I am currently on the wait list for a vasectomy. I'm scheduled with Dr. Jana. My G.P. referred my case to Urology September 13, 2007. I didn't receive a letter from Urology after a few weeks so I followed up with the Kenderdine Clinic to see if the referral had been sent to Urology. The Kenderdine clinic said it had been faxed over. I phoned Urology but my name was not on the wait list. The reception at Urology told me that as soon as faxes come in that the name was added to the list, so they probably hadn't faxed the referral yet. I then phoned back to Kenderdine Clinic and they re-faxed the referral. I did receive a letter from Urology after those conversations. My Urological Surgeon consult appointment was booked for December 5th, 2007, I received that appointment letter on October 17th, 2007. Consult wait time was pretty much 2 months if the first request from Kenderdine would have been successful. My feeling is that I was 99% sure I was going to go for a vasectomy so I would have preferred just to have my surgery scheduled directly from the first request. Maybe even a quick phone conversation to brief me on the procedure and ensure that I wanted it. Dr. Jana did examine me to ensure he could perform the procedure on me but how many times does it happen that it's not possible to do the surgery?
I would suggest that I could have had a shorter wait time if I had been scheduled for the procedure right away.
Dr. Jana told me the likely wait time for my vasectomy would be 3 to 4 months from the December 5th consult date.
It's my opinion that waiting 2.5 months for a consult appointment is excessive then waiting another 3 to 4 months for the surgery is excessive.
Who does this guy think he is, telling me how to run my practice? Does he have any medical training? Does he know anything about assessing men before vasectomies? What experience does he have in booking surgical procedures?
Big fat zip on all counts, I’ll bet.
Yet, oddly enough, he nailed it. Right on the button. Nothin’ but net.
Without any “pertinent” experience, he’s suggested changes to our system that could not only improve service, but also eliminate unnecessary office visits.
The point is this: The medical “system” is not medical at all. Sure, taking out an appendix requires special expertise, but booking appointments, ordering supplies, providing a service – that’s easy for many non-medical folk to understand. So why do doctors get away with the status quo?
Physicians have a very privileged position in society. We enjoy professional autonomy. People entrust us with their health. Governments rely on us to be sound stewards of resources.
It’s best summed up in the phrase, “You’re the doctor.”
Lay people commonly defer to a physician’s judgment in medical matters. They have tacitly made the same allowances in matters of business management. Or, when they do recognize a problem and solution, they’re reluctant to bring it up because… Here, I’m not so sure.
What happens when people do start bringing it up? When patients realize my diploma is an MD and not an MBA? When citizens demand that the services their taxes pay for be provided according to their tastes rather than the entrenched habits of physicians?
If physicians want to maintain society’s respect, we need to lead this change rather than be dragged along kicking and screaming.
Someone has noticed the emperor’s new clothes.
Anyone else feel a draft?
P.S. It's exactly one year since I attended an IHI conference and had my first exposure to Advanced Access. Since that time, our office (staff and physicians) has formed a project team, started measuring our processes and implemented changes. We've worked hard to eliminate our waiting list backlog. We're not there yet, but we're seeing glimmers of blue sky.
I'm grateful for the encouragement we've had from so many sources.
Thanks to everyone involved in the project (in no particular order): Karen, Stephen, Carla, Amanda, Donna, Delores, Peter L., Peter B. (our project team); Calleen, Rachelle, Renee, Shelly, Rosa, Karry, Danielle, Jenna (our terrific office staff); Larry, Saul, Don, Paul, Kunal, Shari (my long-suffering partners, who've resisted the urge to strangle me); Bonnie, Greg, and HQC for the support.
We're getting close!
Posts
This comment has been removed by the author.
ReplyDelete