Medical Scheduling: The Case of the Missing Phone Call

I went for my annual mammogram last week, leaving work early to do so and throwing my schedule into chaos.  When I arrived at the diagnostic center, the woman at the desk told me someone else would be out to talk to me.  Never a good sign.

The second lady took an apologetic tone.  “The doctor’s out today.  I’m sorry.  I thought I called everyone who was scheduled, but I must have missed you.”

“But I phoned this morning to confirm!” I replied with irritation.

After some negotiation and discussion with other people in the back room, they allowed me to have the procedure, with the understanding I’d have to come back again if more “views” were needed.  It was a crapshoot, but better than wasting the whole trip.

I think of how often residents have told me, “They didn’t have the paperwork they needed, so we had to reschedule” or, “The ambulette driver couldn’t find the hospital and by the time we got there, the doctor had left for the day,”  The residents were wrung out from the journey and from trying not to act irritated.  Their anxiety about their next appointment would include the worry about whether or not it would transpire successfully.

Personal reminders like this increase my compassion for those living with illness, and my appreciation for the nurses, secretaries, and transport aides who check and double check that everything is in place so that residents only have to worry about their medical conditions and not whether or not they’ll make it to their appointments.

7 thoughts on “Medical Scheduling: The Case of the Missing Phone Call”

  1. Your post highlights one of the many issues with the medical field in general. Overworked medical staff can't possibly keep up with everything, resulting in patients having more anxiety than necessary. It's the sad state of our healthcare system.

  2. Dr. El,
    I, too, have heard numerous complaints from residents. I believe the problems can be attributed to poor organization, lack of communication and, sad to say, but, at times incompetence. The person scheduling the appointment is not always the one preparing the necessary paperwork or the resident for the necessary test. As far as the ambulette is concerned, the company knows the destination in advance, with today's technology there is simply no excuse.

    On the physician's side of it, overbooking appointments are for the most part the rule. I have had to wait hours for an appointment that I've had to wait months for. On one occasion, I arrived almost 1/2 hour late and was told (despite the packed waiting room) that she would have to check to see if the doctor would see me.

    As far your experience is concerned, she "thought she called everyone?" what is that supposed to mean? And, what about the person that confirmed your appointment? Yes, everyone has to work harder for their money, including doctors. Waiting for appointments, not canceling appointments, make me feel that doctors continue to believe their time is more valuable, more important than their patients'.

    I would love to hear a doctor's thoughts on this.

  3. Overworked medical staff can't possibly keep up with everything, resulting in patients having more anxiety than necessary.

  4. I've been working in long term care for 27+ years now, I believe while healthcare cuts do impact on resident care, improved organizational systems would minimize many of these issues. From a customer service point of view, short staffing and overworked staff members are never an acceptable excuse.

  5. Thanks, everyone, for your comments. There's an increasing awareness in the field of the problems in transitions between hospital and home or nursing home, with high readmission rates, etc. This discussion makes it clear there are also systemic problems with smaller transitions, from nursing home to clinic or medical appointment. I'd venture to guess that a staff person assigned to facilitate these interactions would more than make up their salary in saved costs — the problem is that the costs saved are often for Medicare, Medicaid, and private insurance companies and not necessarily for the nursing home that would be paying the salary. Any thoughts on this?

  6. Our facility has someone that is assigned to make appointments and get the residents to and from them whether they take them or have someone else do so. Our primary problems with this process stem from the doctor's office, just as with your situation.

    This is a relatively new position in our facility. I don't know how much money it saves anyone, but it takes a great deal of stress off of Social Services who used to be in charge of these duties. Unfortunately, our circle of control ends at the doctor's office door.

  7. Very interesting, K. Tree, that your facility has created a position to facilitate the process of getting to and from medical appointments. What would be helpful for the field is if we took some pre- and post-position measurements to see if it does, in fact, save money and increase resident, staff, and family satisfaction with the process. I think you've just inspired a new post! Thank you!


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