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No, you are not "running late", you are rude & selfish

gregsavage.com.au

51–60 of 132 posts

Re: No, you are not "running late", you are rude & selfish

#51

I also find doctors to be late in perpetuity, ive never in my life waited less than 10 minutes PAST the actual appointment time. This is both an easily identifiable problem and easy to fix, the receptionists could easily structure appointments more appropriately.

Well the problem may vary from provider to provider (and country to country), but after observing my wife's situation as a physician in the U.S., I can tell you that many doctors aren't late volitionally.

First, the problem isn't easily fixed. Here's the deal: At her HMO each doctor has a panel of several thousand patients. Each patient visit during a normal clinical day gets a 15 minute allocation with the MD. It used to be 20 minutes at her HMO but was recently reduced in order to increase the patient volume. Typically my wife's schedule is stacked appointment to appointment from 8-Noon and then again from 1-5pm. A couple of time slots are left unscheduled for high priority, emergent visits (if you've got a routine visit, forget it, you'll get something a month or two out into the future).

No as you can imagine, 15 minutes per patient isn't much time. Some patients require more time. With each successive visit, the wait will get longer and longer. This isn't because the doctor (at least some of them) is being a jerk or dismissive, it's because they're trying to do a thorough job with the time allocated. If they can't finish what they need to in 15 minutes, well, she goes over that time. It isn't too hard to realize how screwed up the schedule can get after a couple of tough back-to-back cases.

My wife then tries to catch up during lunch hour because she doesn't take lunch. After working through lunch, she kicks into the afternoon half of clinic hopefully caught up, but sometimes not. And the cycle repeats itself.

The receptionists can't "easily structure" the appointments more appropriately -- at least at the large providers -- b/c they're not the ones running the game.

I'm not going to defend the overall system. That's a much bigger problem and mess that a lot of smart people have looked at and have yet to solve. But I do think it's worth realizing that, yes, many doctors do think your time is valuable and don't purposefully try to waste your time. Many doctors are overworked and are doing the best they can within the parameters of what they've been given to practice medicine and that at some point you might be that person that has an appointment that goes over the time allocated (and when you do, hopefully you'll be happy the doctor ended up being attentive to those needs).

Just hoping to lend some extra perspective (especially as someone who used to feel the same way you do).

Re: No, you are not "running late", you are rude & selfish

#52

Earlier quoted context omitted.

Despite the sarcasm I think this is a great response on a serious level. Most people are not late by intention just as this site wasn't intended to crash.

If someone is late, that is no problem, stuff happens. When someone is always late, that is rude and inconsiderate.

Perhaps the same way dyslectics (sp?) are inconsiderate by always being unable to spell correctly. From time to time, it would be acceptable.

Consider that for the person that is always late, it is probably a bigger problem than for you. She has to endure it in all parts of her life. Assuming that the problem is that she simply doesn't care is as ignorant as assuming that a dyslectic simply doesn't care to learn how to read or write correctly.

Re: No, you are not "running late", you are rude & selfish

#53
It's helpful to define what "being late" means. My rule of thumb is 0-5 minutes late is "on time", 5-10 minutes late is "OK but not great", 10-15 minutes late is "somewhat rude" and 15+ minutes late is "very rude".

One thing that annoys me to no end: people who are very early. If I plan my schedule carefully around you being there at 2pm (or later) and you show up 20 minutes early, you are going to sit around for 20 minutes, and I'll feel like an asshole, even though it's your fault.

Re: No, you are not "running late", you are rude & selfish

#54

I also find doctors to be late in perpetuity, ive never in my life waited less than 10 minutes PAST the actual appointment time. This is both an easily identifiable problem and easy to fix, the receptionists could easily structure appointments more appropriately.

It is only easy to fix at the expense of decreasing productivity of the doctor. Because of that, most doctors do not really see this as a problem, let alone one that needs fixing.

The problem is that meeting a doctor cannot be planned perfectly. A meeting might take 5 minutes, or it might take 20.

If, on average, a doctor can serve 4 patients an hour, and she wants to reach that on a 9-5 working day, she must schedule her first patient at 08:45 or thereabouts. Reason: the first patient might be late. That would give her idle minutes that she would need to serve later patients, some of which might take 20 minutes.

Similarly, she must schedule her second patient at 09:00-ish, to have a patient waiting in case the first one happens to take only 5 minutes to serve.

