Or is it?
I had to make an appointment recently to see my GP. Nothing major, but the issue was a little more personal and complex than my usual, infrequent appointment requests.
Me: Hi, I need to make an appointment to see Dr. X
Receptionist: What is it regarding?
Me: It’s uhhh. Well, you see, I have a… ummm…
I finally blurted out, in probably too much detail, what I wanted to see my doctor about. After I got off the phone, I wasn’t feeling too good about the experience.
It got me thinking about THE QUESTION. I had a pretty good idea why the receptionist asked it. But I couldn’t help but wonder whether there might be a better way.
The rationale behind THE QUESTION
I decided to do a little digging. I started by calling my doctor’s office again. I explained that I was a patient, and had a few questions about making appointments. Here’s what I learned:
- You don’t have to say what your problem is, if you don’t want to. It’s okay to simply say “It’s personal.” (Who knew? I didn’t. “Personal” strikes me as a funny label though. When it comes to our “health” – broadly defined – it’s all pretty personal, isn’t it?)
- Receptionists at my doctor’s office ask THE QUESTION for two main reasons: to determine how much time to allot for me, and to determine whether they need to prepare any materials – for example, supplies for removing a wart.
- When it comes to scheduling appointments, my doctor’s office uses four broad categories: regular garden-variety requests get 15 minutes; minor surgical procedures (e.g. an excision) get 30 minutes; physicals are budgeted 30 minutes; and, appointments requiring the doctor to fill out and sign forms are booked for 30 minutes.
- When patients say their health issue is “personal,” office staff book them for a 15-minute appointment.
The survey says…it’s not just me who squirms
I decided to poll my colleagues here at HQC, to find out whether their doctors’ offices ask the same question, and if so, how they feel about it.
Wow. I was blown away by both the response rate, and the richness of replies. This issue really seems to resonate with people.
Three-quarters of my office mates reported that their doctors’ office also ask THE QUESTION. But less than half are 100% comfortable with being asked.
Here’s a sampling of comments from people who are cool with it:
- I feel good, like they are preparing for us.
- I don’t mind at all because I think it helps them prioritize the appointments.
- It helps everyone do their jobs better. i.e., doc can prepare (yes, I’m optimistic), and medical office assistant can book the right length of appointment and type of exam room, and/or let me know if I need to do anything to prepare for the appointment.
- Different issues require more or less time. Physicals are done at a certain time of the day.
Now let’s hear from the other side:
- I would prefer that they didn’t ask. I feel it’s between myself and the doctor. I know I’m allowed to say “it’s private” to the receptionist, but I would still prefer they didn’t ask. It feels like a violation of privacy.
- I don’t care for feeling like I need to get into the details of why, as sometimes they can be personal!
- I felt super weird mostly because I wasn’t sure how much detail she needed. I was a little confused, whether it was for time/booking purposes or was it directly related with my care (i.e., don’t eat before you come kind of things) which I guess could have changed my response.
- It can feel invasive/uncomfortable when she asks the question depending on what I’m calling about. My doctor is a sole practitioner with one staff who is both receptionist and MOA. I think I would feel more hesitant to share if she was a receptionist only but that’s just a hunch.
- If they asked, I don’t believe I would say because I don’t feel it is any of their business.
Okay, so I’m not the only one who has issues with THE QUESTION. People “get” why they’re asked, but they still don’t necessarily like it.
One colleague reported gaming the system: “I don’t always answer honestly – usually I say what I think will give me the time I want. For example, if urgent then I make myself sound needy so they give me an appointment within the week (my doc uses a carve out model). If not urgent but I want a particular time I usually try to negotiate a bit – in other words haggle for the time I want. I look forward to the day that I can just say what time I want and not have to explain myself or lie to get what I want.”
So let’s recap: THE QUESTION is not universally loved by patients. There’s variation in practice, with some offices asking, and others not. And some patients feel forced to “cheat” in order to get what they want.
What do you think? Are there good reasons for maintaining the status quo? Or is this an outdated practice ripe for a patient-centred makeover, perhaps through standardization?