Monday, February 25, 2013

Appointment Fatigue

As a healthcare professional, when we meet with someone and it looks like the person could benefit from our services, we schedule them in for future appointments (often weekly). It seems fairly simple.

It never occurred to me to ask if the person actually had time in their lives to fit me in. I never asked what activities they would have to miss out on in order to meet with me. I had the arrogance to believe that meeting with me would automatically be more beneficial to the person than whatever else the person would be doing.

I am starting to question this. I am not questioning the effectiveness of therapy, but rather the lack of consideration of what it means for a person to have to attend regular appointments.

I had one client who was involved with several different services. Some were voluntary, and other were not, due to her history. She often had six or more appointments per week. Between dropping off and picking up her son from daycare, and all her appointments, she had very little time for anything else. Often, she was assigned tasks to complete between appointments as well, and frequently wondered when she was supposed to be following through with them.

Let's think about how much time one appointment really takes. If it is at an office, there is transportation involved. If you are driving, probably at least a half hour each way. If you are busing, probably an hour each way. Then there is time needed to find and walk from parking, and allowing a little extra time so that you are not late. Even if the appointment is in a person's home, there is time needed to tidy up the house.

Let's hope you do not have to wait to be seen. Then there is the time of the actual appointment. I always booked 1-1.5 hours for each client.

Wow - now one appointment has cost the client between 2.5 and almost 4 hours! That is a whole part of a day gone. Either the morning, afternoon, or evening is basically completely gone. If the client is part of a family, you have just disrupted the whole family's plans and routines for a whole part of a day.

Now, if the person was just going to be sitting around watching TV and feeling lonely, this is not a bad thing.

With the client I mentioned earlier, even though I thought OT would be beneficial for her, I ended up decreasing the frequency of my visits because I believed the stress of having so many appointments was negating the benefits.

I also see many stressed families who have little ones that have a lot of appointments. Parents are stressed because they have to take so much time off work. Evening appointments mean that the family does not get to sit and eat together, the child does not get exercise or outdoor time, and societal socialization is not happening. The therapy that is happening during the appointment better be worth it.

When one of my family members has an appointment, it is a big deal for us to try to fit it in. I guess we just need to keep it in mind when working with others.

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