Features

‘Same Day’ Service Proves Both Late and Lengthy

From Susan Parker
Tuesday September 23, 2003

Last week I got a “same-day” appointment at Kaiser. 

A “same-day” appointment is for members who have something wrong with them, can’t wait the two or three weeks it may take to get an appointment with their regular doctor, but are not sick enough to go to the emergency room. 

Unfortunately “same-day” appointments aren’t always same day. 

I called on Friday at noon; I got an appointment for 8:30 a.m. on Monday.  

On Monday I saw a doctor who told me to cover my affliction with “warm compresses and not to touch it.” The entire meeting lasted five minutes—40 minutes less than the time it had taken me to make the initial appointment. I thought that her advice, “…use compresses, but don’t touch…” was slightly contradictory, but I did as I was told and by the end of the week I knew I was in trouble. 

Unable to move from the couch I vowed that if things weren’t better by Sunday night I’d make another appointment. But at 2 a.m. on Saturday I abandoned my plan. If I was going to lie awake all night in pain I might as well be in pain in the emergency room. At least, I thought, I’d be around others who could share in my misery.  

I drove to Kaiser in North Oakland. I went through security and stood in the brightly lit waiting room. There was no one at the information desk. The triage nurse was busy. 

I went to the registration desk, but no one was behind the glass partition. Across the room I saw an electric sign. It was new. I knew this because I’ve been to the ER waiting room many times before with my disabled husband. The sign was long and narrow and the words on it moved horizontally across the screen. It gave instructions in English and Spanish. “One:” it said, “Check in with the Desk Technician. Two: The Triage Nurse will call you. Three: The Registration nurse will register you. Four: If you have been waiting for longer than 30 minutes please tell a staff person and you will see a doctor.” 

I reread the sign. 

This was remarkable news. I’d never been to the emergency room when the wait to see a doctor was less than two hours. Sometimes it took longer. I looked at my watch. So far I’d been there 10 minutes. There was still no desk technician, or anyone at the registration desk. The triage nurse was with a patient. I waited and when she was free I approached her. “Sit down,” she said. “Open your mouth and let me take your temperature.” When she was through she told me to go to the registration desk.  

“Fifty dollars, please,” said the person who was now sitting behind the glass. The last time I had been to ER the charge had been $35. But it didn’t matter. I was in so much pain I would have paid with my left arm.  

I sat down and waited. I looked at my watch. I had been in the building for 25 minutes. The red neon sign kept spewing the same information. I decided to wait 30 minutes from the time I had registered before following the sign’s advice. 

At 3:10 a.m. the triage nurse was seeing a new patient. When she was finished I approached her. “The sign says that if I haven’t seen a doctor within 30 minutes I should tell you,” I said. “It’s been 45 minutes since I registered.”  

“What sign?” she asked.  

“The sign on the wall over there,” I pointed.  

“I’ve been on vacation,” she shrugged. “I don’t know anything about it, but I’ll find out for you.” 

Then she asked me to step aside so that she could take care of another patient. 

I went back to my seat. The triage nurse helped three more people. She had obviously forgotten my request. I went to the registration desk and asked the clerk about the sign.  

“What sign?” she asked.  

“The one over there that says I should tell someone if I haven’t seen a doctor within 30 minutes.”  

She squinted at the sign and read it as the words flipped by. “That sign is wrong,” she said. “Why don’t you ask the triage nurse about it.”  

“I did,” I answered. “But she’s busy and besides the sign says to ask a staff person. You’re a staff person, aren’t you?”  

The woman stared at me. “Yes,” she said. “I believe the sign was written that way because we’re having problems with our printer and if you don’t hear from us in 30 minutes it’s because the printer is jammed and we need to know about it.” 

“That’s not what the sign says,” I answered. I looked at my watch. “It’s been almost an hour since I registered. It’s been over 90 minutes hours since I’ve been in this room. I’d like to see a doctor.” 

“Yes,” she said. “I’ll see if I can get you a bed.”  

I knew what that meant. It meant that she was going to find a room to put me away in. It didn’t necessarily mean I’d see a doctor. 

To make a long story short, another hour went by and I finally saw a doctor. He took care of my problem. I was happy to have it solved. 

At 5 a.m. as I was leaving the emergency room I paused in front of the electric sign. It was still going ‘round and ‘round, promising something that wasn’t realistic.  

So here’s my message to Kaiser: Change the sign to read “If you don’t see a doctor within THREE HOURS tell a staff person.” 

Now I really do feel better.