WIBU to leave (consultant appointment)

[onemiddlefinger]

I've been waiting now for 40min, somebody has taken my blood pressure in the waiting room, no sign of the consultant.
It's an antenatal appointment but I'm not actually sure why i need it.
It's in the middle of a work day, i need to get back.

I've never had a problem with any hospital appointment. (Eye Clinic, Eye Surgery, Fracture Clinic, Maxillo-facial clinic). I receive a letter with an appointment.

1. I go or

1. I ring the number quoted and change it on the telephone and

1. I receive a letter with the new appointment so

1. I go or

1. I repeat.

I once waited 3 and a half HOURS for a consultant. Damned glad I did he diagnosed me with something that could have had serious ramifications for baby and I ended up being admitted for 2 days for treatment.

Not antenatal but doctors 'causing' delays.

5 years ago tomorrow whilst in hospital 8 week old ds took a turn for the worse. The consultant on the ward needed a more specialist consultant to help keep him alive. It was this consultants clinic day so I am sure that people in the clinic were inconvenienced in the hour (maybe more?) he was saving ds life. Unfortunatly though people can't pick to only need their life saving at a convenient time!

Ds is still regularly seen in that clinic, a couple of times we have had massive delays and either rearranged appointments or waited it out depending how urgently he needed seeing in clinic. Each time I have felt nothing but relief it isn't us in the situation some other poor family are whilst hoping they also have a positive outcome.

We have also been the patient who takes an hour for a 20 min appointment. Sometimes needs must

Yes it's frustrating when your sat waiting but the vast majority of the time there is a very good reason for it

Of course she could have asked what the appointment was for - but it's good, standard practice for the HCP making the referral to explain why they are making the referral in the first place. Often the patient is bombarded with information, or feels scared, or simply misunderstands - research shows that patients understand and remember less than half of the information they receive in a consultation. What HCPs should do is use the teach-back technique (or similar), so that communication is effective and patients understand fully what is happening to them.

It's far more complex than simply being an active participant in your own care - we recognise that as HCPs if we're working effectively.

That last sentence didn't make sense. I meant - for a patient to be play an active part in their care they are not required assume responsibility for asking the HCP why they have been referred, and we recognise that as HCPs etc

So in your view, would the OP have been unreasonable to leave an antenatal consultant appointment without seeing the doctor, even though she was unsure as to why she was there?

Fwiw, I have always been referred to a consultant in every pregnancy as I tick a variety of criteria. This has always been discussed at the booking in midwife appointment (4 different trusts/hospitals). I struggle to believe the OP was not made aware of this when she had her booking in and, as I said previously, is likely to find the info in her notes.

I had to wait 2 hours for an ECV from my consultant once.
The midwife came in crying; the woman who had come in at the same time as me had lost her baby at full term; they had delivered it and it couldn't be resuscitated.

I felt very lucky, and once the consultant had composed himself he had to make small talk etc.

(I work with them hence unusual breach of confidentiality btw.)

I don't disagree SirChenjin, it is best if the HCP ensures understanding. But it is better, IMO if the patient is active too, if they want to know.

I've never had an appointment and not felt clear what it is for. But have noted that my friends seem to fall into two camps - those like me who ask questions and do research, and those who accept what they're told and just show up.

The latter isn't wrong. My sister is like that, and finds that stress-free. She doesn't mind not knowing and leaving herself in the HCPs hands. Great for her.

But as the OP mentioned she didn't even know why, suggests it did bother her. So - actively ask.

The HCP can support by being open to being asked. Be nice if the entire system supported by giving them time, too!

It is bad service -- if a practice is so overstretched and overbooked that someone is left waiting that long then the doctors have bitten off more than they can chew and need to scale back if that is possible, or make sure they have adequate staff to see patients, factoring in the fact that they sometimes have emergencies that require extra time.

