This is a very interesting post and this, along with the responses of the readers, have offered a lot of insights to us. We’re a Makati-based start-up that focuses on virtual queuing to solve problems like what you’ve experienced.

I know it’s been almost a year since the last reader response but I hope we can still get some feedback from you and from the other readers.

Our start-up developed a virtual queuing aggregator mobile app and one of the verticals we’re looking at is clinics. The doctors and the receptionists will have access to our software through the internet and they can effectively use that to manage the queues and send alerts to patients in case they will be running late. The patients can easily search for doctors/clinics and “set an appointment” by generating an e-ticket using their smartphones. The value proposition for patients is they no longer have to wait in the clinic until the doctor shows up. Say for example at exactly 11AM they are at home and they used our mobile app and got e-ticket number 10 (which means they are virtually 10th in line) but the doctor’s clinic hours is 1-5PM, they no longer have to go to the clinic earlier than 1PM and endure long hours of waiting. They can monitor the queue flow (what number is already being served) in real time and will also be notified (either via push notifications or SMS) if their turn is approaching. This basically frees up a lot of time for the patients. For the doctors, the value proposition is the improvement in customer service and streamlining of patient channels, thus decreasing the likelihood of patients walking away after hours of waiting and increasing patient satisfaction regarding the experience of consulting in their clinic. The app also has a review section (similar to what one of the readers posted about which he wished is available) to encourage doctors to keep it professional at all times and to provide prospective patients access to information about doctors’ professionalism, tardiness, etc. We also have a safety algorithm in the review process to keep the integrity of each review.

We’re now looking to launch it with some early adopters for this. It’s going to be free for consumers (patients) and doctors will only be charged a minimal monthly subscription fee (We acknowledge that charging doctors will make it very difficult to get them on board) but we’ll be offering a free one-month trial period to them so they can see how our software can help increase their bottom line. Having said that, here are some questions which we hope we can get feedback on from the readers:

FOR CONSUMERS (PATIENTS):
1. Is a mobile app like this something you’d use over traditional means (ex.: going to clinics ahead of time and waiting there; calling a receptionist to sign up for a consultation)?

2. What other features do you want to be included in the app?

FOR DOCTORS:
1. Would you be willing to pay for a software like this which can improve the customer experience of your patients and can offer a new channel for patients to “make an appointment” with you? If yes, how much are you willing to pay for something like this?

2. The software has transactional data analytics as part of its core features. As a doctor, how likely would you take the time to look at the analytics to improve your overall customer experience? What metrics will you want to keep track of in terms of the analytics?

Doctors who want to be part of our launch and avail of the free trial may get in touch with us by sending an email to info@tfinnovations.com.

Thanks.

Before walking out of the room she had the temerity to say this: “ If only you could spend more time with me, you could have treated my diabetes better. You just had to be late.”

My years of training in medicine kicked in: “I’m sorry. It’s my fault. It won’t happen again”

She walks out. The next patient walks in. And the cycle repeats itself…

This is a common scenario faced by doctors. We bear the brunt for everything that goes wrong in a patient’s life. The poorly managed disease, the horrid weather, the ungodly waiting hours, the uncomfortable waiting room chairs, the grumpy nurses, the lazy attendants and at times the odious smell that emanates from the person sitting next to them.

We face these frivolous accusations and absorb them, giving our patients an outlet to vent their frustrations and anger. We tell ourselves, “This is part of the job”.

We live by the same mantra regardless of our nationality, color, religion, race or creed… “The patient is ALWAYS right”.

I have listed the following complaints based on my experience and that of my colleagues.

The doctors are inconsiderate towards the patient’s time.

You are probably right. We are inconsiderate. We are inconsiderate for abandoning our health so you could be healthy.

We are inconsiderate for skipping our meals and not giving in to the excruciating pangs of hunger so we could monitor your fluids when you are down with severe dengue.

We are inconsiderate for not returning home to have dinner with our family and loved ones because we are too busy consoling yours.

We are inconsiderate for missing our daughter’s dance recital or our son’s football match because your child was admitted to the intensive care unit and without us being there, will probably never make it through the day.

We are inconsiderate for forgetting our wedding anniversary because our mind was filled with the thoughts of our patients undergoing complications in labour.

We are inconsiderate for placing our patient’s well being above all else, including our own personal time. We should have considered our family and friends before spending so much time at work. We are very inconsiderate indeed.

The doctors are selfish and spend very little time during consultation with their patients

An average doctor sees ten to fifteen patients in clinic and this number varies according to hospitals around the world. The larger the pool of doctors, the lesser the number of patients they see, and the amount of quality time they are allowed to spend with their patients increases.

Bearing in mind this simple logic, if the consultation time runs from 9 am to 1 pm, which is exactly four hours, and in a clinic with roughly ten patients per doctor; we are only allowed 24 minutes per patient.

This does not take into account the walk in patients, the forced bookings, the late comers, the ’missed appointments’ who decide to turn up on that day, the ’selective amnesiacs’ who got their appointment dates wrong, and finally the ’self anointed VIPs’ who probably donated a few dialysis machines and built the entire south wing of the hospital.

If you have been to a hospital, have you ever wondered why our clinics don’t finish on time? Have you ever wondered why the doctors are still seeing patients during their lunch hour? Have you asked your doctors if they have had their lunch or at least a bite to eat from morning?

If you do, I guess you will find out how ’selfish’ they really are.

The doctors have ’special preference’ over certain patients compared to others

You are absolutely right! We won’t even bother denying this.

Picture this scenario. A patient presents to the emergency department with a massive heart attack. Time is of essence. In case you didn’t know, every second wasted is detrimental to the patient’s life. The doctor knowing this well, rushes to the emergency unit, pushes the patient to the cardiac care unit and performs a life saving procedure called ’angioplasty’. He may have to leave his clinic or the wards, where the stable patients are waiting to see him, who are at present in no danger whatsoever, except probably a bit annoyed of having their discharge from the ward delayed.

