Thursday, October 23, 2014

Still using horses and buggies

I recently had to reschedule a routine exam with my hospital-based primary care doctor and so decided to use the supposed rescheduling functionality on the patient portal to carry out this task. 

The appointment was scheduled for September 23, and I sent in a cancellation request on September 14, along with a note suggesting possible substitute dates two weeks hence.

There was no reply.  I later learned that the message was not opened until October 15.

Message Date/Time: 10/15/2014 11:23 AM Subject: We are working on your request

We have received your request. We are working on it.

A minute later, a second reply came back:

Sorry taking so long to get back to you but your appt is on Tuesday 1/27/15 at 10:40am.

I replied that I would be out of town on that date, adding:

Instead of just choosing a date, why don't you offer some possible openings, and I'll let you know which would work?

The reply:

The reason why I couldn't just offer some possible openings is because appts go very fast. You can pick which days and times works best for you and we will try our best to fit you in on those slots. Pls email me back and let me know what works for you and I will schedule it.

By this point, I knew things would be hopeless if we continued writing each other:

Why don't I call so we don't go back and forth on email?

Now, compare that with my experience setting up a routine exam for my Subaru.  I go to the website and a full calendar for several months is presented, showing where there are openings for my particular kind of appointment.

I can even tell them if I want to wait for the work to be done, borrow a car, or get a ride somewhere.  I flip through the calendar, make my choice, and a confirmation arrives instantaneously--along with a button to push if I need to make a change.

I know there are subtleties that sometimes require personal attention when making medical appointments, but many appointments require no human intervention from the doctor's office.  It is frustrating to think that it is easier for me to schedule a routine car service event than a routine physical exam.  It is also a waste of human resources in a cost-constrained health care environment.  For all I know, my doctor was left with an unfilled appointment back in September.  Perhaps another patient with an urgent need could have seen the doctor during that block of time.  It makes me think that some hospitals have a long way to go before they get out of the horse and buggy era.


nonlocal MD said...

Excellent illustration. I am sure doctors will write in complaining again about meaningful use, but really in this sort of situation it comes down to just changing one's mindset from provider-oriented to customer-oriented - a mindset that still escapes health care professionals. Not only that, but as you point out it would help the providers too.
(ps it may be that the software doesn't yet provide that functionality, but then again it would if providers would only use their group clout to pressure the vendors instead of railing against the government.....)

Anonymous said...

We are encouraged to use email to discuss non-urgent concerns with our providers. The web site states we are to allow up to 72 hours for a response to such requests as medication refills.

The web site also states that for same-day medication refills, we must contact the clinic directly.

So, I did. After I called and requested a medication renewal for an expired prescription (for migraine), the clerk on the other end said, "Your provider has up to 72 hours to renew this prescription."

"So, my only recourse is to go to the emergency room to get a prescription renewal?" I asked.

"If that's what you would like to do, you're welcome to go."

So, we can get past scheduling using a computer-based program, but we can't get past poor customer service at the point of service.

Nancy Thomas said...

The medical community could learn much from the business community - think about how operating so inefficiently would impact any of our businesses - we'd be toast. But this insular feeling that no one can contribute anything outside of the inner circle is what keeps them spiraling in their own inefficiencies....

Kelly W said...

The proposed appt date was late January, next year. That's (almost) funny.

There are many things I do NOT want automated, but clearly this is one area where health care provision could improve.

Anonymous said...

I am an older private solo practitioner that has been unwilling to spend the tens of thousands for EMR. Yet, I am also the top rated specialist by the primary care physicians in our PHO every year. Some of those ratings depend upon ease of referral, customer service,and quick communications with both patients and physicians. No cut and paste.

Call my office and you will get a human that will answer in seconds, take your name and you'll be finished in less than half a minute. Yes you can cancel after hours, and there is any issue that you consider an emergency I will call you personally, day or night.

I'm not an IT guy, but I am proud to be a physician. Can't see me typing in front of a patient, and I promise you'll never need Get Human for my practice.

minniemoo6 said...

Have you heard of ZocDoc? They have made scheduling for medical appointments and also finding a doctor very easy and convenient. One caveat I would add is that they may not always reflect the most accurate available times, however, each time that has happened I have been given a call and offered different options for a timeslot available. I will continue to use it because it is so convenient. I hope that more providers use a service like ZocDoc and use it more comprehensively in order to show the most accurate appointment availabilities. I agree that it should not be that difficult!