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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Saturday, August 20, 2005

    The Waiting Game: Is it possible to do away with waiting in medicine? Only if you do away with patients:

    After five years of practicing medicine, Dr. L. Gordon Moore was miserable. His schedule was out of control, patients were piling up in his Rochester waiting room, and they were seething.

    "I was starting every patient visit late and rushing to see the next patient," he said. "I was staying two hours late at the end of the day. And I was thinking, This is my career?"

    But when Dr. Moore asked around to see if there was another way, he was told, he said, to "suck it up."

    When he heard about an idea to apply industrial engineering principles to doctors' offices, he investigated the flow of work in his own office.

    ...Dr. Moore opted for radical change. He quit his three-doctor practice and started a new one.

    "I started with one room, an exam table and no employees, just me," he said.

    Instead of having about 2,000 patients, he cut back to 500. Not only did he get rid of waiting times, but, by getting rid of most of his office and all of his staff, he eliminated his overhead, making his practice affordable.

    He also got rid of most of his patients. So did this doctor:

    Ms. Weinstein's new internist, Dr. Judith P. Delafield, says she was unable to prevent waits when she was part of a conventional practice and seeing 2,000 patients.

    "The handwriting was on the wall for me," Dr. Delafield said. "It was that everyday packing of your waiting room because you have to see a certain number of patients." Now she restricts her practice to 600 patients.

    If we all did this, there would be a lot of patients out there with no doctor to care for them. But at least they wouldn't be wasting time in waiting rooms!

    Unfortunately, this problem of waiting is only going to get worse as the baby boomers hit their morbidity and mortality years. As doctors of baby boomer age retire, that will leave even fewer of their younger colleagues to care for the burgeoning elderly population, which is also a very time-consuming population when it comes to medical care hours.

    UPDATE: Grunt Doc emails to say he knows where all the patients without doctors would be - his emergency department's waiting room. Exactly. And they'd all be complaining about the wait, too.

    posted by Sydney on 8/20/2005 08:10:00 PM 0 comments


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