I have been the woman taking longer than my normal appointment time, having gone to the doctor with spotting and mild cramping that turned into full blown bleeding and unmistakeable labour at 13 weeks in the interval between having my blood pressure taken and the moment the doctor walked into the examining room. I was stretchered out through the waiting room after the receptionist, on doctor's orders, made the calls to get me transported to the theatre. The doctor moved on to other patients, late, after telling me what was happening and what needed to be done in the theatre -- a conversation that took no more than five minutes after his examination of me. Instead of the usual ten minutes' appointment I got somewhere between 15 and 20, partly because the nurse had to go and find and then prepare some sample cups for 'products of conception' that needed to go to the lab.

I had bad news from my doctor or from ultrasound technicians four times. I don't think a doctor or a technician is there to provide a shoulder to cry on any more than a nurse is there to make tea. My doctor had more patients than just me to see every time I went to the office, and I do not know what problems brought them there. Some had routine appointments but some probably went with some problem -- maybe their baby wasn't moving or maybe they were experiencing early labour. If my doctor had been delayed 50 minutes trying to provide emotional support to someone else the day I went in with the spotting, I do not know what might have happened to me, out there in the waiting room. If he spent more time with me than he did, then someone else's equally serious problem might have gone untended.

The OP spent 2.5 mins with the doctor and had her vital signs checked by a nurse. The doctor asked her two or three questions and that was it. I can't help feeling that all of that could have been done over the phone, either in a conversation with the MW or with the OP herself.

Sick mother or dead baby is an adverse outcome.

Poor service is being made to wait a long time, not being able to easily change appointments, needing letters in the post to make appointments, not being told enough details about a referral, going to a referral that was apparently necessary only to have it last approximately 2.5 minutes.

I get where you're coming from. I need to have scans every two weeks and I'm supposed to have blood pressure checks etc. at the same time. Last time it was a 2.5hr wait. Plus an hour each way travelling. I had to take both DC with me (preschoolers) as usual childcare was closed. Apparently my blood pressure was significantly raised. How surprising.

TBH I've given up. There's never any bloody appointments at the high risk pregnancy clinic so I've started making appointments with community midwives to do urine/ blood pressure and scan appointments when the consultant is doing a list and we have a chat whilst I'm on the table. Apparently they're not allowed to suggest this as NICE guidelines suggest fewer appointments are better and more convenient for the patient.

Cabrinha - I've already said agreed that the OP could have asked, and I certainly would have done - but HCPs are generally aware that less than half their patients remember what they've been told at the consultation and don't assume that their patient will ask. We are the professionals in this situation, and it's up to us to make sure that the patient is absolutely clear as to what decisions have been made and why, e.g. why we have referred them on. It's great if the patients ask, but many don't - for a multitude of reasons - and the onus is not on them to remember to question us and our decisions, absolutely not. The onus is on us to give the information and make sure they understand.

I had no idea this thread would bring out so many strong opinions, it seems that there is a general problem with waiting times and the difference is that some people accept it as normal and some think it shouldn't be normal.

Yes, of course I am be lucky that my baby is ok, but it's quite unlikely that the consultant would have found out otherwise during the 2.5min appointment anyway.
And I realise that there could have been someone with a serious condition that caused the delay, but surely the reception staff could have then told people that there is a delay?
Or perhaps the consultant when inviting the next person in could acknowledge it by just saying sorry for the wait?
Maybe it's too much to ask, but I think it shows that it's normal to be left waiting without any explanation or acknowledgement and the patient should be lucky if all is well and shut up.

Yes, I should have texted the MW back and asked about the consultant appointment, but in this case I just thought that if the MW booked it then it must be necessary. I will certainly make sure in the future that I know what each appointment is for.
I think though that even if I asked, it would have been made clear that it was necessary for me to have that appointment and I would have not argued with that. Only after having been there I realised that it was not essential and the same questions had already been answered.
So my time, the consultant's time and the people's time after me was wasted.

I thought this ridiculous practice of giving all patients the same time, such as 9am or 2pm had been outlawed a couple of years ago. It must have fallen by the wayside like the banning of mixed wards.

