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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#51

Post by maxxxxx »

QSIITurbo wrote: post #34
pbhjpbhj wrote: post #6

Earlier quoted context omitted.

>the doctor then ordered someone else not in the room to come and get me a glass of water // It seems possible that was a hygiene issue. For example the doctor knew that he'd need then to wash his hands again (possibly twice, once before going to the cupboard, once after), or change his gloves, before continuing with your consultation?

Another alternative that I've run into. Visiting a doctor friend of mine. She needed to deliver some papers to another room and summoned the nurse for that. I joked that why you can't do that yourself (omg) and she replied that the nurses start to complain if you do stuff that's earmarked to them. It might be that it's because they're in a union or it's a company policy. Who knows, I never asked. But the point was th…

That's a very american thing. I remember reading about engineers from Germany who worked with NASA engineers on a project. The americans were surprised that when something was wrong the germans just took a wrench to fix it where for the americans it was policy to call a technician.

From my own experience the US is a weird mix of "can do" attitude on the one hand with strict hierarchies and enforced policies on the other hand.

Re: Why Did My Patient Leave Me?

#52

Post by brightball »

josephorjoe wrote: post #33

The primary reason I have left healthcare providers has been the poor quality of their administrative staff. There are too many qualified doctors in the major metro area I live in to put up with ones where I can't quickly and efficiently make an appointment, can't get an appointment in a timeframe that is useful to me, and where their staff can't seem to successfully process routine insurance claims with major insura…

If you can justify the expense, MD VIP (http://www.mdvip.com/) is worth exploring. You basically pay an annual fee and in trade, the doctor's office caps their patient load at a certain number. The fee also includes an annual executive physical and work up.

The benefit is that with the smaller patient load, you can almost always get an immediate appointment. The doctor will actually get to know you and your history, have time to call and followup with you and overall just provide a tremendously better experience. Additionally, if you're ever travelling you can go see an MD VIP doctor wherever you are.

It's a really good setup for people who are willing to pay extra for a better experience.

We tried it after my wife went from doctor to doctor trying to figure out her symptoms that we'd experienced over the course of 2 years. The doctor she went to put some serious research time into narrowing down and figuring out what was going on...and correctly identified the issue, finally.

Re: Why Did My Patient Leave Me?

#53

Post by zer0tonin »

speeder wrote: post #20

I don't bother explaining to doctors why I switched. Every time I did in the past they got personally offended and refused to address their flaws, so why bother? Also I am almost convinced good medics in certain fields (endocrinology for example) are almost nonexistent.

Most endocrinologist only ever see diabetics and people with thyroid disorder. They are often quite lost when they get to see something else.

Re: Why Did My Patient Leave Me?

#54

Post by stinkytaco »

I don't know if my doctor would notice. She sees so many patients it's hard to get in when I need to, so I end up seeing whoever is available anyway. That seems increasingly common,large systems with overworked generals and huge administrative headaches. And it's not like we can switch, we've got insurance.

Re: Why Did My Patient Leave Me?

#55

Post by jacquesm »

lmns wrote: post #28

So, in this sense, vaccination should be an individual choice? This is something which concerns the individual, but has consequences for society as a whole.

> So, in this sense, vaccination should be an individual choice?

Emphatically: YES. Bodily integrity is something that is very high on the list of things that a person should have a say over. Whether they do it because they are mis-informed, dumb, irrational or religious doesn't matter, they still should have the final say over whether or not they get a specific injection or not.

There are many things that concern the individual that have consequences for society as a whole, in fact, it is very hard to point at a single thing that concerns an individual that has absolutely no consequence for society. And many of those things are regulated to benefit society. But your body is yours and yours alone and that's a good thing even if there are negative consequences for society.

Fortunately the anti-vaxxers are a small minority instead of a large majority so the risk is somewhat controllable and fortunately the only people at risk are those that have not been vaccinated yet (a risk that for many diseases is extremely small) so the consequences for society as a whole are manageable.

If that should change dramatically then this should be revisited but for now I'm pretty happy to support this even though I would never apply it to myself or my children (who, ironically, don't get to chose because the argument isn't really framed right, it's not an individual choice but in almost all cases a choice for a parent about their child...). This also ties in with religious freedom, and as an atheist you might find it surprising that I'm a big proponent of that, I don't believe in any of this but I will definitely defend the right of others to believe in whatever they want, including in things that may make them make sub-optimal choices when it comes to their own health or the health of their kids.

If you start to take away those rights you will end up with a very unhealthy society, far more unhealthy (and unhealthy on a different plane) than the society that has to deal with some actual health issues in a small part of their population.

