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11/25/14
On Scheduling a Doctor Appointment
Filed under: General
Posted by: site admin @ 8:03 am

The nurses and staff at the Ambulatory Surgery Center were all most enjoyable and apparently competent. I have only positive things to say about them.

I do, however, have one concern regarding the urologist. My concern is this: He is not a man of his word. He apparently finds it relatively easy to break commitments. Further, he does so with apparent impunity – or at least thinks he does. I refuse to do business with people like that.

Here are the details:

I received a call on Thursday, Nov 20 indicating that my follow up appointment scheduled for Nov 24 would need to be rescheduled to Dec 1 because the urologist had a higher priority patient that he was scheduling for Nov 24. While I applaud the doctor’s humanitarian concern about helping the sickest first, that isn’t all that is going on. This is as much about the doctor’s financial concerns and personal schedule as it is helping ‘his’ patients.

First, note that the patient newly scheduled for Nov 24 was not in a true emergency. That can’t have been possible since I was notified 4 days in advance, after the patient had already been scheduled. If this had been a true emergency, it would have been addressed the same day. Instead, the doctor probably just rationalized that this patient X needed to be dealt with sooner than others like me. And since the doctor was unwilling to hand off patient X to another doctor with a less crowded schedule and was unwilling to treat patient X after hours, the choice apparent to the doctor was to move his other appointments (including mine) to a different day.

And note what the doctor did. When I received a call asking me to reschedule, I was asked to see the doctor on Dec 1. There was no consideration given to the possibility that I might have already made plans, that any delay would impact me financially or otherwise. The decision to push things out was simple made by the doctor. The doctor had other choices, had he been interested in taking them, but those were ignored. Perhaps they were ignored because the doctor really wanted to make money from all the patients. Perhaps they were ignored because the doctor simply did not want to stretch out his work day. Perhaps it was a combination of both. Perhaps it was another reason.

Further, though I asked for it, I could get no guarantee that the rescheduled appointment would be any more sacred than the one being broken. Given the doctor’s apparent motivation, I could easily see my appointment being bumped for other ‘higher priority’ patients indefinitely.

If this doctor were a man of his word, he would be willing to pay the price for it. That would mean that he would uphold commitments previously made, making adjustments around those commitments rather than throwing them out wholesale.

In the Innovator’s Dilemma, Clayton Christensen identifies 4 key factors for any purchasing decision. In order of importance they are: capability, quality, convenience and price. I sincerely doubt that this doctor is among the elite who are irreplaceable – although he might think that. For my needs, any competent urologist will fill the needs of both capability and quality. Next comes convenience. Key ways to measure convenience include not just location and office hours, but also the ability to rely on scheduled appointments. When I arrange my commitments based on a scheduled appointment, I expect it to occur. When it doesn’t, I have to rearrange my schedule. This inconveniences not just me, but others I work with. It can also affect travel plans, physical activity, and more.

I understand that everyone has emergencies. Sometimes unplanned things happen. But when a doctor bumps me because he wants to see another patient, it isn’t an emergency unless no other doctor can solve the problem and the problem has to be solved right now. This is not one of those cases.

If this doctor truly believes he is irreplaceable, then I’ll prove him wrong right now by replacing him as my doctor.

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