No triple headers at ped? (3 kids back to back)

[Melaine]

Is this a typical policy? I was just told I cannot schedule all three of my kids' appointments back to back because it "backs them up". I am quite positive I think this is ridiculous but curious if it is common.

[emily_gracesmama]

I think it's stupid. Do they not schedule three Appts in a row for non related people?

[Zukini]

No btdt personally. But I was lead PM at a hospital scheduling center and that was one of the rules for the schedulers in our Peds service. It's a potential backup but also an issue of lost revenue on the multiple slots if the family is a no-show or late cancel. We could do 2 from same household but not 3 back to back.

[Melaine]

Well, I've had issues with my ped. and am kind of embarrassed to be posting another one (why haven't I just switched already). But this one is making me really frustrated. Why is there a potential for back-up? IMO, the reason is that they do NOT schedule a full slot for each child when booking families. I never feel that I get the same time when bringing in multiple children. Still, all three of my kids have to come along with me (I homeschool) so it is unreasonable that my family should have to wait in the waiting room multiple times to be seen for well visits. I pay as much as three separate families so why can't I have my kids seen together?

[o_mom]

Our ped will do all three, though it rarely aligned. DS2 and DS3 usually have their checks together as they have similar birthdays.

Our eye doctor, though, will only do two per family per day so I have to split them up there.

[ett]

How is it a potential backup? Isn't it faster to see three kids from the same family who are already in the room as opposed to 3 kids from different families that have to come in and out?

[Zukini]

For the Peds service I supported, it was an issue of a few bad apples spoiling the bunch for everyone. It was a safety net hospital and resident program clinic so the patient population was a little different from a private doc office. Late patients often expect to be seen anyways and with multiple kids on the schedule, then expect to have all their kids seen and for an equivalent amount of time. It becomes a service issue x3. Now most established practices have schedules where you can squeeze in an extra or late person but having three visits dependent on one person could still be asking for disaster (not with you per se, but someone out there). No shows were a major issue and it screwed us up with underutilized nursing and support staff and also residents who couldn't get the proper "mix" of patients to meet program requirements over time. And of course, lost revenue. So the rule was set at the scheduler level, and they didn't have permission to override it. Oh and sometimes the way the schedule is set, they have a mix of appointment types and the schedule may not allow for 3 of the same type of visit in a row. It may be new patient, follow up, follow up, well visit, new patient etc. The slots are varied to maximize staff efficiency or whatever quirks the practice has adopted!

I'm sure if a parent approached a doctor or the practice manager about the next visit and asked for the scheduling override it could be done based on your own good history with them. I would just ask them as an aside at the next visit and have them coordinate with the desk staff to get you all lined up before you leave. You mention having other issues with the doc. Not sure if those are service related or how the relationship with doc and staff is, but at least inquire why the rule in the first place if you feel they will give an honest answer. I certainly see the issue it creates for the parent coordinating all these visits and yup, its a pain.

[o_mom]

How is it a potential backup? Isn't it faster to see three kids from the same family who are already in the room as opposed to 3 kids from different families that have to come in and out?

The only thing I can think is that typically our ped would be doing other things between appointments. So they see child 1, then before going into child 2 they might review a medication refill, answer a question, review labs, etc. If you have three together, so they are in the room for 30-40+ min straight, those things cannot be taken care of between patients. Ours also has the nurse taking measurements and history ahead of time, so if you had three separate patients, nurse sees #1, then sees #2 while doctor is with #1, then nurse sees #3 while doctor is with #2. When three are together, you have a very long nurse part while the doctor is not seeing anyone, followed by an extra long doctor visit while the nurse does nothing until the very end when they bring in the next patient.

I can see how it can back them up and I would understand if, combined with the potential for three cancelled appointments, they did not want to do that. Peds are not exactly a highly paid specialty either.

[lalasmama]

I think the "backup" reason was a little misleading. For the person rooming a family of 3, that means 3 times the vitals, 3 times the chief complaints, 3 times the aftercare. All those things are typically done while the doctor is in another room. So, when Doc is seeing patient B, we're giving shots to patient A, then rooming patient C. With 3 in 1 room, though, the roomer (RN, LPN, MA, NA) is trying to room those 3 kids at the same time as still giving shots to the earlier patient. And it takes longer to room 3 kids, which means the doctor gets in there later, and then there could be 3 strep tests, 3 shots, 3 eye exams, etc..... And yet, there's no time built in to do 3 whatevers; 1, yes, 2 maybe. But 3 is tough.

