Communication Breakdown…My Patient Story – Communication Solutions Series

The following is a guest blog post by Brittany Quemby,  Marketing Manager of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle
Recently I booked my annual well-woman exam appointment with my family physician.  I went through my regular rigmarole of calling in several times in the morning as quite often I am disconnected before I even get a ring tone.  When I finally was able to connect with the office, I was put on hold right away.  Unfortunately, this is typical for my doctor’s office, so I was prepared to work at my desk for several minutes until someone could get to my call.

After about 15 minutes, the front staff picked up my call and asked for my details.  I let them know that I would like to book my annual physical with my family physician in the next couple of weeks.  She proceeded to tell me that unfortunately, my family physician could only accommodate me on a Tuesday at 12pm and the next available Tuesday was in 3 weeks.  Admittedly, I was a bit annoyed that it would take me that long to get an appointment and that the only available times were mid-day, but I agreed to the appointment and put the date in my calendar and made plans to be in town in three weeks.  You see, I work in the city, so I have to do some finagling with my schedule to accommodate midweek appointments in town.

Fast forward two and a half weeks, I get a call from my doctor’s office letting me know that unfortunately my doctor was out of town and had to cancel my appointment and it could be rescheduled in another 3 weeks.  A bit annoyed, I agreed to the next appointment and again put the date in my calendar and arranged to be in town that day for my appointment.

It was a week later, when I got another call from the doctor’s office saying that my physician had to cancel all appointments due to an emergency and my appointment would be rescheduled in another 2 weeks.  At this point, I was quite irritated and nearly lost my cool on the phone, but agreed to the next available appointment as I would be traveling the next month for several weeks and wanted to make sure I completed my appointment before then. As I had done before, I made arrangements with work to be in town during the day of my appointment.

By the time my appointment came around, it had been well over two months since I had first made my original call and my appointment had been rescheduled three different days, along with three different times.  The morning of my appointment, I looked in my calendar to double check the time of my appointment.  My calendar noted that it was at 11:30am, however due to the amount of rescheduling, I began to second guess if I had the right date and time.   I also began to wonder if there was anything I needed to do to prep for my appointment.  I had been too concerned during the rescheduling calls to ensure I could get an appointment that I couldn’t remember if I needed to do or bring anything to my appointment.

In an effort to make sure I was prepared, I called my doctor’s office to confirm these details.  When I called the office, I was again put on hold for about 10 minutes. When the front office staff picked up the phone, I asked her to confirm the date, time and details for my appointment.  She confirmed it was that day and it was at 11:00am (not 11:30am) and that I should be prepared to give a urine sample and to have my blood taken.  She also proceeded to tell me that unfortunately, my doctor was called out and he has another doctor covering for him who would do my annual physical.

As I hung up the phone, completely irritated at the turn of events, I couldn’t help but think several things about this entire experience:

  1. Why was it ok to keep someone on hold for over 30 minutes in total to make a single appointment at my doctor’s office?
  2. Why did it take me over two and a half months to actually get this appointment?
  3. Now that I have the appointment, why am I having it with a doctor who I have never met and the only reason I know this is because I called in to verify my appointment information?
  4. Why did I even have to call to ensure I was properly prepared for my appointment?
  5. Is there not a better way?
  6. And, how is my doctor’s office able to function like this daily? Isn’t their schedule a jumbled unpredictable mess, and don’t patients come in unprepared and confused about their appointment times?

As I drove to my appointment, I thought of my massage therapy appointment I had been to just weeks before which was a completely different experience:

  • I booked my appointment online
  • I was able to see all of the open upcoming appointment that were available with my massage therapist
  • Once I confirmed the date and time, I received an email reminder for the date of my appointment with a link to directions and a link to add the appointment to my calendar
  • A few days before my appointment, I got a call from my massage therapist office reminding me of my appointment
  • The day of my appointment, I received a text message reminder that my appointment was only a couple of hours away
  • I arrived on time, prepared and completely satisfied with my experience

I know there has been a lot of discussion recently over whether healthcare organizations should take more of a “customer” “vendor” relationship with their patients. Although, this conversation goes much deeper than just communications, I think when it comes to patient communications we should absolutely start treating patients like customers if that means ensuring that patients have the information about their appointments that they need when they need it. Communication is the foundation of any relationship, whether it be vendor and consumer or provider and patient.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

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10 Comments

  • SGC,
    That’s not an option for many people. Plus, I’m sad to say that Brittany’s experience is more common than most in health care want to admit. There are certainly exceptions to the experience that Brittany had, but there are many many doctors who provide a similar experience to what’s described in this post. It’s sad since there are a lot of solutions out there to the problems she mentions.

