05/28/2013    Bryan Markinson, DPM

Staff Makes it Difficult to Get Appointments (Name Withheld)

I feel compelled to add another point of view to
this discussion. First of all, any staff member
purposely refusing urgent appointments to
decrease their work load speaks to volumes of
office procedural flaws and should never be
tolerated. On this everyone agrees. However,
think of how many times patients call on
an "urgent" basis for things that turn out to be
minor but embellished by the patient into an
emergency because they are going on vacation the
next day? This is disruptive to your schedule as
well as selfish to legitimate emergencies.

In addition, many physician offices are
overbooked and stretched to the max legitimately.
I have had several instances over the years where
I needed to refer urgent cancer cases to
oncologic surgeons who offered appointments up to
three months away! One can easily understand how
an "in-demand" surgeon for serious problems may
actually not have an opening for extended
periods. Yes, he can operate until midnight to
lighten the load, but the realities of that are
obvious.

When it comes to podiatry, a new patient visit
involving diabetes and an open infected wound
without a primary care physician can take several
hours to dispense with. If you do this on any
sort of regular basis, your availability becomes
increasingly more limited. In my particular case,
being hospital based, I have a very high ratio of
new to established patients throughout the work
week. If I try to plan accordingly, bracing
myself for the diabetic infections along with the
mycotic toenail patients, I have to limit my
availability or someone will be getting cheated.

So, my point is that with all the best practice
efficiencies, procedures, staffing and good will,
if you are not saying "NO" when you can't fairly
accommodate a new patient tomorrow, then you will
be hurting your practice by squeezing them in
more than helping it by accommodating everyone. I
find it best to identify a colleague you trust to
recommend such patients to, and everybody wins.

Bryan Markinson, DPM, NY, NY,
Bryan.Markinson@mountsinai.org

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