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  • Two for one special

    I have many older couples who insist on scheduling their appointments back to back so they can attend each other's. Sometimes it is helpful to have a spouse but most of the time it is not and leads to a lot of distracting talk. But the biggest issue is that it takes the nurse twice as long to get them in a room putting me behind before I even see them. And now in flu shot season it is compounded afterwards as well.

    It is less of a big deal with kids. I can do 2-3 sibs at a time no problem but complicated old people are different.

    Anyone else annoyed by this? Anything you do other than ask them to come earlier? Does anyone actually refuse to see them together?

    Also I just don't get it. I have zero desire to go to my wife's medical appointments and even less for her to attend mine.

    I am not talking about demented or comprised patients. Just the older bored people. And now that I think about it younger couples who do not work for one reason or another seem to do this a lot too.

  • #2
    Originally posted by Lordosis View Post
    I have many older couples who insist on scheduling their appointments back to back so they can attend each other's. Sometimes it is helpful to have a spouse but most of the time it is not and leads to a lot of distracting talk. But the biggest issue is that it takes the nurse twice as long to get them in a room putting me behind before I even see them. And now in flu shot season it is compounded afterwards as well.

    It is less of a big deal with kids. I can do 2-3 sibs at a time no problem but complicated old people are different.

    Anyone else annoyed by this? Anything you do other than ask them to come earlier? Does anyone actually refuse to see them together?

    Also I just don't get it. I have zero desire to go to my wife's medical appointments and even less for her to attend mine.

    I am not talking about demented or comprised patients. Just the older bored people. And now that I think about it younger couples who do not work for one reason or another seem to do this a lot too.
    But you do not fit in either category, which is why you don’t get it. As people age, they do want to know if those unusual memory lapses are dementia, for example, and may want to hear the convo and possibly correct the spouse’s statements. I know, because I’ve been there the last couple of years. And older patients sometimes complain a lot about aches and pains and the spouse really wants to know what is discussed in the doctor’s office.

    As for younger couples, this is a little bizarre unless something is going on. Or that’s the only way one spouse can get the other to go to the doctor in the 1st place.

    Let’s see if anyone else is up and posting this early on a Sunday morning.
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    • #3
      Takes longer to room but since I have them for 2 slots (or 30 min total) it doesn’t impact my day personally. I find in general they’re quick/easy visits.

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      • #4
        This happens a lot in OB/GYN practices. Usually mother/daughter. Sometimes it slows down finding out things like is the teenager sexually active. You ask when Mom is in the bathroom.
        A husband coming to a Gyn appointment and doing all the talking raises a lot of issues also.

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        • #5
          Originally posted by jfoxcpacfp View Post

          But you do not fit in either category, which is why you don’t get it. As people age, they do want to know if those unusual memory lapses are dementia, for example, and may want to hear the convo and possibly correct the spouse’s statements. I know, because I’ve been there the last couple of years. And older patients sometimes complain a lot about aches and pains and the spouse really wants to know what is discussed in the doctor’s office.

          As for younger couples, this is a little bizarre unless something is going on. Or that’s the only way one spouse can get the other to go to the doctor in the 1st place.

          Let’s see if anyone else is up and posting this early on a Sunday morning.
          In those cases where there's actually an agenda it makes sense. But it seems to happen all the time with people who have no good reason to be there other than the fact that it seems like an outing. Or maybe it's a convenience of ride factors but I'm more specifically talking about the Go-Go retired people who getting to a medical appointment is not a big deal.

          So when it would be highly appropriate to have a family member there when somebody is actually concerned about dementia or something that the patient is not telling their physician it seems to be the time that nobody does attend or sometimes even less useful they call ahead and say "my spouse is demented but I don't want to talk to them about it please don't tell them I told you."
          Last edited by Lordosis; 10-17-2021, 05:50 AM.

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          • #6
            Husband comes alone for appointment. He has major hematological issues or early pre cancerous issues that needs monitoring. He goes home after the appointment.

            Wife: What did the doctor say.

            Husband: He said that I was fine, just fine. Nothing to worry about.

            We get to hear about this exchange when the spouse calls us or comes for the second visit. This is why wives tag along. Men have serious memory issues when it comes to relaying things to spouse / adult children.
            Last edited by Kamban; 10-17-2021, 06:15 PM.

