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Late patients

How do you all handle patients who arrive late for scheduled check-ups (not
sick visits)? If they are more than xx minutes late, do you reschedule? What
is the usual parent reaction if you reschedule?

We generally reschedule if the patient arrives more than 15 minutes late
unless it is a newborn. Some parents understand and handle it gracefully
while others make quite a scene.

Late patients

On Wed, 19 Mar 1997 19:38:37 -0500 (EST) hidden@email-address writes:
>How do you all handle patients who arrive late for scheduled check-ups
>(not
>sick visits)? If they are more than xx minutes late, do you
>reschedule? What
>is the usual parent reaction if you reschedule?
>
>We generally reschedule if the patient arrives more than 15 minutes
>late
>unless it is a newborn. Some parents understand and handle it
>gracefully
>while others make quite a scene.

In our busy 8-doctor pediatric practice, we usually reschedule if the
patient is more than 20 minutes late for a checkup, usually even if they
have a good reason for being late. This has done the most good to
prevent repeat offenders. Of course, it helps if the doctor doesn't run
habitually late in seeing his patients.

By the way, most patients seem to add their travel time in to their
doctor visits, so that a patient who has traveled 30 minutes to see the
doctor is more upset if the doctor is 20 minutes late than a patient who
has only traveled 10 minutes.

But to return to your topic, I've had the most trouble with late patients
over the years when I've scheduled a double checkup for siblings.
Frequently, the patient shows up 5 minutes late for the second checkup,
and expects to be seen for both. Usually, I will see only one of the
siblings in this situation. The solution for us has been to tell the
parent that the appointment for both sibs is at the time of the first
appointment. In other words, "your appointment for John and Mary's
checkups is at 2 pm", rather than "John's appointment is at 2pm and
Mary's at 2:15".

An excellent discussion concerning scheduling patients efficiently
appeared in the NEJM about 4-5 years ago, although I don't believe it
addressed your question directly.

Dave Arkin
Richmond, VA

Late patients

On Wed, 19 Mar 1997 19:38:37 -0500 (EST) hidden@email-address writes:
>>How do you all handle patients who arrive late for scheduled check-ups
>>(not
>>sick visits)? If they are more than xx minutes late, do you
>>reschedule? What
>>is the usual parent reaction if you reschedule?
>>
>>We generally reschedule if the patient arrives more than 15 minutes
>>late
>>unless it is a newborn. Some parents understand and handle it
>>gracefully
>>while others make quite a scene.

I usually set a 30 minute limit for well checkups, unless the family is
coming from more than 20 miles away. I give the sick checkups leeway but
gently remind them that their being late throws off my whole schedule. I
have more of a problem with no-shows than late parents.

Len Leshin, MD
Corpus Christi, TX

Late patients

In a message dated 97-03-19 19:44:44 EST, hidden@email-address writes:

> How do you all handle patients who arrive late for scheduled check-ups (not
> sick visits)? If they are more than xx minutes late, do you reschedule?
What
> is the usual parent reaction if you reschedule?
>
We try to work them in if we can, and it's not too late (in the middle of
lunch, or as we're about to lock the doors at night). If it's not possible,
we'll reschedule for a later date. They usually understand, but there's
always the parent who thinks they should be seen any time they arrive . . . .

Moshe Adler

Late patients

At 07:38 PM 3/19/97 -0500, you wrote:
>How do you all handle patients who arrive late for scheduled check-ups (not
>sick visits)? If they are more than xx minutes late, do you reschedule? What
>is the usual parent reaction if you reschedule?
>
>We generally reschedule if the patient arrives more than 15 minutes late
>unless it is a newborn. Some parents understand and handle it gracefully
>while others make quite a scene.

Have you looked at the top three reasons why patients arrive late and
designed some interventions that will lower the incidence of late arrivals?
Same idea applies to missed appointments.

Best regards,

Bill Braun

-----
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Medical Practice Systems Inc. (216) 382-7111 (Voice)
and The Health Systems Group http://www.hlthsys.com
Mergers - Planning - Management Services
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Late patients

Late patients are given a choice: reschedule, or wait to be seen "when
possible," which can mean a 2 hour wait. Very few complain.

Late patients

>On Wed, 19 Mar 1997 19:38:37 -0500 (EST) hidden@email-address writes:
>>How do you all handle patients who arrive late for scheduled check-ups
>>(not
>>sick visits)? If they are more than xx minutes late, do you
>>reschedule? What
>>is the usual parent reaction if you reschedule?
>>

Reply- I work in a busy inner city clinic. Late and no show patients are a
major issue (My no show rate is about 36% whichi is considered good). The
providers generally are asked if they will see a patient who is more than
15-20 minutes late. I generally reply that I will see the person/ child if
the parent is will ing to wait until the "on time" folks have been seen. I
will waive this if the child/ person's social situation is very difficult
and I am fearful of loosing them entirely.

Giving the option to wait seems to take the heat off the situation and
keeps everyone happy and served.

Peg Fitzgerald, MS, RN, CS, Family Nurse Practitioner
>

Margaret A. Fitzgerald, MS, RN, CS-FNP USPS Mailing Address:
Fitzgerald Health Education Associates | 11 Appletree Ln
| Andover, MA 01810-4101
Home of Nurse Practitioner | Voice Mail:
Certification Exam Review '97 | (508) 470-3412
| FAX:
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RE: Late patients

KidDoctor wrote:

>>How do you all handle patients who arrive late for scheduled check-ups (not
sick visits)? If they are more than xx minutes late, do you reschedule? What
is the usual parent reaction if you reschedule?

We generally reschedule if the patient arrives more than 15 minutes late
unless it is a newborn. Some parents understand and handle it gracefully
while others make quite a scene.

If the patient is more than 15 minutes late (for sick or well visit), we tell
the parent we will work them in where and when we can, and we give them a
broad estimate (range) of how long they might be waiting. We also give them
the option of rescheduling. Sometimes I can start their visit, then interrupt
it to see the patients who arrive on time, then return to complete their visit
as my schedule permits. I will not keep patients who arrive on time waiting
to accommodate those who are more than 15 minutes late. Of course this policy
means that I must strive to stay within 15 minutes of my schedule, or else the
message to the patients is that my time is more valuable then theirs.

Most parents don't object to this policy. I'm not troubled by those who do,
since I think it is reasonable.

Bob Mauro, MD
hidden@email-address