And then, of course, there are unreliable families that will book the 3 and then no show, or show up 15 minutes late and still expect everyone to be seen....

[dogmom]

Is this a typical policy? I was just told I cannot schedule all three of my kids' appointments back to back because it "backs them up". I am quite positive I think this is ridiculous but curious if it is common.

I completely get why it would be frustrating and make no sense from the outside. But Google "scholarly articles pediatric scheduling" or primary care scheduling and there is not shortage of work on this area. It really is a huge issue that the public never sees. I work at a big teaching hospital and when I see a surgeon there is always some irate person that they have to wait for 30 min to an hour at times. Of course they would be equally irate if they had a loved one inpatient in the ICU and wanted to know why "their" surgeon couldn't come by at a drop of the hat and see them whenever they show up. Or why they aren't on the regular inpatient floor when there are problems. Or in the ED when a patient comes back with problems after surgery.

The reality is the physicians I see work insane hours, have an insane patient load, and although they are not poor, for the amount of work and stress they do I can think of many professions they would make a lot more money at for less effort. I'm not saying I don't get irritated when I have to wait, but I try to remember this.

[Zukini]

// The reality is the physicians I see work insane hours, have an insane patient load, and although they are not poor, for the amount of work and stress they do I can think of many professions they would make a lot more money at for less effort. I'm not saying I don't get irritated when I have to wait, but I try to remember this.

Agreed. Practicing medicine these days is not for the faint of heart. Hours are crazy, insurance costs, staff costs, health insurers squeezing you on everything, and still trying to meet the physical and emotional needs of patients and their families... I see why so many private practices are closing or why docs are leaving the profession altogether.

[AJP]

I understand the issue with backups if the patients are late etc. our Ped always did back to back well visits for our twins and she enjoyed taking the "extra" time with us. It wasn't really "extra", but since the nurse came in and did measurements etc for one right after the other it gave the Ped and I a nice long time to talk without interruption.
This year we have well visits scheduled for all 3 back to back. My office didn't have a problem booking them since we booked a while ago and the ped's schedule allowed it. We will probably do my DS first and then DDs "together" so they both get measurements, eye tests, etc one after the other.

[abh5e8]

mine wont' even let me schedule 2 well child checks on the same day. which can be annoying, but i understand. if the one family is a no-show, then you lose 2 or 3 spots in your schedule, vs just the 1. i think its a business decision.

[KrisM]

I haven't been able to get 3 in a row, just because it hasn't worked. I"ve not been told I can't. I often do 2 in a row, go for lunch, and then come back for #3. I don't know why they would want the 4 of us crammed in a too small room 3 different times, really. Kids are restless enough for 1 kid, let alone 3 days in a row or something.

[swissair81]

My ped lets me bring three together, but since it's one appointment they won't let me book it when there isn't a big enough slot. I did one appointment with my three school bound girls at the end of August and let's just say that I'd rather do multiple appointments at different times.

[pb&j]

Stupid. Our family doc LOVES it when we pile all of us in at once. She books us for four appt slots and we're usually out in half the time.

ETA our doc is in solo practice and has only a billing/reception person, no nurse. So she does all the weighing/measuring herself in the exam room, and sends in prescriptions on the spot as soon as she says what she's prescribing. And we are very good patients - never cancel, always on time, pay the bill promptly.

[hellokitty]

This is annoying. Ours wouldn't let me do two back to back well child appts until I threw a fit. I had to bring both of them anyway? So I was aggravated that they thought it would be all rainbows and roses for me to repeat another visit with two children again for one stinking appt!

Sent from my SPH-L720 using Tapatalk 4

[hellokitty]

Oh and our well child appts do NOT get their own time slot. The staff squeezes them in btwn other appts. Don't get me started on it. Waiting over an hr with at least half of that with a child down to their diaper is crazy. So while it may suck for them to have a cancelation, at our particular practice they intentionally overbook and pts have to deal with insane waits. I would have left the practice long ago if it weren't for the fact that I really like the Ped we see. As my children get older, we often see the NP instead, which has been fine.

