Friday, June 15, 2012

Can You Get a Prompt Appointment With Your Doctor?


Having trouble getting an early appointment with a doctor? It’s a common problem. Here is one company’s proposed solution.

It takes an average of 20.5 days to get an appointment with a physician, according to a study by Merritt Hawkins & Associates and related to me by the principals at ZocDoc, a startup company. That’s a long time. ZocDoc aims to fix that problem with a rapid appointment scheduled on line.

Perhaps your need is not urgent in the classical sense but imagine you were just told your mammogram was suspicious and that you should see a surgeon for a biopsy. Waiting three weeks just to be seen (plus another wait for the scheduled biopsy date) will seem like a lifetime of anxiety,  but a company called ZocDoc has set out to improve patients’ access to care by making the market for doctors’ appointments more efficient, to the benefit of patients and doctors alike.

But if the doctor is booked up what can you do except wait it out? It turns out that physicians have a 10-20% cancellation rate. Maybe someone’s serious problem got better on its own. Maybe they went to the ER instead of waiting. Or maybe he or she just forgot because the appointment was made so long ago. For whatever reason, the doctor has many last minute openings; but you don’t know about them.

Cancellations mean no income for that time slot, but the physician’s fixed costs of office rent, staffing, insurance, etc. don’t go away. So he or she would like to fill those empty time slots if possible. 

In response, ZocDoc has created a software system that works with physician’s scheduling systems. Basically, patients go online and insert the particular type of physician they need to see (e.g., primary care, ENT, dermatologist, etc.) as well as their location. ZocDoc scans the real-time schedules of the physicians meeting that search criteria and allows patients to instantly book an appointment online. ZocDoc tells me that 40% see a doctor within 24 hours and 60% will be seen within 72 hours. And, although ZocDoc does not presently put you on a waiting list, you can always check back on ZocDoc and see if an earlier time slot becomes available.

My only concern is that you as a patient are best served with a single primary care physician (PCP) with whom you have a long standing personal relationship. He or she knows you, your medical status and the issues of work and family. Going to a different PCP for a one time problem is not the best medicine – although I would agree that it is far superior to a long wait in the emergency room.

The specialist situation is somewhat different however. Usually, your PCP is the best person to make a referral. As your advocate, the PCP wants you to be well served with quality care and so will generally refer you to a specialist that the PCP knows by years of personal experience is not only competent but respectful of patients. And if the PCP is really on your side, he or she will personally call the specialist, explain the reason for the referral and, when appropriate, ask for an early appointment.

But if you can’t get to your PCP for many days and you just fell and have a swollen ankle, ZocDoc could presumably get you into an orthopedist’s office quickly. Or to a surgeon for that breast biopsy. Getting to see that orthopedist or surgeon in one to three days rather than three weeks would be a godsend – getting appropriate therapy for the sprained ankle or just relieving three weeks of anxiety waiting for a biopsy. 

ZocDoc appears to be at first glance a game changing approach. If they are correct it will make a major transformation in the delivery of medical care. It will be interesting to watch ZocDoc and see how it evolves.



Notes – ZocDoc was noted in a Wall Street Journal article today on innovation. I have no financial relationship with ZocDoc; I learned about it serendipitously. There is more about the delivery of health care in my new book The Future of Health Care Delivery-Why It Must Change and How It Will Affect You.

2 comments:

Anonymous said...

Very interesting concept and one that seems conducive to reducing wait-times for new patients. As mentioned, it may not be ideal for maintaining consistency with a single PCP; however, I wonder if EHR systems are looking into the capability of such a system. This may bring the ZocDoc model to be physician-specific. Currently many EHRs have the capacity to hold a cancellation list, but it seems that these require a staff member to manually check the list and call patients to fill these slots. Making this automated or integrating it with online patient portals would certainly streamline the process a bit better, one would think. Good post.

karthiga saravanan said...


Thank you for the info. It sounds pretty user friendly. I guess I’ll pick one up for fun. thank u.

Patient Appointment Scheduling

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