Absolutely nothing ruins my work day more than getting deeper and deeper into my schedule and falling further and further behind. And, it seems, nothing angers patients more than waiting–except for maybe feeling rushed.
See the problem?
When I was fresh out of residency, I joined a group of old men (not being disparaging but they were literally OLD and MALE.) One was retiring and I was “chosen” to fill his shoes.
On my first day, his nurse explained that Dr. B would often “take breaks.” As in literally sit down between patients at his desk and read the paper. He just “needed some time. ” Nevermind that at the time of these breaks he had a waiting room full of people–some of whom would wait for 1-2 hours or more to see him. “Make ‘em wait” he advised. “Then, they think you are really somebody.”
Thank God, after 4 years, I clearly did not have “what it takes” and ultimately was let go. Apparently, running to stay on time and apologizing profusely to patients was not appreciated. But, that is for another story.
I want to tell you about this past Friday.
It was one of the worst work days I have had–EVER. I never once took a break to eat, drink, or pee, much less “read the paper.”
What in God’s name went wrong?
It was my first Friday in my glorious, new and highly organized for maximum efficiency office.
I arrived 30 minutes before my first patient.
By lunch time, I was exactly ONE HOUR behind. That means I walked in to my poor 11:45 patient at 12:45.
Here is what I think happened to me that day and happens to most doctors on many days.
It is not one “emergency” that ruins the morning for most of us. It is a series of small things…many small things. Like: a couple of patients that are five minutes late for their fifteen minute visit. They lament “but I have waited HOURS for her!” So, of course, they are seen–cutting into the next patient’s time.
Next, there is the “my office screwed up” patient. That is someone who arrives for an appointment that is not in the system. How do I turn someone away who promptly produces a reminder card penned by one of my receptionists?
How about the “walk in?” Not long ago, a patient of mine called from her cell phone as she was literally driving by because she could not read the street signs. Thank God she pulled in safely only for us to tell her she was most likely having a stroke. 911 was called, the patient was stabilized, her family was notified and….you guessed it, I was an hour behind.
How about the patient scheduled simply for “diarrhea” that really had a slew of symptoms, the least important of which was the loose bowels? He was scheduled for 15 minutes but needed 35.
On this particular day, even the patients that normally do not take more than seven minutes, thus helping me recover, were complex. A simple urinary tract infection was stalled for 20 minutes because of the inability to obtain a specimen.
From there, I enter into a quick “recheck blood pressure” appointment to find my patient sobbing uncontrollably. I pulled up a seat. Literally 30 minutes later, I felt comfortable enough that my patient was consoled enough for me to move on.
It’s not only patients that cry. On Friday, I saw a LONG time patient of mine who travels quite the distance to see me. He mentioned a blog post I wrote about my kids fighting and got teary as he recounted his own similar story. I scurried out of that room only to spend 10 minutes composing myself and removing a trail of mascara from my face.
Invariably, there is the “Doctor So-and So is on line 6. He asked me to interrupt you.” I am sorry my doctor friends, but let’s be real. When you insist on pulling another doc out of a room, how often is it for a “life or death” situation? I dare say, that most times, it is just easier to do that than to play phone tag. Guess who pays for that interruption? Yep. My patient who had an appointment time an hour ago.
This day was further complicated by a photographer who was there to shoot promotional pics for our contractor. He was to be there for thirty minutes. He was there for three hours. Meanwhile, several of my exam rooms were off limits while he was shooting and my staff was shooed out of the way for “one more shot.” I even got corralled into posing for a photo in my waiting room. The same waiting room that was FULL of patients waiting to see me. Some had been there an hour. I. Wanted. To. Die.
I emailed one of those poor patients this weekend to apologize and she was gracious as can be. She even thanked me for being her doctor. And yet, I feel about as big as a flea for making her and so many others wait.
I don’t really know what my point is except perhaps to apologize and explain. Most doctors really do HATE to run behind. But, it is a constant juggle between giving every patient prompt, thorough attention and all the “other” time sucks.
Friday was my Hadley’s 6th birthday. I was supposed to get home early enough to make a gourmet dinner. Instead, I arrived two hours late with pizza.
As she ran to hug me, I, for the hundredth time that day, found myself saying “I am so sorry to keep you waiting…..” Only, this poor victim threw her arms around my neck and planted a gigantic wet kiss right on my lips.
Horrible Friday? What horrible Friday?