A Tale of Two Offices

There are a lot of things – little, nitpicky things – that affect how difficult the patient experience is, such as expense, physical access, health illiteracy, just lots and lots of things. Then, there are other people (aside from the doctor). Office staffs can make or break a patient’s experience at doctors’ offices.

Office Staff 1

This week, I had two appointments at two separate facilities within the same hospital system. I scheduled them carefully. (The staff at the second facility is not the comparison I am making. I mention it to make a point about respect.)

The first was for an annual exam, which historically never takes more than 30-40 minutes, even with the occasional EKG. The office, which I have been going to for over a decade, is usually a smooth, coordinated experience. My previous experience said 75 minutes would be plenty to also get a flu shot and make the 15-minute drive to the other office.

After the 40-minute appointment, the doctor said the nurse would be “right in”. This usually meant a handful of minutes. That day, they were a bit shorthanded, so I understood if it was going to take a little longer. After 10 minutes, and feeling the clock counting down, I poked my head out, caught one of the nurses, and explained I had to leave in five minutes to make an appointment at a sister office. She said someone would be “right in”. After another 10 minutes, I could stay no longer. I popped my head out and informed the nurses, all four of whom were just sitting there chatting – not work related, it’s not hard to tell – I informed them I had to go. The nurse I had spoken to scrambled to apologize, to which I did not respond as I rushed out to just miss arriving at the other office on time.

This cost me anxiety, frustration, the time I will need to make and go to an alternate appointment for both vaccine and next year’s annual (didn’t have time to stop after waiting so long), and a longer exposure to the flu than I wanted. Even if they didn’t care about all that, it crossed my mind that they might have shown a little respect to the other office in their own hospital system and helped me not set their daily schedule back. Considering how things played out, I am also fairly sure it wouldn’t have mattered if there had been more time between appointments.

Office Staff 2

This is also an office I have been going to for over a decade different state, different hospital system. And it wasn’t even an appointment, but a time-sensitive prescription renewal. I had realized when I opened the last vial of insulin of the last delivery that I was going to be about three weeks short. I had asked my doctor to increase the dosage at the last appointment, but between a slight underestimation of my average intake, a pump set-up that required about 10-20 units to be needlessly spilled every other day, and my two-trips-to-a-600-blood-sugar-in-12-hours last month, I knew I was going to need more before I spoke with her again.

With about 10 days to go, I emailed the office, anticipating that I would need to follow up by phone since my email was a bit hit or miss on delivery to my doctor’s assistant. Plenty of messages I sent just weren’t delivered.

Turns out I didn’t need to follow up. They got it out the next day. However, the computer system, which is not scrubbed after insurance information is updated, spat out two wrong phone numbers for the mail order pharmacy. This was cleared up the same day, and the pharmacy called me for delivery confirmation the next day. I will receive the delivery today, which will carry me through the next 84 days, perhaps even with a little cushion this time.

I know this is not a direct apples-to-apples comparison, but it does illustrate the differences in both attitude and approach. Both were offices I had worked with for a long time. They knew me. One heard me and understood the logistics and anxiety that lived with me until I had what I needed, and responded appropriately. One did not.

I also know that it’s not fair to judge based on one shorthanded day. But this is not an isolated incident. Things like this happen to patients thousands and thousands of times every day with issues great and small. They accumulate and make our lives just that much harder. It takes less than three minutes to fill a syringe with flu vaccine and deliver the injection. Would it have been that difficult to save the office gossip until after I got my shot?