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Tuesday, April 7, 2009

Why your doctor runs late...

I don't think I ever really appreciated this while working in the ER urgent care center. The idea of waiting in an emergency room is sort of expected. Especially in a pediatric one. You show up to the ER on Saturday evening with pinkeye and you are gonna wait (it just goes without saying).

Now that I am a primary care physician, I understand why doctors always seem to run late. I will stipulate this with the disclaimer that I am REALLY fast when it comes to charting and getting other paperwork stuff done. My patients probably don't have to wait as long as average. If you come in with ear pain, I am not going to ask you what you second cousin once removed had at last year's Easter dinner to make him sick. If you have a rash that looks like eczema, you will have a prescription for a steroid cream within 5 minutes. That said, I have my list of why your PCP runs late.

(Let the record show that I also get ANNOYED when my doctor runs over an hour late...it has happened to the best of us.)

-The printer/computer system/appliance-from-1970 was down. I cannot tell you how many times I have struggled with a Macintosh Classic computer for 20 minutes (cursing silently all the while) for the scheduling system or prescriptions to work. Makes me want to use an abacus.

-Endless phone calls from patients about lost prescriptions, fevers that they magically were able to take without a thermometer, ER calls and radiology/lab calls.

-Paperwork: The bane of my existence. It takes me more time to chart an ear infection and write a prescription than it does for me to actually see one. For real. Diagnosing an ear infection = 1 minute. Paperwork to chart and bill for an ear infection = 5-7 minutes. The satisfaction of it all = priceless.

-Occupied support staff: the problem with pediatric office visits is that half of the kids need shots. It takes about 5-10 minutes to draw up the medication and document the appropriate paperwork. If you normally have 2 nurses and are down to one to help out with stuff, well...you get the picture.

-The doorknob phenomenon: This is the thing that every doctor dreads. You have asked the questions, offered a diagnosis and you are leaving and then you hear, "Oh, I have another question for you..." or "...can you take a look at his little brother/sister/cousin/the rash on my butt?" Seriously, people.

-Actually sick patients: It has happened to me at least once or twice a week where a patient who really should have gone to the hospital in the first place comes in looking like poo. Thirty minutes later, after calling the paramedics, calling the ER and reassuring crying/scared parents, your schedule is all shot to hell.

-The double booking: I am expected to see a patient every 15-20 minutes and most of my slots are double booked to make up for the inevitable no-shows and late patients and the dreaded siblings visits.

There are also the not so good reasons we are late, such as getting stuck in traffic, having a slow-a$$ waitress at lunch and Facebook (just kidding, I only do that during lunch). So next time your doctor seems to be running late, cut them some slack. You never know where they may have to examine you (snapping my latex glove and grinning maniacally).

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