Monday, 11 February 2008

How Hard Is It To Be On Time?!

There is only one excuse for being late - being dead (ok, so maybe are a few more than that..)

How hard is it to be on time. A ridiculous proportion of my patients today have been late, 1 didn't even bother to show up at all?! I understand that GPs are often running late, but that is often unavoidable due to the 10 minute appointment system and it is certainly no excuse for patients being late. I have half hour appointments which are almost always concluded within half an hour so I'm never running late - that is until Miss X turns up at 10:15 and knocks me all out of kilter.

If I was a GP, patients being late would drive me bananas! If you've got a genunie reason, i.e. unforseen circumstances then fair enough but if you're just being lazy and or late for the sake of it then you may as well not bother coming at all. Although, if you're not going to bother coming, it'd be very kind of you to at least ring and let the surgery know. GPs should do what dentists do and charge for DNAs (Did Not Attend), that might make patients think twice about not bothering with their appointments.

I'm a lateness nazi as it is and I can't stand being late (note: this often leads me to be ridiculously early for things - much to missbliss's displeasure) but if I ever become a GP unless you've got a damn good reason for being late - you won't get seen. Simple as.


Xavier Emmanuelle said...

That drives me NUTS. I'm like you -- I'm 20 minutes early for everything, but I like it that way!! You should charge for DNAs, that's what they do here in many clinics! If you don't show up for a regular doctor's appointment it's $20, and if you're no show for a physical then it's $40. Seems pretty fair to me! That way the doctor's time isn't wasted.

Good luck with getting your first choice at your deanery!!

Anonymous said...

Yeah I can't stand being late. They give us 5 min breaks between lectures where students often wander off for 10 mins only to come back, sit down and chat.

It really pissed our lecturer off today, and rightly so.

I think if your patients are late, then you have every right to bring it up and challenge them in a rational way.

dr_dyb said...

My childhood GP practice did have DNA charges for non-emergency appointments (i.e. ones arranged more than 48hrs beforehand). In exchange they would happily ring you 2 days before your appointment to remind you that you had it. The money raised during the year went to the local childrens ward at the DGH.

There was no charged for DNA on emergency appointments though.

Future Doc said...

I'm exactly the same. It drives me nuts if someone is late. A mate of mine always is, so whenever we go anywhere. It's always twenty minutes earlier for him. He'll catch on eventually but hopefully not too soon.

If I don't pop by before, good luck with Wednesday next week. Hope you get your place in the Severn Deanery (that's me)! I'll also drop you a line about Manchester when I've got the time!

Anna said...

I was running late for a doctor's appt once, as I'd been in teaching at the children's hospital and missed the train I should have got. So I rung the receptionist, explained, and she said if I was less than 5 minutes late I'd be seen. I ran from the train station to the GP practice and arrived exactly 5 minutes late. I was the last appt of the day (at 4pm mind, not some godforsaken hour) and the GP refused to see me. I nearly cried. I was stressed by running late, I really needed to see the doctor, and I'd rung to let them know beforehand. I think the GP was mean not to see me, I really do. Especially as when I made an appt for the next day, the same GP was running 30 minutes late by 3pm... Sod's law, isn't it, the GP only running to time the one time I wasn't.

Ms-Ellisa said...

I'm on the same page too.

Let alone the fact that booking an appointment means you actually NEED it, so being there and being on time should not be a matter of discussion.

It's possible that the same people would NEVER - God forbid- be late for a movie...

Elaine said...

I think I might be even worse than you; I get to the check-in desk at the airport in time to check in for the flight BEFORE mine.

the little medic said...

Xavier Emmanuelle - Yeah, they should definitely charge for missed appointments and thanks for good luck message

Harry - That drives me crazy too. There are various people at uni who are always late but one girl in particular drives me insane. She is late for everything, not matter what time it is she is usually 15 minutes late at least. I wish sometimes, lecturers would lock the door a couple of minutes after the session has started.

future doc - HAHA, thats a good idea.

anna - That does seem rather mean, considering you phoned to say you were going to be 5 minutes late. Its not like you just turned up.

ms-ellisa - good point!

the little medic said...

elaine - that sounds very familiar. During our travels, we were frequently several hours early for our planes.

Whenever I'm getting a train, i'm usually there in time to get the train before the one I'm supposed to get, if not two trains before mine.

dr_dyb said...

TLM, is that not called OCD?????

Whilst I know why being timely is good, being too early can be seen as a sign of being over-eager or not having enough to do, as an FY you will have to get used to being late to see patients, giving unrealistic timescales and arriving at work on time, because you know you will be in late, so if you go in early you might as well just get a bed there.

the little medic said...

dr dyb - yes it is a little OCDish, I do have the occasional OCD tendency.

I know i'll have to get used to be being late, and I already am. But when I can do anything about it, i'll always be early

PhD scientist said...

OCD tendencies may serve you well in some specialties, LM (esp surgical ones?)

Re DNAs, my understanding was always that the rate of DNAs, both in GP-land AND in hospital outpatient clinics, was quite significant -see e.g. here, and some GPs say 10-15%. Missed appts are always cited as one of the "hidden costs" of the NHS, with the implication often drawn that you are far less likely to DNA in "patient pays" systems as you will typically be charged whether you turn up or not. Hence the demands in some quarter for penalty payments for non-attenders.

Another approach some hospitals supposedly use is to overbook ourpatient clinics on the assumption that some people won't show.

BTW, in the non-acute but hosp based specialty Mrs PhD Sci works in, roughly 10% of the patients do not attend their booked appts. On nasty wet days the rate of non-attendance typically goes up. She looks forward to a non-attender or two as it gives her more time to sort the paperwork and dictate letters. The most she has ever had not turn up (not long before Christmas one yr, as I recall) was 5 of the 8 booked patients - I sh*t you not.