Friday, June 24, 2011


"Welcome to the emergency department. May I take your order?"
"I'll take the chest pain value work-up."
"An EKG with a side of blood work. Any toppings today?"
"Sure how about aspirin, nitroglycerin and dilaudid. Morphine makes
me itchy."
"Would you like a CXR with that?"
"No, I want to supersize that to a CT scan."
"That will be an extra $2,000; is that okay?"
"Sure, why not!"
"Okay that will be $50 with your co-pay; anything else?"
"Yes, make it snappy!"

if you've ever ordered fast food over the counter, you'll know that once you get to the front of the queue & you've made your order, the food comes pretty fast & furious. it's what we've come to expect, so you can imagine at some time in the future, we might just demand medical help ASAP.

we all can't bear waiting at A&Es, or at any hospital department, for that matter. everything seems to go at slow-motion & what's worse than waiting is waiting WITHOUT explanation.

patient satisfaction is one area that hospitals try hard to improve. even as a patient, i don't mind too much how high the quality of care is, as long as it's reasonable. & as long as the pain is relieved, the swelling reduced or the bleeding stopped, i'm quite happy. throw in doctors & nurses who are emphathetic & can communicate well, then forgive me for thinking i'm in 7th heaven!

the only thing out of control is waiting time. hospitals can work on this by setting expectations & providing explanations.

by setting expectations, the patients are informed of the timing of each step of their workup. here the business principle of "under-promise, over-deliver" is practised. by setting an estimated time that can be met 99% of the time, patients are more likely to be pleasantly surprised when less time than expected is spent on waiting.

however, in the 1% chance of time over-run, explanation should be given to the patients, & apologies extended if appropriate & an updated encounter timeline offered. patients understand difficult situations when these concerns are conveyed to them.

we're still a long way off from providing quick & efficient service in our healthcare system, unlike the way it's done at fast-food joints, but if we can achieve half that customer satisfaction, expect to see patients clients with smiles as wide as the golden arches.

**thanks, T1, for the email**


Yan said...

I set my mind that "waiting" is the name of the game when I go to clinic or hospital. I allow generous time for the visit.

So, I am quite settled with it every time.

I am only annoyed by doctors who are late. Say, your appointment is 9 am, obviously the first patient of the day. But he came in at 10 am.

It's still ok if I am in a public hospital or even a private hospital,because he is probably around the hospital attending to emergencies or surprises in ward rounds that keep him late.

But if he is a dentist in a private clinic, or a doctor operating independently in a clinic, I think as a responsible person, he should be in time - as highly expected of in the corporate world, or in journalism!

Fair patient, doc?

Yvonne Foong said...

I've gotten so used to waiting in hospitals that I don't remember the last time I ever wanted to complain. Hmmm... when was that? Maybe my KLGH days. That was beause the doctor himself was at least an hour late to come in!

doc said...


you obviously have been visiting a lot of doctors to know their time management habits, which i admit, is generally poor. (wonder if there should be a time management module in med school?)

some doctors run around a few clinics, eg. one in hosp & the other outside, esp in big cities, & maybe that's why they are never punctual & not around when you need them!!

but i agree, if the doctor has only 1 clinic, he should be punctual, as much as he expects his patients to be punctual.

yes, you are a fair patient with a fair expectation of your doctors.

keep well!

doc said...


waiting seems to be a practice deeply ingrained in hospitals...until perhaps Golden Arches take over?

Yvonne Foong said...

You mean the doctor could have been thinking, "They are used to waiting anyway. Coming in a little later won't make much of a difference to those who are used to waiting for me."

doc said...


i can only speak for myself: patients will need to wait for me if there is some other matter more urgent to attend to.