We may have to delay your MRI appointment for an hour, as patient may come in with a spinal cord injury requiring urgent radiological diagnosis and surgical intervention.

A pediatrician may take an hour of her time to review a child in an acute cubicle but may only spend minutes with your child who is well and awaiting discharge.

We recognize the ‘frequent visitors’ to our emergency department. And we know the ‘funny feeling’ you have around your fingertips at 3 a.m can wait while we attend to a patient brought in unconscious after an accident.

There are times the operating theaters are fully booked, that we need to postpone elective surgeries to accommodate urgent life threatening cases. We can’t proceed with removal of a lipoma from your hairy back if a mother with fetal distress arrives in labour. If an emergency Caesarean Section is not performed in time, we could lose both the mother and her baby.

You can’t imagine our trepidations when we approach your bed, as we prepare ourselves mentally for the verbal abuse that is about to follow, knowing in full knowledge that you have fasted the whole night prior to surgery.

You will inadvertently be mad. We know. And we can’t help it. We do have ’special preferences’. But what you don’t realize is this; it’s best not to be one of our ’special preferences’.

The doctors are supposed to know everything about us and don’t have to keep looking at their notes

Patients have accused me of showing little interest in them if I can’t recall every detail of their symptoms, admissions history and medications, especially if I have to keep referring to my notes.

I am often left embarrassed by the cynical looks some patients give me when I am unable to answer all the questions. Even when I say with all honesty , ’I will look into it and get back to you’, the disparaging remarks can be quite hurtful.

I have often wondered if a lawyer is able to recall with exact precision every case he has tried? Can a teacher recall at will the details of every one of his students examination results? Will a bank manager remember every single detail of his client’s account?

The doctors are responsible for our health and it’s their fault if we don’t get better.

We are responsible for our patient’s well being. Only a fool would say otherwise.

We can continue to admonish obese diabetic patients to lose weight and control their diabetes but they don’t heed our advice. They return time and time again for more medication and continue deteriorating and get upset with the doctor when they develop complications from the disease. They assume it’s our responsibility to fix things as they pay taxes.

We can only counsel a patient with scarred lungs to stop smoking and to be more compliant to their medication, but if they choose to continue smoking and disregard our advice, are the doctors to be faulted when they have done nothing to help themselves?

It’s still difficult for us to comprehend the unrealistic responsibilities placed on doctors.

There is a quote by Rumi, “Out beyond ideas of wrongdoing and rightdoing there is a field. I’ll meet you there. When the soul lies down in that grass the world is too full to talk about.”

We are not perfect. We are not trying to be. But our patients often forget as they tend only to look at the ’thorns’ in their lives, that we, the doctors, are ’patients’ too.

And it is not always our fault.

From Dharmaraj Karthikesan’s blog.

Another thing, don’t you guys notice how stuck some people are on their titles? Everyone has to be called “doc” or “atty” or “engineer ” in the Philippines. I have never yet met a lawyer here in the US that asked to be called “attorney” or “esquire”. I call my lawyer by her first name as I do my boss and my boss’ boss. My son had a classmate in preschool whose dad introduced himself as Jim. I only found out he was a doctor when I chanced upon his picture a hospital poster. No airs at all.

Love your blog Marketman!

Once I was stuck at the traffic , although I still had ample of time I called his clinic to let them know I was few mins late. The secretary could not believe it.

I echo JCP’s view on having too few doctors. For certain sub specialties, there are sometimes to few of them serving the NCR area. Heck, in some provinces, 1 specialist serves 2 whole regions!!! These sub specialists (endocrinologists, oncologists, gastroenterologist, neurologists and even urologists to name a few) have a list of 20, even more patients queued up for out patient consult in their clinics in the bigger hospitals. These patients sometimes have no choice but to wait their turn, even if it means sitting for more than 2 hours – kasi they travelled all the way from far flung provinces. All because walang specialist sa bayan nila, or they were initially managed by general MDs but have turned to become complicated cases. Also, the bigger hospitals in the metro have the newer, state of the art machines and are able to perform breakthrough procedures not seen in their provincial equivalents.

One patient waited 3 hours the day before (and the doctor was a no-show), and waited an additional 49 minutes the following day (and even asked if willing to wait for another 51 minutes)? Time to write Makati Med.
The good doctor deserves at least a warning from the hospital administration.
Or, at the very least, should inform clients of any “foreseeable/controllable” tardiness not more than 15 minutes after the appointment. The secretary should have elaborated, and made every effort to apologize/ advise all patients of the reason for the delay. Sometimes, it is all in the way patients are told, advised, informed — respect.

This was a 10am Saturday appointment. Presumably, there were no clinic hours earlier than 10am (at another hospital) for the doctor?

Malala yung sa mga weekday afternoon appointments. Doctors usually hold clinic-hours at two different hospitals, and when patients who come in for the morning appointments present complicated cases, patients waiting for the afternoon appointment will really have to wait. Seems more than a statement on tardiness and professionalism, the situation points us to the fact that we have few doctors in the country. Too many lawyers, too few doctors?

we all hate waiting and I understand the frustration of having to wait but I wonder how many of those who voiced out their opinion about their “late” doctor do actually show up on time to their own appointments whether at a doctors office or at a dinner party, given that they bother to set or agree on a specific time or not.:))

In socialized care, the complaint is how long it takes to get an appointment or even see a specialist. In the US, you hear complaints about their doctors not having enough empathy for the patient. There is no perfect system but there is always room for improvement and courtesy to one another.

Thanks MM! Sorry to hear about your bad experience with this doctor. Very informative entry.