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March 12, 2008

Healthcare Consumer Question of the Day

Carroll Andrew Morse

Here is a question for the sage and practical-minded readers of Anchor Rising:

Recently, a friend of mine had an appointment with a doctor who has a policy requiring a $40 payment for appointments cancelled on the same day. Said friend arrived on time. Said doctor did not, not seeing the patient until 45 minutes after the scheduled appointment time.

The question is: in a completely fair universe, shouldn't the patient get $40 knocked off of the bill in circumstances like these?

Comments

Yes, indeed. Flavored liquid suitable for the female Branta Canadensis is certainly suitable for the male.

Posted by: Monique at March 12, 2008 9:59 PM

There's a funny Seinfeld vignette about this, with George as the patient. (Or, I should say, it is as funny as Seinfeld ever is).

I agree with Andrew and Monique, but I'm surprised at their views on this. I thought the proper AR answer is that the consumer is always free to choose a health provider with a different policy.

Perhaps I misjudged.

Posted by: chalkdust at March 12, 2008 10:10 PM

What you're missing, Chalkdust, is that there are multiple strategies toward moving the universe closer to complete fairness (which, of course, it could never reach).

In this instance, the conservative would promote greater choice for the healthcare consumer and greater variety in the settings in which one can receive various types of care (as with those locally maligned CVS-based clinics). If doctors had to compete more for patients' business, they'd learn how to keep close to their schedule (or else they'd stratify such that other benefits to seeing a particular doc would outweigh the inconvenience).

Posted by: Justin Katz at March 12, 2008 10:27 PM

On that note Justin, if there's one thing that the glut of lawyers in RI caused me to do in private practice, it was to attempt to provide good client service, including keeping appointments on time. There's a lot of competition out there!

Posted by: Jon at March 12, 2008 10:44 PM

There are two sides to this issue, though.

Sometimes during the course of an appointment issues will come up that require the physician to spend a little more time with a particular patient. How would you feel if, during the course of, say, an eye appointment, your Dr. said, "Sorry, we'll only be looking at the left eye today because I'm running a little behind and I don't want to keep other folks waiting any longer."

I think most of us who have attained legal age have enough experience to know that it's not at all unusual for doctors to run behind, and we know which of our own doctors generally suffer from this malady.

We had this experience with a very talented pediatric orthopedist. We would wait a while to get in, but when we saw him you could see why; he was totally focussed on our son (not the clock), developed a real bond with him, and really gained our confidence which, given the very serious surgery he was doing, was quite beneficial. We would not have traded that relationship for a shorter stay in the waiting room.

As a professional, like Jon, I try to stay on schedule in my office. I know that if I have a mid-day appointment with my doctor, I might be a little delayed in getting back to my own office and I schedule my office appointments accordingly. I also bring some work with me so that I can get something done in the waiting room.

Of course, if I'm doing work, I can bill my clients for the time I'm sitting around in the doctor's waiting room. Ain't this a great country?!

Posted by: brassband at March 13, 2008 6:09 AM

Given that I had a dentist appointment canceled yesterday on two hours' notice (and because of the hour's drive involved, I'd already made arrangements to leave work early), this sounds fair to me.

Posted by: rhody at March 13, 2008 11:04 AM

I am the friend that Andrew blogged about.

What really irks me is that an appointment was scheduled at the request of this particular physician. As I have to make up any time that I am away from work, I scheduled this appoint as late in the day as possible (4:00 p.m.). Not only did I wait in an "empty" waiting room for half an hour, I also was brought into an examining room in which I then had to endure another 15 minutes for the physician to appear, review my chart, and then proceeded to ask me riduculous questions including "why did you make this appointment?" Having advised her in a very restrained voice that it was "at her suggestion" that I make this appointment. She kindly responded "oh".

Oh did I mention, I was her last patient for that day? There was no "overbooking" and in checking with her staff, the physician books every half-hour!!!!


Posted by: gin at March 13, 2008 8:28 PM