We took our kids to see a specialist today (they’re fine), and it showed clearly that despite how widespread lean concepts are becoming, there are many places that have never heard of them and BADLY need to.
On the phone, the clerk made a big deal about how important it was that we arrive early to fill out paperwork, etc. So we actually ran into the building with the boys in our arms to make sure we were there with plenty of time.
We filled out the paperwork and put the boys down at an activity table to wait. FORTY-FIVE minutes later, a nurse finally took us to an examination room and took some basic height and weight measurements, checked blood oxygen levels, etc. She then left us in that small room (with nothing to occupy two toddlers’ attention) and said the doctor would be in soon.
We waited a while, and after one of the kids began to melt down through boredom (toddlers just don’t have the ability to wait long periods of time), we went back to the main waiting room, which at least had a TV and space to roam around.
Finally, TWO HOURS after our appointment began, the doctor finally ushered us back to the examination room. There was no apology or even any acknowledgement that we’d spent the last two hours occupying little children in a boring waiting room. He performed the EXACT same tests (looking in the ears, listening to the chest, etc.) that the nurse had done earlier, and gave us the diagnosis.
The news was good, and my relief almost offset my annoyance at having our time so thoughtlessly wasted. The doctor apparently had been tied up at the hospital, which is why he was so late, but we were not told this until we’d been waiting for almost two hours. If we’d known, we could have gone to the grocery store or to lunch, but nobody said a word. Instead, they actually misled us: The nurse who’d taken the vitals told us she would confer with the doctor and he would be in soon, even though the doctor was not actually in the building and wouldn’t be for another forty five minutes.
The shame is, the doctor was nice. The nurses were nice. The clerks were nice. Nice people and probably fine medical care, but way we were handled made me feel bad about the whole thing.
It didn’t have to be this way! There is information all over the place about “lean medical practices,” and how they raise profits while increasing patient satisfaction (partly by eliminating waiting and overprocessing like we experienced). Here’s one piece about how medical practices can become lean organizations, and there’s a LOT more where that came from. The information is not hard to find. The only thing that prevents apparently nice and intelligent medical practicioners from learning and applying these ideas is that they simply don’t care.
It’s understandable; they have a captive market (it’s a pain to change physicians) and no price pressure (who pays attention to what the insurance pays?), so they feel no need to raise their game. They aren’t the first industry to feel this way.
They also won’t be the first to find out that they are wrong. There’s a reason why General Motors is mostly owned by the federal government now. If medicine wants to avoid being socialized, it’s time for them to step it up and get lean.