Monday, October 15, 2012

A Different Kind of "Lean" Needed at the Doctor's Office

I had an ophthalmologist appointment today. I arrived on time. It was a good 70 minutes before I was seen by the doc. And the worst part? Neither by word or manner did the doc betray any indication that he was aware of running late. This was clearly business as usual.

I am aware, of course, of the primary motivation for running their practice that way--the doc's time is infinitely precious, the patient's utterly expendable. Could the situation be improved? I think so.

Even if we accept the proposition that the scale will be heavily tilted toward optimizing physician time, I bet there is a lot of room for improvement--if only there were a will.

First of all, I wonder how much of the backlog is non-optimized, sheer waste? Could the backlog be halved, and still achieve the same level of physician utilization?

Following close after that is the question of sharply diminishing benefits. What is a reasonable tradeoff between wasting patient time and doctor time? 10-to-1? 50-to-1?

Okay so those considerations are the low hanging fruit. Next comes simple process improvement. Could the practice take a page from appliance deliverymenpeeps, and book you for a large window (e.g., 9-11), but let you call in beforehand to get a refined estimate? Obviously, even better would be an automated, real-time system with web lookups and notification texts.

Of course, the cynic in me has to wonder--is part of it image? Does a long wait at a specialist's office serve as a signal that their time is hard to come by, and you are lucky to get an appointment at all?

All I can say is--thank goodness for smartphones. Wait time == reading time.

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