|December 5, 2013
Broken medical appointments impair health care services to others
By B.L. Azure
ST. IGNATIUS — Broken scheduled medical appointments are often an overlooked medical issue — they are a big problem for the Confederated Salish and Kootenai Tribes’ Tribal Health and Human Services Department as well as the folks eligible for health care services there.
They compromise the care of the person missing the appointment as well as the care of another person that could potentially be using the missed time slot. Also the medical professionals have pre-invested time in preparing for the person that doesn’t show. They also are a drag on the bottom line of Tribal Health because of the domino effect it has on the medical services delivery staff that are left scrambling to fill the void, sometimes it can be filled with walk-ins but not all the time.
According to Dr. LeeAnna Muzquiz, MD, medical director of the Tribal Health and Human Services clinics in Polson, Ronan and Elmo, approximately one-third of scheduled medical appointments at those clinics are broken. Those numbers are similar in the south Flathead Reservation Tribal Health clinics in St. Ignatius and Arlee.
“It’s almost the same in every (THHS) clinic,” Muzquiz said. “It’ll never be 100 percent, that’s just the way it is but some people are just not serious about keeping their appointments and they probably don’t understand the problems it causes.”
When a person calls to schedule an appointment they are put into an open time slot in the medical provider’s schedule. When a person doesn’t show up it throws everything off balance. The THHS medical providers can pick up some of that balance with unscheduled walk-ins or emergencies but walk-ins and emergencies aren’t automatically there when people don’t show up. It creates inefficiency.
“We want to provide our patients with the best medical care we can but we can’t do that if they don’t show up for their appointments,” Muzquiz said. “And there is no real consequences for people breaking appointments. It seems we don’t hold people accountable for anything.”
At the very least people should call and let the clinics know if they can’t make an appointment, the sooner the better. That provides a bit of wiggle room that gives the medical providers time to squeeze-schedule someone else.
Tribal Health Director Kevin Howlett said private medical practices have a hammer that THHS lacks.
“In the private sector a person that misses an appointment will be charged for that time. We don’t have that option and really we don’t want to shut the door on people who need health care,” Howlett said. “Our only option is to ask people to be courteous to the providers and be considerate to their fellow tribal men and women who are in need of and are seeking medical care.”
The medical business accounts for one-sixth of the American economy and it is growing. Tribal Health adopted the medical professions business model a bit more than a decade ago. Then it switched from being primarily a bill payer to medical providers for services they provided to eligible tribal clientele to being a provider of health care services and billing third party resources for those services.
The switch from bill payer to bill sender has provided revenues that previously weren’t mined. The switch has meant an increase in medical professional and axillary employment opportunities, as well as Improved clinical facilities.
“People often complain about not being able to see a doctor or other medical professionals because the schedule is full. Medical practice is based on scheduled appointments. That is very important to the efficiency of the delivery of health care and to our ability to collect revenues for the services we provide,” Howlett said. “We currently have a third of medical appointments broken and that is unacceptable. We don’t have enough resources to accommodate this excessive no-show rate. When someone with a scheduled appointment is a no-show it deprives others of access because the time has already allotted to that no-show. I strongly encourage people who have scheduled a medical appointment to keep the appointment.”
To schedule an appointment or to cancel or reschedule, contact the THHS clinic in your area. Arlee: 726-3224; St. Ignatius: 745-3525; Ronan: 676-8778; Polson: 883-5541; Elmo: 849-5798; and, Hot Springs: 741-3266.