OP: initial thoughts on your post is that you have a doctor that churns to make more or is not very good at time management. However a couple thought to give benefit of the doubt.
1) some issues in some states LEGALLY require a separate visit. Ie. In our state the law was changed years ago to legally require any chronic pain prescription to be a separate visit. When it first came out every doctor followed it by the book. Ie. You come in with a cold that takes 5 minutes to see but you want a refill of your controlled substance, too bad come back another day. People were scared to loose their license since they were really cracking down. Fast forward, same law and most docs would still address both problems same day.
b) similarly state law has a lot of “shoulds” and “shalls” around any controlled substance. Shawls are required, shoulds are recommended. Some people still make people follow-up every month, every 3 months or every 6 months based on interpretation of the same law. All well meaning.
2) studies show after addressing 3 problems in 1 visit outcomes of care drop for patients, despite how satisfied the patient may feel and competent the doctor. There is a real diminishing returns and sometimes negative returns to adding more to a visit.
3) some patients really just take all g time because they are either long winded, anxious, have lots of complicated problems and you have to cut them off at some point to remain on time/be fair to other patients. One commonly taught technique that studies say help patients to not feel ignored is to say something like “I can see that you have additional concerns or this is really important to you. Unfortunately, this is not what you were scheduled for (or I can’t address this adequately today). We will get you set up for an appointment in x days to address that.
4) often we overbook patients for an acute issue with limited time but people try to squeeze in other issues. Again to be fair to other patients, they can’t see you for the other issues that day .
All this being said, doesn’t sound like that is what you are seeing.
Our area/organization has such a shortage of providers we are quite the opposite. Currently, we have an initiative organization wide to try to improve access. Part of that is trying to decrease # of visits per patient by 0.3/yr (or about 17% so we can get more “unique patients” in. Among other things like handing simple follow ups to RNs, etc, that includes trying to get people their annuals and problems taken care of at the same time and looking if they are due for any follow-up soon at every visit (even the colds/overbooks) and taking care of it at the same time, decreasing followup frequency if chronic conditions are stable/controlled (ie diabetes, HTN, adhd, etc,etc, etc. in looking at numbers of visits per patient per year with our group at large I see a HUGE difference in practice between honest hard working providers (also see some who are obvious churners). Among the honest hard working, in interview the difference ranges from how they were trained, how long they have been practicing and just confidence, support staff ability to do simple follow-ups, how they interpret state laws and quality of care and more. So a lot that goes into it.
All that being said, the way you wrote things, doesn’t sound good for the docs you are seeing
(Again- I can’t see intentionally WANTING more to do in a day. There is always TOO MUCH already).
1) some issues in some states LEGALLY require a separate visit. Ie. In our state the law was changed years ago to legally require any chronic pain prescription to be a separate visit. When it first came out every doctor followed it by the book. Ie. You come in with a cold that takes 5 minutes to see but you want a refill of your controlled substance, too bad come back another day. People were scared to loose their license since they were really cracking down. Fast forward, same law and most docs would still address both problems same day.
b) similarly state law has a lot of “shoulds” and “shalls” around any controlled substance. Shawls are required, shoulds are recommended. Some people still make people follow-up every month, every 3 months or every 6 months based on interpretation of the same law. All well meaning.
2) studies show after addressing 3 problems in 1 visit outcomes of care drop for patients, despite how satisfied the patient may feel and competent the doctor. There is a real diminishing returns and sometimes negative returns to adding more to a visit.
3) some patients really just take all g time because they are either long winded, anxious, have lots of complicated problems and you have to cut them off at some point to remain on time/be fair to other patients. One commonly taught technique that studies say help patients to not feel ignored is to say something like “I can see that you have additional concerns or this is really important to you. Unfortunately, this is not what you were scheduled for (or I can’t address this adequately today). We will get you set up for an appointment in x days to address that.
4) often we overbook patients for an acute issue with limited time but people try to squeeze in other issues. Again to be fair to other patients, they can’t see you for the other issues that day .
All this being said, doesn’t sound like that is what you are seeing.
Our area/organization has such a shortage of providers we are quite the opposite. Currently, we have an initiative organization wide to try to improve access. Part of that is trying to decrease # of visits per patient by 0.3/yr (or about 17% so we can get more “unique patients” in. Among other things like handing simple follow ups to RNs, etc, that includes trying to get people their annuals and problems taken care of at the same time and looking if they are due for any follow-up soon at every visit (even the colds/overbooks) and taking care of it at the same time, decreasing followup frequency if chronic conditions are stable/controlled (ie diabetes, HTN, adhd, etc,etc, etc. in looking at numbers of visits per patient per year with our group at large I see a HUGE difference in practice between honest hard working providers (also see some who are obvious churners). Among the honest hard working, in interview the difference ranges from how they were trained, how long they have been practicing and just confidence, support staff ability to do simple follow-ups, how they interpret state laws and quality of care and more. So a lot that goes into it.
All that being said, the way you wrote things, doesn’t sound good for the docs you are seeing
(Again- I can’t see intentionally WANTING more to do in a day. There is always TOO MUCH already).
Statistics: Posted by FIRWYW — Sat Jun 01, 2024 2:33 am — Replies 49 — Views 3287