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EYE-BALL Opinion’s “YUCK” Files – Medical Appointment (Doctors) Wait Times –

December 12, 2012
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Title:
– “YUCK FILES” –
– Medical Appointment (Doctors) Wait Times –
| Author: EYE-BALL Opinion “YUCK” Files | 12 Dec 2012 |
Ihave a few pet hates – none more than the wasted time spent in a Doctor’s surgery waiting for my alloted ‘time-stamped’ appointment.   I bet there is no one out there who does not agree with this waste of time.

In my life time I have seen 50 odd doctors including, GP’s, specialists, radiologists, dietitians, optometrists, podiatry, and the like.

I have moved around a lot which is the reason for the high doctor count – there are other reasons as well and we’ll talk about that later.  The common thread in al these different medical appointments was the wait-time delay in seeing the doctor relative to the appointment time made.

I would always be early – a creature of habit, some 10-15 minutes and done so as to not keep the Doctor or staff waiting.  I dare say everybody does this as a measure of respect for Doctors and the regard we all have for a Doctor’s time.   But I ask – what of the value of the waiting patient and their time?

There are countless articles written about lost productivity caused by ‘strikes’, ‘sick days’, and other personal type days.   Nobody counts the cost attached to the millions of patients spending their wasted hours sitting waiting for Doctors to see them.   To give a rough calculation of the stats –

  • assume 150 patients per Doctor – that estimates some 150,000 GP Doctors practising in Australia,
  • assume a working day of 9 hours – i.e. 8:30am – 5:30pm with an hour off for lunch and an appointment schedule of say 5 appointments an hour – that equates to some [150,000 * 8hrs * 5 appointments * days in a year, [Mon-Sat] * 52 weeks a year = 1,872,000,000 doctors appointments a year [1.872 billion] – that is just GP’s mind you.   The other point being that with a population of 22,000,000, that means we all see a doctor 85 times a year – this is obviously a little askew … but remember elderly people will see a doctor 2-3 times a week when they develop health issues.
  • now assume that each one of those appointments had a wasted wait time of 30 minutes = 1,872,000,000/2 = hours wasted = 39,000,000 days of lost production.
  • Assume a working day means $200 in gross revenue, the total cost of wait times in a Doctors surgery converts to some $7,800,000,000 i.e. $7.8 billion a year.
  • Now do the same sums for all the other specialists, radiologists, dietitians, optometrists, podiatry, and all the other medical professionals … and the picture looms large as to what the cost of Doctor wait times mean to the economy.

[The above numbers are very rough – extremely rough with an error factor of roughly 20-25% either way]

The pendulum has swung too far – Doctors bulk bill for a reason – it is mass production – 4-6 patients an hour and when a consultation becomes lengthy because it requires good Doctoring, i.e. blood pressure, temperature, weight, other measurements, prescription printing, and then the doctor patient discussion – how can they fit all that into say a 12 minute appointment.

No – Doctors are playing the game – out with patient interface and small talk. The concern of a Doctors time overrun is all the responsibility of the next patients waiting – they have to make the sacrifice, they have to do the deal with employers for time off, to have relatives wait with you, babysitters engaged, all the spin-off wasted time multiply’s the above number.

A Personal Experience:

Yesterday mid-morning I discovered what might be a serious health issue – blood in the urine.  When I spoke to the surgery nurse she though it urgent enough  to make a 12:30pm appointment the same day.  I arrived at 12:20pm and took a seat.

The Doctor saw 5 more patients after I arrived before my queue appointment became next in line – a full hour after I had arrived.  The Doctor confirmed the urine blood and sent me for urgent X-rays – another wait time experience because of the walk up appointment.

The Doctor told me during the consult he would ring me in the afternoon to confirm the X-rays results and his suspicions – i.e. kidney stones.  I waited for the call for the rest of the afternoon – it never came and I decided to ring the surgery at 6:10pm.  The Doctor had left and the receptionist told me there appeared to be no results received from the X-ray radiology place.

The Doctor had told me to see this particular radiologists facility because he had an electronic hookup to give him fast results on-line.  the receptionist searched to see if any results had been received – have no idea how she did that – look for a fax, check the Doctor’s physical in-box – she stated she found nothing.

Now I had to wait until the morrow before I would get the results.

About 10:00pm that night I started to get some serious pain in my left abdominal side – I could not sleep so around 1:00am I took some serious pain killers … my urine showed I was still peeing blood.

Other causes were discussed during the consult – the worst being cancer but was at the low end of the risk profile.  I was the right age so it had to be considered.  The Doctor said the X-rays would confirm if the problem was kidney stones, and if not,  then more decisions would then be made for more tests.

To me – the phone call promised in the afternoon was important – am I to assume it is non-urgent, I would rather have the call to reassure me it is was non-urgent.

I finally got some sleep and awoke to the phone ringing – it was 9:30am and it was the Doctor’s surgery telling me that the Doctor wanted me to make another appointment.  I asked if he was going to ring me – the receptionist had no idea … and she told me she could not give the results over the phone.   I asked a few more questions about how serious it was but she gave me no indication other than the request from the Doctor to set up another appointment.

One might think the Doctor might have some understanding about patient concerns and act to allay any anxiety given the range of possibilities canvassed the day before – cancer being one.

I made the earliest appointment available – 9:50am the next day – so another day and night with pain and anxiety over what the problem might be.  Then there would be the expected wait time at the surgery to add to the already pissed off anxiety levels.

Personally – I think it is kidney stones and am confident that it ain’t the other …

Summary:

Doctors have a job to do and these days and primarily see their patients for what they represent – income.  Nothing wrong with that so long as they don’t abuse the trust the patient has to feel towards their doctor.  Consultation times alloted have come down – now up to 4-6 and hour depending on the mercenary attitude of the Doctor – the was 2-3 some 30 odd years ago.

The why is unknown – is it because there are fewer doctors to see to the extra needs of population growth, or is it a rorting of the medicare system and the bulk-bill ease of payment for Doctors?

Doctors are not concerned with the wasted time patients endure waiting their turn.   Can you imagine what would happen if Lawyers made clients wait 40 minutes or so for an appointment?  What about and service industry apart from medical – do you think they would still be in business if they forced clients/patients to wait 30-40 minutes.

No – this is a pet-hate and what I see as a blight of the Doctoring profession – I despise wasted time, especially if I am the one doing the waiting.

When one works out the gross income for a Doctor for a day – after GST – the Dr is direct credited with a min of $70 per consult – i.e. @ 5 patients an hour = $350 per hour = $2,800 per day = $14,000 gross a week (5 day week) = $672,000 per year (48 week year).

Some appointments may only take 3-5 minutes – the bulk-bill cost is the same … and this is where Doctors make up time for the overbookings elsewhere …

I intend writing to my local MP and the Minister [Plibersek] about a review on standardising consultation times – say 20 minutes, i.e. 3 an hour.

This would on the same above calculations bring a Doctors income down to $403,000 per annum.   Now cost that Doctor’s income reduction i.e. = 150,000 * $269,000 = $40.32 billion.

On the strength of this equation result alone – Government will look and judge the tax revenue collect on some $40+ billion in Doctors income, and equate that with a reduction in wasted wait-times where no real tax income will be earned, and it’s a no-brainer as to who will win out.

There would then be the community impost of needing more doctors to take up the additional appointments not available under current appointment times – it all has a flow on effect …

Just another case where the almighty $dollar rules and the practise of being a Doctor is further dehumanised…

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  1. December 15, 2012 at 6:51 pm

    The crisis was Kidney Stones … painful but over now.

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