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            • #7
              I have many husband / wife combos coming on same day to save on separate trips. Usually I see the wife first and then she comes in to the husband''s room so that she can hear about his condition.

              I also have a few daughters bringing their mother and MIL at the same time to make caregiving doctor visits easier and not take too much time off from work / home.

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              • #8
                Originally posted by Kamban View Post
                Husband comes alone for appointment. He has major hematological issues or early pre cancerous issues that needs monitoring. He goes home after the appointment.

                Wife: What did the doctor say.

                Husband: He said that I was fine, just fine. Nothing to worry about.

                We get to hear about this this exchange when the spouse calls us or comes for the second visit. This is why wives tag along. Men have serious memory issues when it comes to relaying things to spouse / adult children.
                When a wife comes to a medical appointment and over talks her husband is because she cares about him and he will not ask the right questions or take care of himself.

                When a husband comes to an office appointment and over talks his wife it's clearly that he is abusing her and doesn't want her to tell any of the secrets.

                I think we are all adults and we can deal with our own issues. There is obviously special cases where things are complicated and one person does have more knowledge than the other or somebody's illness prevents them from obtaining useful information but I am talking about the mundane blood pressure checks and diabetes that I see day in and day out. Not somebody talking about chemotherapy options.

                I'm not conveying my point very well. I'm probably just a curmudgeon that had a busy week and am being grumpy.

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                • #9
                  •Older- you do realize that communication is a two way process. Sender/receiver and comprehension. There is zero fluency in medical terminology and you “dumb it down” for the patient. The patient then does not have the skills or capability of translating this to the spouse or other party. Much is lost in translation. Think of “It’s all Greek to me” or “speaking In tongues”.
                  The second party rarely has a clue of what actually was discussed. Your discussion actually “educates” the patient. The other person wallows in ignorance. The patient cannot translate.
                  That said, there are only several situations where another person should be present.
                  Sorry, the ultrasound during pregnancy.
                  Child birth.
                  Appointment to discuss serious issues and alternatives.
                  A true need to assist the patient (this can be subjective-minor, age, patient’s unwillingness or ability to communicate).
                  None of these need to interfere with the patient/physician communication. I am sure their are more and I am sure it can be abused. I would suggest requesting exams in private, back to back. Deal with a request for joint attendance. A quick note might suffice. A cheat sheet they can discuss on their own time. The one or two points needing attention.
                  As far as the mother/daughter pregnancy thing, that is Hatton’s turf. Mandatory restroom stop?

                  From the patients point of view, they do not realize they are impacting anything. Ask or suggest they refrain. 90% of the time, no problem. It’s not offensive, just ask.
                  I am sure you are capable of extending joint attendance when appropriate. Back to back is simply a convenience for a trip to the doctor.

                  Once you start, removing that option might be a transition. Better care? Sends the message.

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                  • #10
                    It can be tough to have any family in the room. Sometimes they are helpful but most times they usually steer the conversation in unproductive directions.

                    I always enjoy the people that bring their entire family to the ED. Not just a 2-fer, but a 3-fer, 4-fer, 5-fer, etc. Once you establish there isn't an environmental exposure like carbon monoxide, the chance for serious pathology effectively goes to 0 once 3 or more family members check in at the same time.

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                    • #11
                      Originally posted by CordMcNally View Post
                      It can be tough to have any family in the room. Sometimes they are helpful but most times they usually steer the conversation in unproductive directions.

                      I always enjoy the people that bring their entire family to the ED. Not just a 2-fer, but a 3-fer, 4-fer, 5-fer, etc. Once you establish there isn't an environmental exposure like carbon monoxide, the chance for serious pathology effectively goes to 0 once 3 or more family members check in at the same time.
                      A copay charge per headcount or how about ER’s selling seats?
                      The NFL, NBA and MLB make a ton marketing spectator seats.

                      Stubhub: Cord McNally 3:15 front row for $2k?
                      You folks are pros, this “free seat” thing for reserved seating or general admission is a big mistake. A family of 5 at a game is expensive.
                      Spectators need to pay for seats.

                      ScubHub- VIP package includes a meet and greet in the recovery room for gunshots and car crashes. New spectator sport. Get an agent!