What if you're the one who serious problems being made to wait?
What if your appointment was meant to be in a ten minute appointment at 2:30, and because of all the delays you're sitting there at 3:30? do Kids collect themselves from school, or do you leave the consultants office saying that you have to go (and then your potentially serious problems are never seen.

For any scenario you can say but what about the person who does this, or that.
And any scenario can be countered with, what about the equally or more serious condition that is made to wait?

The problem isn't that people are occasionally made to wait, it's that everybody seems to wait all the time for hours.

It seems that the real problem is that there are more appointments booked than there are hours in the day.
It seems obvious that if you expect that an appointment should ideally last 15 minutes. That you should book a 20 minute slot, enabling a thorough level of care to be given, and notes to be written up properly.
Some appointments will overrun, some will under-run allowing time to be lost and made up throughout the day...
what seems to happen is that appointments are expected to last 15 minutes, so a ten minute slot is booked. patients are left waiting for hours and then feeling rushed.

It is bad service,
How would you feel if you were moving house and the estate/letting agent arrived a few hours late? with no reason or apology. -you'd call it bad service.
Or if a delivery company says they'll deliver between 8am - 11am so you plan your day, then they turn up at 2:30 wasting your day? -again bad service.

I don't think that anyone is expecting the consultants or nurses to be gushing with apologies, but it seems obvious that if "emergency situations are expected" (and they are) that it wouldn't be unreasonable to schedule appointments with enough margin to allow for this (averaged over a day), without having to rely on people leaving without having seen the person they had an appointment with because they have to get to work/school pickups/drop offs/childminders etc.

This approach of being grateful for delays and poor service infuriates me. Every country has poorly pregnant women but friends who have had babies in other countries do not have excessively long waits for appointments. If clinics are regularly running late then surely it makes sense to have a look at how other countries manage their patients appointments better.

People are so self centred at hospital appointments. They can't seem to open their minds to think that at a hospital, serious things might be going on behind the scenes. The NHS is not like a restaurant or a hotel 'service' may be a little slow but less than an hour is not unreasonable. You may very well find yourself waiting in a private hospital too. Shit happens and although in your world, picking your kids up from school might take priority, in a hospital, lives do.

they are self centred usually because they are ill, worried or in pain.

Spending an extra 5 hours waiting whilst ill, worried or in pain pretty much focuses your mind on your problem you are there to get fixed. You also have to think about the fact that your kids will be waiting to be picked up, the dog will have been crossing his legs for a couple of hours, you will need to eat something before you get even more ill, etc, etc.

But if I went private (have done so on 3 occasions) I would either be seen within 20 min or - on one occasion, with an emergency coming up with the appointment prior to mine, my appointment was rescheduled immediately the emergency came up, for a convenient time the next day.

brummie so sorry for you xx

I have experience of three countries maternity care now.

UK, I had a consultant appt, not sure what for, probably age related. Waited about 2hrs. DH was more upset as he'd taken time off work to accompany me, as you know, having a consultant appointment seemed to be serious. Was irritated it was per the OPs, couple of questions, in and out. Total waste of time for him who used to stress about taking time out from work. Midwife was lovely and popped in to see us after the birth as she'd had to go off shift to see DS1. Drop in centre for weighing etc was good too.

Canada. I would wait on average 3hrs to see my OBGYN for a 5min appointment. The longest time I waited was for 5 HOURS!! FIVE HOURS! With a 3yo. Who behaved impeccably considering the circumstances. It was common with this OBGYN and I only got in with him as a friend worked in the medical field and called in a favour. When I was in labour and ready to push, I WAS NOT ALLOWED TO until this 'rockstar' obgyn arrived. He had pride in the fact he attended EVERY birth of his patients babies. When DS2s heart rate started dropping, they let me push and the obgyn did arrive in time to see my DS arrive. Dreadful, arrogant man. When I was in my room, paid for a private room instead of ward. I kept saying I was so hot and sweaty, and had opened the window to let in fresh air. What no one told me was there was an a/c hose running the corridor (very old hospital, retrofitted system) and I was so hot because it was boiling outside and I was letting it all in. I didn't realise until DH came to visit and he kept popping out to the corridor to cool off .