Sent from my SPH-L720 using Tapatalk 4

[alexsmommy]

Financially, I get it. Once again, I don't this this board is represented of the masses. As a clinician, I am still surprised how many people will no show/no cancel or think they can come late and should get their full time slot - even though this would punish the person who comes on time after them. Insurance will not cover no shows, and it's the very type of people who think nothing of blowing off their appointment are the ones who sign the no-show policy, but are then a nightmare to collect the (nominal) fee from.
My ped doesn't allow three in the same family and I find it a PITA, but I get and respect why, even though I am not one who would abuse the convenience.
At the end of the day, my office rent and malpractice insurance doesn't pro-rate based on how many clients kept their appointment.

[Starfish]

The only thing I can think is that typically our ped would be doing other things between appointments. So they see child 1, then before going into child 2 they might review a medication refill, answer a question, review labs, etc. If you have three together, so they are in the room for 30-40+ min straight, those things cannot be taken care of between patients. Ours also has the nurse taking measurements and history ahead of time, so if you had three separate patients, nurse sees #1, then sees #2 while doctor is with #1, then nurse sees #3 while doctor is with #2. When three are together, you have a very long nurse part while the doctor is not seeing anyone, followed by an extra long doctor visit while the nurse does nothing until the very end when they bring in the next patient.

I can see how it can back them up and I would understand if, combined with the potential for three cancelled appointments, they did not want to do that. Peds are not exactly a highly paid specialty either.

:yeahthat: I am in peds. Exactly this reason.

[AngelaS]

Our ped won't let me do the visits back to back either. They said it's because of no shows. I wish they'd give me a chance before they just assume I'm a slacker, ya know??

[niccig]

Our ped won't let me do the visits back to back either. They said it's because of no shows. I wish they'd give me a chance before they just assume I'm a slacker, ya know??

But if they give you an exception, then what about other people? They'll want an exception too and before you know it, there is no policy/rule anymore as there's so many exceptions. The practice seems to have tried it back to back and found it didn't work out, so in this situation, the practice has their reasons. You may not agree with them or think they should apply to you as you're never late. But they're dealing with hundreds of families, so set a rule that works for their situation.

I've had to set policies at work for customer service and my intent is never to make things more difficult for people. I need to be fair to all the people we serve (in my case thousands of people) and our work staff.

[oneplustwo]

Huh, this is all news to me. When the kids were younger, I used to have their annual well child checks all at the same time, so that was 3 appointments in a row. Their dentist always schedules the three at the same time so I don't have to bring them in at different times for their 6-month checkups/cleanings. And recently I got all three scheduled for full hearing exams at the same time ~ the woman doing the scheduling sounded like I had hit the jackpot in getting two kids seen simultaneously with one kid's appointment immediately after, and I agree with her, it's pretty hard to find the slots available like that ~ but scheduling all three back to back has only depended on whether the slots are available. I've never been told it wasn't allowed.

[kellyd]

Our peds office has the same policy, but it's a policy by the doc, some of them will see everyone at once. Everytime I have to traipse there with all three kids for one or two of them I'm reminded why. 3 kids in one room is chaos! I can't remember everything I wanted to discuss for each child (even when it's written down) when they're all there with me. We have the good fortune to literally live 2 doors and across the street from our peds office. So for me it's not a big deal to take the girls and then later in the day take DS as long as I have someone to stay w/ the opposite. 2 weeks ago we had the girls checkups in the am and DS's in the pm and the doc volunteered to just take them all since DS was with us. My kids are well behaved and I still left there feeling like I would have gotten further ahead if I had just played in traffic. Since then I'm called twice with follow up questions for things I forgot about.

[AnnieW625]

I might be annoyed, but honestly it wouldn't be the end of the world to me. I am one of three and I don't ever remember going to the doctor with my two siblings or even just one sibling past maybe the age of 5. I have gotten lucky and been able to do back to backs with my kids on a few occaisions, but it still wouldn't be the end of the world if I didn't have that option.

[tmahanes]

I completely get why it would be frustrating and make no sense from the outside. But Google "scholarly articles pediatric scheduling" or primary care scheduling and there is not shortage of work on this area. It really is a huge issue that the public never sees. I work at a big teaching hospital and when I see a surgeon there is always some irate person that they have to wait for 30 min to an hour at times. Of course they would be equally irate if they had a loved one inpatient in the ICU and wanted to know why "their" surgeon couldn't come by at a drop of the hat and see them whenever they show up. Or why they aren't on the regular inpatient floor when there are problems. Or in the ED when a patient comes back with problems after surgery.