  • John if Brittany can’t change, most likely due to insurance and provider networks, then she needs to submit a complaint to her insurance company.

    I would hope your referring to there being exceptions is a large percentage. However, exceptions are generally a small number.

    What she describes is not a hitech issue that needs solving. She describes a human issue. I wonder if that physician would like his family treated in a similar fashion. As I’ve said many times, physicians need to treat their patients as if family. Then Brittany’s blog post would be about some thing else.

  • Maybe part of the message is that doctors can use IT, including PM and EHRs to greatly improve the patient experience. For those patients that can, let them book online, fill out initial questionnaires online, communicate with the doctor about issues not (yet) needing to come in, have their data online available in secured apps if that patient has to see some doctor in another specialty who can’t get data directly from the regular doctor. Something as simple, as I’ve done, seeing specialist A who wants to know about recent tests, I pull out my smartphone and 30 seconds later am showing him the results. Or booking an appointment from the app in a minute instead of an hour on the phone. And far more. Tech doesn’t fix all problems, but it can help doctors better serve their patients and make their practices more efficient, and more respectful of their patients time.

    Ron

  • Very frustrating and agree changing one’s primary care physician or practice would be the best option. For example not all McDonald’s, Best Westerns, Hertz rent-a-car… etc function well, in fact a few of my encounters in those industries would serve as examples of how really bad the operations of a business or service may run at specific location!
    Much of the medical office operations/admin is no longer under the direct control or oversight of the physicians but rather the overarching ‘corporate operations/admin managers’ are in charge of these functions and the physician[s] are unaware of what may be taking place nor have the authority to control those parts of a ‘healthcare facility’ operations which are dysfunctional.
    Try contacting the identified ‘practice manager’, or if the practice is ‘owned’ or part of a large healthcare corporate system [hospital+clinics +ancillary services] contact the higher levels of operations/management for the entire system about your difficulties in accessing appropriate and timely care.

  • It’s well known that the U.S. is years behind with healthcare IT. For instance, over by me in Israel, the process of making appointments online that Brittany describes for her massage appointment has been routine for many years. Along with integrated electronic healthcare records so that any doctor you go to who works with your HMO can access its system and see your record of care (not just for his/her specialty), current and past prescribed medications, doctors visited, etc. A private doctor may not always call you back to confirm you’ll make the appointment, but if it’s a doctor in your HMO’s own clinic, or a test you’ve ordered (like a mammogram, ultrasound, whatever) your HMO certainly will – either a human or more often a computer-generated call to your cellphone (press 1 if you can make tomorrow’s appointment, 2 if not – that kind of thing). And if it’s time for a routine test and you haven’t scheduled one they’ll call you to remind you and make the appointment; and if it’s to be done by a separate clinic they contract with, that you have to make the appoint with separately, they’ll email or fax you a payment authorization valid for the next few months so that you don’t have to contact them again about it.

    Why can’t the US do that???
    We still have a way to go – e.g. your HMO doesn’t routinely get the record of care from a hospital if you’ve been hospitalized or had surgery, or for treatment you’ve paid for privately.

  • Hi Judith,
    Interesting to hear about your experience in Israel. I think Brittany’s experience above was actually outside of the US as well. I think it was probably in Canada. However, her experience in Canada is similar to what happens in some parts of the US as well.

    I think the key you highlight is that it’s possible to do much better and we should across all of healthcare around the world.

  • The reason her doctor is so busy is because people are coming in for unneeded annual exams.

    Over the last several decades, numerous studies have failed to find a connection between periodic health evaluations in healthy people and reduced mortality or improved health outcomes. Groups including the American Medical Association, United States Preventive Services Task Force and the Society of General Internal Medicine have moved away from promoting the yearly head-to-toe exam in symptomless, healthy adults.

    A 2012 review from the Cochrane Collaboration, a nonprofit organization that surveys medical research around the world, looked at 14 clinical trials involving more than 180,000 people and the effect of “general health checks for reducing illness and mortality.” Their findings: The checkups had no effect on hospital admission rates, absences from work, disability, specialist referrals, additional doctor visits or even patient anxiety. They didn’t improve patient health or reduce mortality, and the review concluded the checks were “unlikely to be beneficial.”

    If this is for an annual GYN exam that also isn’t needed if you are healthy “In the new guidelines, published in the Annals of Internal Medicine, an expert panel appointed by the American College of Physicians recommends that healthy, low-risk women not have routine annual pelvic exams. The panel based this advice on a systematic review of prior studies. They not only found no benefit from the annual pelvic exam, they found that it often causes discomfort and distress. Sometimes it also leads to surgery that is not needed.”

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