Why are doctors always running late? Should I just plan to arrive later, too?
I completely understand the inconvenience of having a physician who runs late! Sitting in that tiny exam room, every minute feels like an hour - plus there aren't enough copies of outdated magazines to keep you entertained! As a physician, I hate running behind. Here are some things that might be happening when your doctor is running late.
New disease diagnoses: While we can't talk about the other patients we see, usually if we run late it means they are likely having a worse day than you. We often have to deliver diagnoses that are life-altering or life-limiting, and those diagnoses bring a lot of questions we answer as best we can. While your family practice doctor may not be the one treating cancer, we are often the ones addressing many questions about how to best coordinate care.
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"Oh by the way" comments: Any physician in practice can tell you about these discussions that set them back. You may see a patient for a quick sore throat visit, and as you are opening the door the patient says something like, "Oh by the way, doc, I've been having some chest pain for the last few days. Think I should get that checked out?" These comments are not something we can push back, but need addressed right then.
Babies: Delivering a baby is one of the most rewarding aspects of my career, but sometimes they can be stubborn -- ask any mom who has pushed for two hours! While babies do like to make appearances in the middle of the night, sometimes they come smack dab in the middle of a busy clinic. We make it back as soon as possible, but that may mean a long wait time for you.
Arriving at your appointment on time is key for your provider to stay on schedule. Remember that check-in and getting you settled into the exam room take time as well, so arriving on time is the best way to help your provider keep moving. We appreciate your patience and if you ever fall into one of those categories, we promise to spend the extra time with you.
What is “coding”? I’ve been to my doctor’s office and someone told me my condition wasn’t “coded” right. What does that mean?
When doctors do paperwork, we have to choose the disease or problem you have from a list of 69,823 diagnoses. Many of these are very, very similar diagnoses in clinical practice, but can be coded very differently. Insurance companies are quite particular about reimbursement, and if even a single letter or number is off between the expected diagnosis and the code we enter, they will fight to reject the insurance claim.
If you receive a bill that is unexpected or much higher than anticipated, call the billing department at your doctor's office. Coders are specialists who bridge the gap from the doctor to the insurance company. They can review what the doctor stated in the chart and see what the discrepancy lies. If appropriate, they may send a "query" to the physician, asking if the diagnosis was entered accurately or if other diagnoses might apply.
How do doctors keep from getting all the diseases they encounter?
I have never been as sick as the month I did my pediatrics rotation in medical school. I managed to get a GI illness and an awful upper respiratory infection within about two weeks of starting. I swore off a career in pediatrics at that point, thinking I would just have to call in sick every day.
Doctors do have some advantages when it comes to staying healthy. First and foremost is good hand hygiene. Over the course of the day, I wash my hands or use hand sanitizer before and after every patient, after coughing, sneezing, or touching my face. In the course of a day, I probably wash my hands 30-50 times.
We know what fomites are, and we disinfect them. A fomite is any object that can carry germs. The shopping cart you use at the grocery is a great example of a fomite. Say someone has the flu, coughs into a hand just before grabbing a cart, and goes shopping. You are the lucky one to grab that cart next, you touch the handle, pick up some influenza virus and then try a sample from the deli. You have just fallen victim to a fomite, and may have given yourself the flu.
We get immunized. Most hospitals and clinics require all physicians to get their influenza vaccine every year. Before starting medical school we are also required to be fully immunized and we have to have titers (blood work) drawn to show that the vaccines were effective.
Despite all these measures, doctors do get sick. When we do, we make terrible patients and often don't listen to the advice we give. You may see us in clinic while we are both nursing the same cold, and we will tell you to go home and rest. Do as we say, not as we do.
