The U.S. came in dead-last out of the 11 countries surveyed for after-hours primary care: Only 35 percent of adults’ primary care physician practices have arrangements for patients to see physicians or nurses after hours. (In the Netherlands and the United Kingdom, this figure is 95 percent.) The U.S. came in third-to-last when it came to physicians’ response time to patients who call with a question — 73 percent of U.S. adults said they “always or often hear back on the same day,” while 90 percent said the same in Germany.
This is what the research says, but it’s quite easy to pick up on this trend anecdotally, as well. At the Becker’s CEO Roundtable last week, a speaker told a story about how someone he knew grew very frustrated with his medical care. This man’s physician told him to make a follow-up appointment for six weeks later. When he called to book the appointment at said time, an administrative assistant told him the best they could do was an appointment two months later. “Well, the doctor told me to come in six weeks from now,” the patient said. The administrative assistant’s response? “Well, that’s what he said. This is what we can do.”
Long wait times for physician appointments make up a huge problem, but it’s a complex one not easily solved by one party. What healthcare providers can fix, though, is their attitude about this. The lack of apology and consolation in that employee’s response is absurd, as is the suggestion that a physician’s recommended timeframe for an appointment is secondary to the front desk’s booking outlook. Patients aren’t exactly being high maintenance when they want to abide by the schedule their physicians set for follow-up care. Front desk personnel may want to stop treating them as such.
There are plenty of problems to ponder and discuss in healthcare, but access to care is one that seems downplayed among hospital and health system leaders. A few executives at the roundtable event did mention their partnerships with federally qualified health centers, to match patients in their ERs with primary care physicians if they do not have one, and the development of after-hour clinics. It’s my hope these initiatives are being executed much more regularly than they come up in conversation, maybe because they are not as risky or interesting to discuss as say, accountable care organizations or launching a health plan. Sometimes the talk doesn’t match the pace of the walk, and I’m hoping that’s the case here.
If not, I think another speaker said something quite interesting at the roundtable, and I’ll leave you with his words. Michael Sachs, chairman of Skokie, Ill.-based Sg2, brought the conversation back to what the patient sees. “You walk in, you need care — do you really check to see whether the physician is employed or independent? I don’t really care what the organizational structure is,” he said. “I think what we need to be doing is thinking about how to create the best patient experience.”
