I was recently catching up on a backlog of reading. I get a lot of journals and magazines in the mail, and when things are busy, I toss them in a pile on a corner of my desk. Recently, the pile was so high it threatened to topple over onto my little dog, Cassie. (Cassie is sometimes in the office with me, and when she is, she sits atop a quilt on top of my cage of a desk. I call it a cage, because I actually have three desks in a "U" shape with just one, tiny opening on one side. Not my idea of good office configuration, believe me.)
Anyway, in this pile that was endangering Cassie, I noticed an article form the December 2007 issue of Current Psychiatry: "Help Your Patients Keep Appointments." I read with interest what the professors/authors thought would help increase the likelihood that I would show up for an appointment.
They suggest "clever" ideas like:
- "Get a cell phone number."
- "Call and remind them the night before."
- "Ask for a commitment."
- "Offer less frequent but more regular appointments."
- "Express your concern."
I read these things, and they just make me (more) crazy. It seems like providers just don't understand how consumers think, act or behave.
If providers want us to show up for our appointments, what about focusing on important things like:
- Making sure their 15 minutes with us has some meaning.
- Treating us with respect and being fully engaged for those 15 minutes.
- Focusing on recovery goals during our session so they can ensure that the treatment plan has some relevance to what we care about.
- Using a measurement-based approach (e.g., the QIDS, PHQ-9 or, better yet, the Sheehan Disability Scale) at every session so that we both have a real sense of how things are progressing instead of asking us "how we feel."
- Allowing us to speak for more than 10 seconds before interrupting us. (According to research, that's the average amount of time it takes for doctors to interrupt consumers during appointments. If they let us say all we need to, on average we need just two minutes.)
If the interaction between us and our providers has value from our perspective, I think we're much more likely to make those appointments. More than half the time, I come away from my doctor's appointment (which I never miss) feeling like it was a huge waste of time and money. For what? From my perspective, nothing of real value was accomplished. It's my commitment to myself and my wellness that gets me there each time.
So, instead of asking the question, "How can we help consumers keep appointments?" doctors need to ask, "How can I make this appointment have value so the consumer understands they're not wasting their time or money to be here?"
I bet then we wouldn't be no-shows.
What makes for a quality, valuable interaction between you and your provider?
Published On: June 10, 2008
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