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                      • #12
                        Originally posted by Lordosis View Post

                        When a wife comes to a medical appointment and over talks her husband is because she cares about him and he will not ask the right questions or take care of himself.

                        When a husband comes to an office appointment and over talks his wife it's clearly that he is abusing her and doesn't want her to tell any of the secrets.

                        I think we are all adults and we can deal with our own issues. There is obviously special cases where things are complicated and one person does have more knowledge than the other or somebody's illness prevents them from obtaining useful information but I am talking about the mundane blood pressure checks and diabetes that I see day in and day out. Not somebody talking about chemotherapy options.

                        I'm not conveying my point very well. I'm probably just a curmudgeon that had a busy week and am being grumpy.
                        i have had plenty of scenarios where it is less than helpful so not just grumpy. plenty of “tell him/her i’m right” type situations. we all have our own agendas it may not be in service to our loved ones.
                        “. . . And the LORD spake, saying “First shalt thou take out the Holy 401k. Then shalt thou save to 20%, no more, no less. 20% shall be the number thou shalt save, and the number of the saving shall be 20%. 25% shalt thou not save, neither save thou 15%, excepting that thou then proceed to 20%. 30% is right out . . .””

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                        • #13
                          Originally posted by Lordosis View Post
                          When a wife comes to a medical appointment and over talks her husband is because she cares about him and he will not ask the right questions or take care of himself.

                          When a husband comes to an office appointment and over talks his wife it's clearly that he is abusing her and doesn't want her to tell any of the secrets.
                          To avoid such overbearing / controlling scenarios, for the initial appointment I only have the patient in the room for H/P ( unless there are issues like memory. hearing, language etc). The MA tells the accompanying person - the doc will see the person first and the call you in when the discussion part begins.

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                          • #14
                            Originally posted by blippi View Post

                            i have had plenty of scenarios where it is less than helpful so not just grumpy. plenty of “tell him/her i’m right” type situations. we all have our own agendas it may not be in service to our loved ones.
                            The google MD and experience one spouse has often come into play. My spouse and MD daughter disagree with my recent visits to PCP and dermatologist. What did they say? I disagree. I don’t care I had the derm write out the name and blood tests being done.
                            No way am I going to let them into an exam room to debate. I have a doctors note! If I want a second opinion, it’s not in the office. That conversation lasted longer than the appointment! Not all agendas are bad or deserve discussion during an office visit. Waste of time. Do it at home.
                            Lordosis I agree with you, keep family out of the exam room unless there is a need. Let family discussions happen at home.
                            BTW, the derm wrote down a one liner as I indicated I needed it. 5 seconds at most. More time expressing a laugh about why I wanted it.
                            Family dynamics are amusing. Control your environment, keep it separate, waste of time. You won’t change Dr Google or opinions and no need to try.

                            Comment


                            • #15
                              Originally posted by Lordosis View Post
                              I have many older couples who insist on scheduling their appointments back to back so they can attend each other's. Sometimes it is helpful to have a spouse but most of the time it is not and leads to a lot of distracting talk. But the biggest issue is that it takes the nurse twice as long to get them in a room putting me behind before I even see them. And now in flu shot season it is compounded afterwards as well.

                              It is less of a big deal with kids. I can do 2-3 sibs at a time no problem but complicated old people are different.

                              Anyone else annoyed by this? Anything you do other than ask them to come earlier? Does anyone actually refuse to see them together?

                              Also I just don't get it. I have zero desire to go to my wife's medical appointments and even less for her to attend mine.

                              I am not talking about demented or comprised patients. Just the older bored people. And now that I think about it younger couples who do not work for one reason or another seem to do this a lot too.
                              I see a lot geriatrics and I see this A LOT! I’ve seen some couples for close to 20 years, and have never seen them apart, ever. Even when one comes in for something simple like a rash, the other one comes in with them. As for as the back to back appointments in the same room, I don’t mind it, but I won’t adjust my schedule for it. They need to find a time on my schedule in the future with back to back available slots. Some want their spouse squeezed in on their appointment day for their spouse’s to be seen also, but I pretty always say no, and they adjust. I actually don’t mind it too much, less walking room to room for me!

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