Re: Why Did My Patient Leave Me?

#56

Post by icantdrive55 »

josephorjoe wrote: post #33

The primary reason I have left healthcare providers has been the poor quality of their administrative staff. There are too many qualified doctors in the major metro area I live in to put up with ones where I can't quickly and efficiently make an appointment, can't get an appointment in a timeframe that is useful to me, and where their staff can't seem to successfully process routine insurance claims with major insura…

I don't know if doctors know we are not the completely oblivious patients of the past?

We know when we are being overcharged. We know when we are being dragged in for unnecessary office visits for a refill. (By the way--it's one year)

I don't mind waiting. I don't mind egotistical doctors. I just don't want to be taken advantage of when I'm at my worst. It's simple.

Yea--I know it was a bitch getting through med school, and most residencies, but ethics will take you a long way. It's better than advertising. Hell--it used to be taboo for doctors to even think about advertising.

The last thing you want is a bunch of free, usually petty, but usually spot on true, negative reviews on Yelp? By the way, I don't usually use Yelp. I give doctors the benefit of doubt, but sometimes all those reviewers can't be wrong? And when it comes to money/padded fees--that's when I take notice.

This goes for Dentists, and Veterinarians too. And yes--I know running a practice is expensive. I know MP insurance never seems to go down. On the bright side, Trump might give you Tort reform? Obama said, hell no! I really think some of you deserve it--some.

Re: Why Did My Patient Leave Me?

#57

Post by ghaff »

lmns wrote: post #28

So, in this sense, vaccination should be an individual choice? This is something which concerns the individual, but has consequences for society as a whole.

It is. Not many people favor coming in with a SWAT team and vaccinating children against the parents' will. However, society and institutions do in many cases also properly forbid unvaccinated children from attending school and participating in various activities with other children.

Re: Why Did My Patient Leave Me?

#58

Post by muninn_ »

josephorjoe wrote: post #33

The primary reason I have left healthcare providers has been the poor quality of their administrative staff. There are too many qualified doctors in the major metro area I live in to put up with ones where I can't quickly and efficiently make an appointment, can't get an appointment in a timeframe that is useful to me, and where their staff can't seem to successfully process routine insurance claims with major insura…

I hear you. Previous office I went to I had to wait more than 30 minutes past my appointment time before being seen by the nurse (before being seen by the doctor) which didn't include "arrive 10 minutes before your appointment". Obviously this is annoying. The third time I showed up to the same office I was 10 minutes late to my appointment, and they told me I would have to reschedule or wait about 45 minutes to an hour.

I told them to cancel the appointment then. They asked if I wanted to reschedule "Nope. I'm going to find another office".

I did find another office, and the doctor was more professional, thorough, and I had next to no wait time.

Re: Why Did My Patient Leave Me?

#59

Post by Lordarminius »

pbhjpbhj wrote: post #6
jacquesm wrote: post #4

I've done this, without feedback. The reason was that doctors seem to come in several varieties when it comes to bringing their ego to work and my doctor had a serious case of that. I was dehydrated after an operation and when he asked if he could do something for me I asked for some water, the doctor then ordered someone else not in the room to come and get me a glass of water. He couldn't be bothered to walk to the…

>the doctor then ordered someone else not in the room to come and get me a glass of water // It seems possible that was a hygiene issue. For example the doctor knew that he'd need then to wash his hands again (possibly twice, once before going to the cupboard, once after), or change his gloves, before continuing with your consultation?

I am a doctor, and this was the first thought that came to my mind

Re: Why Did My Patient Leave Me?

#60

Post by builtinbuffalo »

We've created a patient feedback software (http://www.repcheckup.com) that allows doctors to automate their patient feedback by sending email and text rating/review solicitations.

On average, less than 5% of all patients seen will leave feedback. When prompted, we've seen this jump to 10-15% of patients seen, although we do have a few who have much higher conversion ratios.

(This is likely due to the doctor introducing the feedback concept at the end of the consult.)

What has been most interesting to see, contrary to the story, is that most doctors and healthcare professionals are still on the fence about implementing these sorts of feedback loops.

We find often times that buy-in does not occur until the professionals can see "comparisons" as to how others are doing.

There are also a ton of hurdles to implementation of these types of feedback loops, due to HIPAA and other requirements that often makes things near impossible.

This makes the whole thought of introducing this into a practice daunting for some and that's why usage of feedback loops like these are not already widespread.

Hopefully, as legacy practitioners give way to a new generation of medical and Heath professionals, patient feedback will be more widely solicited and used.

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