Crossed Lines

An elderly lady was in to see me two weeks ago.  She was given a backlog appointment, so I had seen her within 10 days of receiving the referral.

"How did you like our appointment system?"  I admit that I was (partly) fishing for a compliment.

"I didn't like it very much at all!"  Uh-oh. Snagged line.  "Your secretary phoned me with the appointment.  Why couldn't you just send a letter?"

I explained that a letter would have taken several days to reach her and she wouldn't have as much time to make arrangements for travel to Saskatoon.

"But when she called me, I had to write everything down.  I had to find my glasses and some paper. I asked her to spell everything twice.  It would have been a lot easier for me if you just sent out a letter!"

That was some interesting feedback.  As we get closer to our goal of reduced appointment wait times, we're reconsidering how we notify patients.  Traditionally, appointments were made three or four months in advance, so we sent out a letter.  Now that appointments may be within seven to 10 days of the referral being made, we need a more timely notification method.  It may take several days for a letter to reach some areas, and some people who live in rural Saskatchewan may not check their mailbox every day.

We discussed this at our last project team meeting.  Office staff felt it was easier to send notification by mail: Form letter, cut and paste the name, mailing label - you're done.  Phone calls take longer, especially if you have to spell everything twice.

Stephen, our patient representative/advocate, begged to differ.

"Sending out a letter may be easier for you, but it's not necessarily considerate of the patient's schedule.  It's one-way communication.  The patient has no choice."

I pointed out that our notification letters included this line: Contact our office if this time is not convenient for you.

Stephen stuck to his guns. "Yes, but that's an extra effort for your patient. It would be better if they could negotiate the appointment time immediately, and that requires a phone call."

He really had his teeth sunk into this one.  And, doggone it, he was right!  We'll never get our 5's up if we keep force-feeding people their appointment times.  But how to resolve my patient's complaint about having to write down all the information during the phone call?

How about this small test of change: For the next week, we'll phone any out-of-town patients being scheduled in backlog slots with their appointment time.  They can accept the time and mark their calendar, or ask for a different date.  We'll tell them that a letter will follow with the appointment details and our address.  Plenty of advance notice plus all the details on paper. And the added bonus of more patient control over appointment time.  Best of both worlds?  Maybe.  We'll keep track of how much extra work it is to make the calls (which should be fairly brief if we’re just giving the appointment time).  We'll see how many patients take the earliest date offered and how many want to negotiate a different date.

P.S. Re: last week’s post about canvassing patient opinions, I’ve got another little venture going. Check out the letter “Make Rate MDs work for you” in National Review of Medicine.  Then visit my Rate MD post April 17/07.