Monday, April 26, 2010

Melissa Young, MD: I need 36 hours in a day and two pairs of hands

I shouldn’t complain. Venturing out on my own has not been the financial disaster my former senior partner predicted despite the often miserable reimbursements. I have a steady stream of patients and the schedule is reasonably busy. After six months of practice, the current wait for a new patient is six weeks. For the coveted late afternoon slots, it’s about two months.

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So, yes, life is good. For me, anyway. For the most part. But for the patients who call and want to be seen ASAP, and for my poor office staff who get yelled at on a daily basis by these same patients, not so much. Not a day goes by that a patient doesn’t pour out her sob story, or name-drop, or just get plain nasty with my staff. Like doing any of those things will miraculously make a new appointment slot appear. Some of them hang up threatening (?) to find another doctor, only call back two hours later because at ever other practice the wait is six months.

I understand their frustration — their fear even. If your primary care doc says “You need to get in to see her right away,” you want an appointment right away. And yet, what am I to do? I can only see one patient at a time. I refuse to double book. I refuse to make patients wait for two hours because I am behind schedule. I get patients all the time who say they left another practice because they had to wait for two, three, or even 10 — oh, yes, 10! — hours to be seen. So while they may wait six weeks to come in and see me, once they are here, they are seen promptly and have my undivided attention. I’m not looking at the clock thinking, “Oh my God, I have eight more patients to see in the next 45 minutes”.

So what do I do? Do I accept the way things are, and say “sorry, such is life”? I will gladly take suggestions … or a time machine.


  1. What a great topic- what do we do? As a primary care doc, I worry about my liability if I tell a patient to see a specialist and they can't be seen for 6 weeks. Even worse is the patient with a managed care plan with no network specialists in the area- I have to pick a name off a list.

    Most of referrals I send are patients that need a specialist, when my expertise has reached its limit. I know some docs refer all their diabetics and thyroid patients to endocrinologists, which I see as a waste of the specialist's time and waste of their training. I'd rather you be sitting around waiting for me to call with the patient with Addison's or a pheo.

  2. I couldn't agree more. At my old practice, because of our patient volume, we did not accept new patients who weren't sent by their physician, and generally, their doc had ot speak to us directly. Since my practice is new, I have been letting patients self-refer. Which means I get patients who "just don't feel good" or who think "it must be their hormones" or are tired and can't lose weight (welcome to the club). I may have to resort to my old ways soon, so that I cna see the people who really need me - the pituitary tumors, pregnant Graves' patients, and type 1s on a pump.