After care nurse was awful. I mentioned in general chat that DS1 totally loved his brother, and he said to the cleaner in my room taking garbage "don't take our baby", she said, "that won't last" It has 7yrs later, as I knew it would. When she visited us in our temporary accommodation of 1 bed apartment with plenty of room, and we repeatedly told her we'd just moved there and had a 4 bed apt we were waiting to move into 2 weeks, she kept on criticising, saying this is no place for a newbaby, how can you live here, when are you moving etc...... And when trying to help me breastfeed, and DS1 was kicking off, as 3yo's do, she said "can you take him out, I can't work with all this noise" Utter, utter bitch.

USA. 5min wait maximum to see my OBGYN. One time I did wait an hour, but that was my fault. Someone else was at the counter so I didn't tell the receptionist I was there, just assumed she'd seen me. But I just waited as I figured they were attending a birth or something. When I asked how much longer it would be, they were most apologetic and couldn't understand how it had happened and saw me straight away, even though it was my stupid fault. I did have a 13hr wait to be admitted to hospital though, and saw a poor woman in full labour sitting in the waiting room when her waters broke in front of everyone. She wasn't admitted until that happened.

Otherwise I couldn't fault the care at all I received in the US. Nursing staff amazing, except for 1pair, when I mentioned to the patient care person, who did numerous visits to me to ensure all was well, that they were a bit flat and I wasn't comfortable with their care, he took them off my bed. He also arranged snacks to be delivered as they felt I wasn't eating enough (all meals tracked). My OBgyn didn't have priveleges at the hospital I was in, but came to visit me on the weekend, and phoned me during my stay. She has made followup calls to me to see how I'm getting on and I've had 2 followup appts with her so far all included.

The surgical teams were spot on, especially the anaethetist who had the most lovely blue eyes and really kept me calm in an emergency, making sure I was comfortable and warm, and explaining everything that was happening. My consultant gave me a hug when I was discharged as I offered him my hand to thank him for his care. The only Dr I never want to see again, short story, is my DDs consultant. She was Dr Doom and Gloom all the way.

I had a nurse practioner handling my case on discharge who would send me letters to see if I needed anything.

Yes, the insurance is horrendous if not partly covered by work. I only pay about $50 per fortnight towards it. A colleague has a teacher husband and he would have had to pay $800/mth if he couldn't be included on his wife's policy. But, the care here is great and I can see the sense in it, if you can afford it. The care for people who can;t afford it needs to be addressed, no one should be bankrupted due to medical bills.

That's a really interesting comparison Royal. Does Canada have an NHS or is funded by insurance?

Having a baby in the US is was comparatively very luxurious. Moreover they really can't afford to waste your time in waiting rooms, because you have a lot more choice in who your doctor is.

Aren't births in the US very medicalised?

Canada is NHS in style yes. There is a payment in the taxes that covers it. Each province does it slightly differently. In BC we paid CAD110/mth for a family for the health provision, in Quebec it was deducted in taxes etc..

From what I see most US births are hospital based, very few midwife units (same in Canada actually). There are maternity nurses, then your obgyn team, and then the neonatal team. (from what I saw based on my experience). Everyone is offered an epidural. Another thing I found really comforting was the separation of women admitted for antenatal issues. I was in a separate ward, private room, 5 patients to a nurse + nurse aid. Even after I gave birth, they returned me to that ward so I did not have to be on the post natal ward with new mums and their newborns.

The consultant had been sitting for 50 minutes with no patient in the room whilst I was waiting outside.

She could have been filing her nails, or might have forgot (quite likely as I was seen so quickly after asking about the delay) or performing some long distance life.saving thing in there on her own. Who knows. It was blatantly obvious that her time was worth more than mine. I got that message loud and clear!

I wa also in and out after 5 minutes. I don't think that she even knew what I was there for.