The reality is the physicians I see work insane hours, have an insane patient load, and although they are not poor, for the amount of work and stress they do I can think of many professions they would make a lot more money at for less effort. I'm not saying I don't get irritated when I have to wait, but I try to remember this.

I wish we had a like button :)

I work for a surgical practice a scheduling is a NIGHTMARE. People are late, they might get mad cause they have to wait, they might be early, but then get mad if they are not seen early, they don't show up and then expect to be seen the next day. The other day we had 7 no shows. It seems like you can never please anyone. We routinely have people get mad because they have to wait when they are late for their appointment and they get mad because the MD does not come in as soon as the patient is in the room, never mind they were late to the office in the first place.

I get that this is hard to understand because even as a healthcare professional I didn't really get it until I worked in a specialist practice. For example at our office my MD might have been doing a colon resection for part of the night followed by an appendectomy then they had to do rounds before their office hours started so yes they might be a half an hour late because they were speaking to someone's family in the hospital etc. And unfortunately the office staff does NOT always know this to keep you updated because if an MD is in the middle of a precarious spot in an operation etc they are not going to stop and call the office as nice as that would be (believe me we are sometimes the last to know :) ).

My job has given me a much greater appreciation for scheduling and policies and I try my best to be patient when I go places with these things in mind.

[Melaine]

I might be annoyed, but honestly it wouldn't be the end of the world to me. I am one of three and I don't ever remember going to the doctor with my two siblings or even just one sibling past maybe the age of 5. I have gotten lucky and been able to do back to backs with my kids on a few occaisions, but it still wouldn't be the end of the world if I didn't have that option.

Sure, but it's safe to guess that's because after age 5 you were in school. Since I homeschool, all three of my kids get carted to each appointment. So while it isn't the end of the world, it is an issue that will come up repeatedly for us.

[AnnieW625]

Sure, but it's safe to guess that's because after age 5 you were in school. Since I homeschool, all three of my kids get carted to each appointment. So while it isn't the end of the world, it is an issue that will come up repeatedly for us.

You are probably right, but couldn't some friends watch your girls or your baby for you to take the other one or the other two to the doctor? Do the twins go to any drop off activities that you could schedule the baby's appointment to coordinate with?

[Tondi G]

That's annoying. Way to make it inconvenient for parents of larger families! "backing them up" is a poor excuse.

[infocrazy]

I understand WHY the dr may not like it, but I still think it is annoying...says the mom who delayed everyone's well child so I could schedule a quadruple LIKE I DID WITH NO ISSUE LAST YEAR, only to be told the office doesn't do that... I've been doing this since DD was born--aka 3 together for 3.5 yrs, but I guess no longer. FWIW, I always bring either DH or a sitter. They gave me two rooms. We either did 2/2 (I stayed with the doctor and then the shots), or we had a rotation one kid at a time. They offered to do 2 in the morning and 2 in the afternoon on the same day...because that helps me how? I am annoyed enough to be looking for another practice, but for other reasons as well (closer).

The big boys probably just won't have their well visits since they are all caught up on shots and have no issues that need discussing. I don't see the point since I believe if you take a healthy child to the doctor, they will come home sick.

PS, it was quicker for that visit than it was for the sick child visit for ONE kid I recently endured...

[Melaine]

You are probably right, but couldn't some friends watch your girls or your baby for you to take the other one or the other two to the doctor? Do the twins go to any drop off activities that you could schedule the baby's appointment to coordinate with?

Sure I could, but should I have to? I don't think so. I'm the customer, and pay the same as everyone else. I've never been late for an appointment and we have had dozens and dozens (literally, DS has been that many times just himself). Now, I'm certainly not expecting to have my choice of times to have all three kids seen, but being told I can't schedule them together is frustrating. And I am 100% with the previous poster. Take a well kid in, bring them home sick, so I like to minimize that as much as possible. Bottom line: Bringing all three kids at once is convenient to me, and that should be enough IMO regardless of scheduling issues it may bring up.

ETA: I know I am in the minority but I never ask anyone to watch my kids and if I do get childcare, you better believe I'm either doing something much more fun than seeing the doctor or am in an emergency situation.

[bisous]

My peds office allows triple headers and so does my pediatric dentist. I would be very annoyed with a policy that does not permit this. I'm sorry if that is inconvenient for the office but it might motivate me to search for a new office, it is that big of a deal for this mama!