I follow an appointment system in my clinic.
I believe that my patient’s time is as precious as mine, and try to ensure that
they do not have to spend too much time waiting in my clinic. I also feel that
as my patients are emotionally distressed, waiting could worsen their
condition. I try to ensure that no patient waits more than 15 minutes in my
clinic. The maximum time a patient has waited in my clinic is about 1 hour.
About 50% of patients, who are scheduled to
see me for the first time (New patients) don’t turn up. And they do so without
informing me, which means I wait for them and after half an hour of ‘no show’,
conclude that they will not come. About 40% patients coming for follow up are
delayed by at least 15-20 minutes. Around 10% patients schedule appointments
repeatedly but fail to make it with/ without informing. A small percentage,
walk in without appointment and insist on being seen. Another (surprisingly common) patient is the
one who arrives in clinic after I have reached home and then phones me
requesting me to come back to clinic or that the patient will come to my home
for consultation. Their logic is: now I have the time- see me. I never
entertain such requests.
To ensure proper time management, I never
schedule anything else near my clinic timings. I ensure that I leave home early
and always arrive on time. I prepare in advance for my therapy appointments and
long review appointments. I schedule the patients carefully, so there a few who
require more time and few who require shorter consultations. I always schedule
regular and punctual patients in the first slot. No matter what time the
patient arrives, I always end my consultation at the same time. (Yes, I do
charge full consultation fee, why should I not do so?) If there is not enough
time left, I reschedule the appointment. For habitual latecomers, I do not give
appointments, but tell them to walk in a range of timings and wait. Due to the
large numbers of new patients coming late (cant estimate commute time?) or not
coming at all, I never schedule appointments but ask them to attend the walk-in
clinic on weekends.
I often feel that the appointment system is
counterproductive for me. The no-show and latecomers throw my schedule out of
gear and it is quite unfair on the patients who arrive on time. Some patients who arrive on time, don’t
understand that the earlier patients had come late and so their appointment is
getting delayed. Another set of patients who come late just want to be seen
right away, without realising that the next patient who is likely to arrive on
time, will get delayed because of them. I feel I should detain the first type
of patient and make him/ her explain to the second type- but both usually fight
loudly with me. Patients who come late
are seldom remorseful and never care to mend their ways. This way everybody is
a loser. Meanwhile, I am paying for the
overheads, I don’t get to express my disappointment and my family always has to
see me home later than expected.
I sometimes feel, that I should abandon the
appointment system as it affects me badly. I can tell all patients to come and
be prepared to wait indefinitely and see them on a first-come-first –seen
basis. This is followed by most doctors. It clearly places the doctor at an
advantage as the doctor does not waste time waiting for the patient. But I feel
it is not fair, to make the patients wait like that. I don’t know how much
longer I can act with regard this principle of propriety and stick to the
appointment system.
But of late, I do turn away patients who
habitually come late, or are delayed by more than 30 minutes. I charge full
fees for the second missed appointment. This way I feel I can control my
schedule as well as have some sense of justice for my efforts.
