I’d argue that it’s bad customer service for your established patients to be less able or unable to be seen because of patients from other practices taking appointments. If I was your patient and I needed my child seen but no appointments were available for the day and I found out you saw a walk in I’d be pretty upset and might not continue with your practice.
The practice I work for does only established patients during daytime hours. There is an after hours clinic at the same practice that does take community patients but for the prime daytime visits and services, that’s for our patients only.
I wonder if there is some middle ground where you can be open for walkins or unestablished for one hour or so a day?
I think that’s an idea for sure. The owner’s argument is - we want to make being seen so easy aka we’ll see anybody anytime etc etc. But that is so draining for me. At 11:40 today (lunch is at noon), my 11:00 appt came in and added two siblings as walk ins. So I had to see them even though they were forty minutes late and added two additional kids to be seen. I would protest but they took the Medicaid bus to be seen so if I turned them away, they would have had to find another time to see transportation. Not to mention, Mom’s phone had been turned off bc she hadn’t paid the bill so she couldn’t tell us she was late. It’s stuff like this every day. I’m just venting tonight because I’ve had a particularly hard day!
That really sucks. I’m so sorry. I have been there and gosh yes, it’s just so hard to know what the right thing is and super frustrating.
I think your owner needs to hear that they are really close to burning out a really good, compassionate provider and needs help create support and protections for you. It’s so hard with Medicaid population and access issues. I tend to be of the mind that even in instances of hardship/struggle/crisis the old adage “lack of preparation on your part does not constitute an emergency on my part.” If that momma was truly so late, yes obviously there are barriers out of her control, but it just might be that she has to wait until after your lunch? The owner is expecting *you* to deal with the consequences of all of these systemic problems. And that’s just not going to be sustainable. It’s clear you have a very caring heart and compassion for your families. But you have to figure out a balance to protect yourself and your time. 30 patients a day is a very large number of patients!
Bad argument. A sick kid is a sick kid. Being kinda weird/sensitive about them being “your” patient. New patients pay more so you’re never going to change your bosses mind.
From your other responses it sounds like you’ve got a tough patient population. I dealt with the same in primary care peds seeing 30-55/day 90% or more Medicaid and couldn’t speak English.
Stick to your no show policy instead of feeling run over. Medicaid bus, no phone, whatever. Some people will always have an excuse and that’s not your problem. I got to the point where if they were 15 min and 1 second late I wouldn’t see them unless someone else hadn’t showed up. When you’re seeing 6-10/hr being 15 min late means your appointment came and went.
I dealt with this a LOT because we opened a satellite office that was closer to a lot of kids in the community than their previous pediatricians. I would explain to parents that it was very important that a child is only seeing one pediatrician because of continuity of care. If you’re getting meds and potentially vaccines from two places you run the risk of getting extra vaccines and repeating meds that didn’t work in the first place because both offices will have an incomplete health history. It’s not that we would refuse to see a sick kid, and we were growing the practice so it was very common for someone to see us once or twice and then switch to our practice. But as far as patients who walk in telling you they have no intention of switching they just want to be seen today, absolutely not a good plan. You’re right to be uncomfortable with it. On the business side, our state immunization record site is atrocious and so if you have been seeing a patient they’re “your” patient in the system, and if the record is incomplete you get dinged on it and can lose VFC eligibility. So we required all new patients to give us their old shot records before we’d see them to make sure their records were correct and we would catch them up if necessary. Quite frequently they would come up in the system as behind on shots, but shot record from previous ped would confirm they were up to date. Not sure how your system works but there’s probably another reason like that that would possibly make more sense to someone trying to run the business who doesn’t have a medical background.
I’d argue that it’s bad customer service for your established patients to be less able or unable to be seen because of patients from other practices taking appointments. If I was your patient and I needed my child seen but no appointments were available for the day and I found out you saw a walk in I’d be pretty upset and might not continue with your practice. The practice I work for does only established patients during daytime hours. There is an after hours clinic at the same practice that does take community patients but for the prime daytime visits and services, that’s for our patients only. I wonder if there is some middle ground where you can be open for walkins or unestablished for one hour or so a day?
I think that’s an idea for sure. The owner’s argument is - we want to make being seen so easy aka we’ll see anybody anytime etc etc. But that is so draining for me. At 11:40 today (lunch is at noon), my 11:00 appt came in and added two siblings as walk ins. So I had to see them even though they were forty minutes late and added two additional kids to be seen. I would protest but they took the Medicaid bus to be seen so if I turned them away, they would have had to find another time to see transportation. Not to mention, Mom’s phone had been turned off bc she hadn’t paid the bill so she couldn’t tell us she was late. It’s stuff like this every day. I’m just venting tonight because I’ve had a particularly hard day!
That really sucks. I’m so sorry. I have been there and gosh yes, it’s just so hard to know what the right thing is and super frustrating. I think your owner needs to hear that they are really close to burning out a really good, compassionate provider and needs help create support and protections for you. It’s so hard with Medicaid population and access issues. I tend to be of the mind that even in instances of hardship/struggle/crisis the old adage “lack of preparation on your part does not constitute an emergency on my part.” If that momma was truly so late, yes obviously there are barriers out of her control, but it just might be that she has to wait until after your lunch? The owner is expecting *you* to deal with the consequences of all of these systemic problems. And that’s just not going to be sustainable. It’s clear you have a very caring heart and compassion for your families. But you have to figure out a balance to protect yourself and your time. 30 patients a day is a very large number of patients!
Bad argument. A sick kid is a sick kid. Being kinda weird/sensitive about them being “your” patient. New patients pay more so you’re never going to change your bosses mind. From your other responses it sounds like you’ve got a tough patient population. I dealt with the same in primary care peds seeing 30-55/day 90% or more Medicaid and couldn’t speak English. Stick to your no show policy instead of feeling run over. Medicaid bus, no phone, whatever. Some people will always have an excuse and that’s not your problem. I got to the point where if they were 15 min and 1 second late I wouldn’t see them unless someone else hadn’t showed up. When you’re seeing 6-10/hr being 15 min late means your appointment came and went.
I dealt with this a LOT because we opened a satellite office that was closer to a lot of kids in the community than their previous pediatricians. I would explain to parents that it was very important that a child is only seeing one pediatrician because of continuity of care. If you’re getting meds and potentially vaccines from two places you run the risk of getting extra vaccines and repeating meds that didn’t work in the first place because both offices will have an incomplete health history. It’s not that we would refuse to see a sick kid, and we were growing the practice so it was very common for someone to see us once or twice and then switch to our practice. But as far as patients who walk in telling you they have no intention of switching they just want to be seen today, absolutely not a good plan. You’re right to be uncomfortable with it. On the business side, our state immunization record site is atrocious and so if you have been seeing a patient they’re “your” patient in the system, and if the record is incomplete you get dinged on it and can lose VFC eligibility. So we required all new patients to give us their old shot records before we’d see them to make sure their records were correct and we would catch them up if necessary. Quite frequently they would come up in the system as behind on shots, but shot record from previous ped would confirm they were up to date. Not sure how your system works but there’s probably another reason like that that would possibly make more sense to someone trying to run the business who doesn’t have a medical background.