And yes, that appears rude, but mostly, it is the economical thing to do. You can only get better service by paying your doctor more. You will notice that many people who can afford that are willing to do so. As an extreme example, I doubt that the president of the USA has spent much time waiting for his doctor.

For the maths behind this, google queueing theory.

Re: No, you are not "running late", you are rude & selfish

#55

Interestingly, this is mostly an American (and a also a Western) problem. In most of the world (South America, Middle East, Africa, East Asia, etc), "on time" ranges anywhere between 30 minutes to 3 hours later. We grade our personal productivity level much more than other cultures. Other cultures value other things such as community and relationships at a higher level than we do. A story: I was invited to an Indian…

We have the concept of "fashionably late" in the US, too. A late night party might be scheduled to start at 7 or 8, but people might not show up until 9 or 10.

Re: No, you are not "running late", you are rude & selfish

#56

Two potential solutions: 1. Plan around it - be somewhere where the person being late doesn't affect you. Have people meet you at your home or at a cafe where you're doing other work or reading a book and it doesn't adversely affect you. Oftentimes, if I'm traveling with a group of people, I give a time range - "Be there between 7:30PM and 8PM" - that lets the early birds get there at 7:30, and the "oh shoot! gotta r…

When I was teaching my solution was that homework which was not at the front of the table, at the start of class, was not accepted. I also graded people on only a certain number of homeworks, so missing a homework or two was not a big deal.

It worked. Class started on time, with the question and answer period that I thought was the most important part of class, but which the students probably didn't realize was that important. (Well they did partway into the course. But that is another story.)

Re: No, you are not "running late", you are rude & selfish

#57
post #22

I'm reminded of a talk at a medical conference about patient interaction. The talk was scheduled. People showed up. No speaker was visible. The doors closed. People sat there. Finally someone got unhappy enough to leave. Discovered that the doors were locked. Soon the whole room was up in arms. Then the speaker got up from the first row, went to the stage, and said, "I did this because no words are as effective as de…

I wish more doctors followed this...Ive spent far too many hours of my life waiting in receptions or exam rooms at hospitals. Unfortunately they are kind of squeezed in to seeing more patients per day than they would probably like, and one delay ripples through the rest of the patients.

I wish there was some sort of system to know exactly how far behind (if at all) your doctor was running that you could check online to minimize lost time.

Re: No, you are not "running late", you are rude & selfish

#58

I also find doctors to be late in perpetuity, ive never in my life waited less than 10 minutes PAST the actual appointment time. This is both an easily identifiable problem and easy to fix, the receptionists could easily structure appointments more appropriately.

The real problem is that the customer is not the person getting the care, it is the person paying the bill, so that is what gets optimized for.

The healthcare world is directly analogous to the auto repair world, we just don't fit in the same place:

You, car, mechanic :: Insurance co, you, doctor.

Re: No, you are not "running late", you are rude & selfish

#59
post #22

I'm reminded of a talk at a medical conference about patient interaction. The talk was scheduled. People showed up. No speaker was visible. The doors closed. People sat there. Finally someone got unhappy enough to leave. Discovered that the doors were locked. Soon the whole room was up in arms. Then the speaker got up from the first row, went to the stage, and said, "I did this because no words are as effective as de…

I wish more doctors followed this...Ive spent far too many hours of my life waiting in receptions or exam rooms at hospitals. Unfortunately they are kind of squeezed in to seeing more patients per day than they would probably like, and one delay ripples through the rest of the patients. I wish there was some sort of system to know exactly how far behind (if at all) your doctor was running that you could check online…

I've recently been seeing an Osteopath, and I've been really delighted that his administrative staff have twice contacted me a couple of hours before appointments to reschedule (by 30-40 minutes) as his schedule had slipped during the day. I haven't spent more than 1 or 2 minutes waiting for him. It's kind-of sad that this level of service is remarkable rather than customary.

Re: No, you are not "running late", you are rude & selfish

#60
post #30

Earlier quoted context omitted.

I dunno, in much of southern Europe it's certainly not expected that people will be there to the minute even for one-on-one meetings. Probably not an hour late in that case, but I don't think anybody would bat an eye if you had planned to meet at a coffee shop at 2:00 and someone showed up at 2:15. You'd just get a coffee and read a book or the paper or something. (Being exactly on time, and being angry if someone's…

15 minutes in a coffee shop is one thing. 45 minutes in an office is another.

What about 45 minutes in a coffee shop?
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