Gaming The System

If you don’t want to hear me complain about work, stop reading here!

If you are still with me:

As I was leaving the office last night to pick up my kids, my office manager stopped me because she wanted to talk.

As it turns out, on Tuesdays someone “up there” is now running a report to see how easy it is to get in to see me in a seven day window. On the surface, this is a noble ideal. I would pose that 7 days is not good enough. We try to accommodate everyone in a 48 hrs window as the standard in my office. The problem with this is that a computer program is only checking to see if I have open appointments.

I don’t.

Apparently this is bad.

We are off the grid in our endeavors. A computer algorithm does not tell the whole story. I work people in all day long. On Tuesday, even though I had a full schedule, I worked in four patients at the end of the morning and at the end of the afternoon. This is pretty standard. I just don’t have appointment slots made up to go there until they are needed. We also slide people into cancellation slots when they occur.

The problem with being a busy physician is balancing my sanity, patient wait times, and patient access. This is impossible to do in a perfect way but we do our best to accommodate everyone. I bristle at some computer telling me how my schedule should look, particularly when patient satisfaction data tells another story.

Yes, I could add a few slots to my schedule every day and tell staff they are not to use them under any circumstance in order to beat the system but I’ll be damned if I am going to play a meaningless game because a computer algorithm says I should. THAT does not improve patient access.

Now I will return you to our regularly scheduled programming…



8 thoughts on “Gaming The System

    • Only if you are in private practice, which is actually quite rare now. It is very difficult in our system to negotiate good insurance contracts and such when you are only you. Used to be that this particular group worked for me, now they believe I work for them. Huge change in culture over ten years. Shrug.


  1. I am going to find your posts interesting. Like so much today, all simple reason has gone out of the window, causing what I think to be more confusion, stress and chaos for all concerned, including doctors!

    I am not a doctor, but given that I am 68 and have grown up with the NHS and have spent 28 years in the States in their dreadful system, I find what’s going on today re the NHS fascinating and worrying.

    I think doctors today have a very difficult time of it….and I do believe it’s time that we the public wake up to this, Janet.


    • Yes! Clearly there is no perfect system. But the standard has to be what improves patient outcomes, access, and satisfaction. If it is not accomplishing that, it is bogus busy work or a smoke screen. This particular issue is reminiscent of the US VA system’s problems and the cooking the books that went on regarding patient access. Call my clinic and ask for an appointment with me as an established patient and measure THAT! Thank you do much for your comment! 🙂


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