This kind of success takes coordination across multiple areas, constant review of our procedures, use of mystery shoppers to evaluate the patient experience, and transparency of the results both to ourselves and our patients. Speaking of mystery shoppers, our customer service ratings for these clinics had an average of 4.5, on a scale of 1 (poor) to 5 (excellent). We're still shooting for better -- a goal of 4.8.

8 comments:

Bernie said...

I am a patient of BDIMC and I am followed by Rheumatology, Cardiology, Liver, GI, Pain Clinic, and neurology on a regular basis. I have also needed to be seen by (but not on a regular basis) Colorectal Surgery,ENT and Allergy. Within the last 4 months I have needed to make appointments with all these specialist except liver (more than a 9 months out for Liver.) Let me give you my experience compared to your rating.

Under 3 days -- Rheumatology, Cardiology, and ENT

3-5 days -- GI

5-10 days -- Neurology, ENT, Allergy (only because Rheumatologist pushed -offered me 3 months out).

Over 10 days -- Colo-rectal Surgery, pain clinic, Liver,

Paul Levy said...

Thanks, Bernie. As I mentioned, this was based on a sample, so everybody's experience is likely to be different -- some better some worse.

Susan said...

Paul, I am constantly perplexed by these alleged metrics. We cannot take the subjective out of health care and therein lies the problem with ratings and rankings. That said, I'm off to see my MD today. Best of health to all.

Paul Levy said...

Susan,

"If you don't measure you can't manage."

e-Patient Dave said...

Can you tell if this is apples to apples? That is, is your 4.4 days really 91% shorter than the 49.6 days reported by USA Today - for the same thing?

Do you have an info on whether BIDMC's demographics are the same as the city average?

I'm not happy with the authors' speculation about the universal coverage requirement in MA, for two reasons - and I mean "inferentially unhappy," not politically. First, if their surmise is correct, then measuring another city in MA should have produced the same result. Too bad they didn't. Second, it's too easy to indict a change based on the initial status after the disruption, before the system's had time to adjust, and I'm tired of seeing people point to a very early status and say "See, I told you it wouldn't work." (Perfect example: the idiots who are already clamoring to say "Obama's stimulus didn't work.") Providing fodder for such speculators would be irresponsible on the part of the authors, I'd think.

Otoh, I haven't read the article so I don't know.

ANYWAY, is you apples to apples, or what?

Paul Levy said...

Can't tell, Dave. I don't know what their methodology is. But there is no reason to assume that our demographics are different from the community as a whole

Alex said...

Paul, thanks for giving us your take on the wait-time issue. We've linked to your post from the New America Foundation's New Health Dialogue blog at http://www.newamerica.net/blog/new-health-dialogue/2009/quality-cutting-waiting-times-getting-needed-care-one-busy-boston-hospital-

Amin said...

I am a physician coming from another major academic center to begin a job at the BIDMC. At my current institution, patients wait, on average, greater than 30 days to see doctors within my specialty. The low wait times are one of the reasons I'm so happy to be coming.