Doctors need to talk about death instead of trying to keep patients alive at any cost

I like this title: Doctors need to talk about death instead of trying to keep patients alive at any cost.

This was the title used by Kate Mclean in her article:

Doctors Need To Talk About Death Instead Of Trying To Keep Patients Alive At Any Cost

https://www.huffpost.com/entry/doctors-talking-to-patients-death_n_5e272d2dc5b63211761a5c30?fbclid=IwAR1bhvrUUeHg-lmo2zKpsVGyLyaX0kbmmCuPRkBY9G-bsA9stqeLuJODiGY
I am an advocacy of this medical management since I started my private practice in 1982. I somehow formalized my advocacy when I started formulating my Self-declared Life Plan / Intentional Living Plan Program in 1994. I formalized my advocacy on this through my ROJ-OCIL on Intentional Living in October 2019.

I will continue to advocate this up to the time I die.

I am collecting articles written by other authors to support my advocacy. Here are 3 of them so far. I hope other people will show me more.

Doctors Need To Talk About Death Instead Of Trying To Keep Patients Alive At Any Cost
https://www.huffpost.com/…/doctors-talking-to-patients-deat…

My 92-Year-Old Father Didn’t Need More Medical Care
https://www.theatlantic.com/…/we-protected-my-term…/604312/…

Atul Gawande’s ‘Being Mortal’
nytimes.com
https://www.nytimes.com/…/atul-gawande-being-mortal-review.…

How to prepare yourself for a good end of life
sfchronicle.com

https://www.sfchronicle.com/…/How-to-prepare-yourself-for-t…

https://www.facebook.com/rjoson2001/posts/10155951427140800

May 7, 2019, 10:16 PM

How to prepare yourself for a good end of life
sfchronicle.com
DEATH AND DYING
HAPPY DEATH
GOOD END OF LIFE

This article supports, substantiates, affirms, validates and endorses (SSAVE) ROJoson’s Intentional Life Plan Project and Advocacy.

Some exceprts that I pick up from this article the SSAVES my Intentional Life Plan Project and Advocacy:

The peculiar problems of modern death — often overly medicalized and unnecessarily prolonged – …..

According to a 2017 Kaiser Foundation study, 7 in 10 Americans hope to die at home. But this is not happening. This state of affairs has many causes, among them fear, a culture-wide denial of death, ignorance of medicine’s limits, and a language barrier between medical staff and ordinary people.

Have a vision. Imagine what it would take you to die in peace and work back from there. Once you’ve got the basics clear, expand your horizons.

Stay in charge. If your doctor isn’t curious about what matters to you or won’t tell you what’s going on in plain English, fire that doctor.

Know the trajectory of your illness. If you face a frightening diagnosis, ask your doctor to draw a sketch tracking how you might feel and function during your illness and its treatments. A visual will yield far more helpful information than asking exactly how much time you have left.

When you become fragile, consider shifting your emphasis from cure to comfort and find an alternative to the emergency room.

Find your tribe and arrange caregivers.

Don’t wait until you’re at death’s door to explore your passions, deepen your relationships and find your posse.

Take command of the space. No matter where death occurs, you can bring calm and meaning to the room.

Clean house: Hospice nurses often list five emotional tasks for the end of life: thank you, I love you, please forgive me, I forgive you, and goodbye.

Think of death as a rite of passage. In the days before effective medicine, our ancestors were guided by books and customs that framed dying as a spiritual ordeal rather than a medical event. Without abandoning the best of what modern medicine has to offer, return to that spirit.

Over the years, I’ve learned one thing: Those who contemplate their aging, vulnerability and mortality often live better lives and experience better deaths than those who don’t. They enroll in hospice earlier, and often feel and function better — and sometimes even live longer — than those who pursue maximum treatment.

We influence our lives, but we don’t control them, and the same goes for how they end. No matter how bravely you adapt to loss and how cannily you navigate our fragmented health system, dying will still represent the ultimate loss of control.

But you don’t have to be a passive victim. You retain moral agency. You can keep shaping your life all the way to its end — as long as you seize the power to imagine, to arrange support and to plan.

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

I, ROJoson, have this template of Intentional Life Plan for those with terminal illness (about 6 months to live). This was adopted by GCG.
(https://rojosonnotesonlife.wordpress.com/…/my-intentional-…/)

My Intentional Life Plan

6 months (March 2019 – August 2019)

IF I HAVE MORE OR LESS 6 MONTHS TO LIVE, I WILL:

1. Try my best to stay alive and productive up to my last moment on earth.
2. Make peace with God.
3. Make peace with everybody.
4. Endorse my material possessions.
5. Make clutter management of my stuff.
6. Make an advance directive on how my family will manage me when I am near death and after I die.
7. Bond or maximize bonding with my family.
8. Enjoy myself to the maximum or fullest.

Will try to complete Nos. 2 to 6 as soon as possible without waiting for 6 months. Will try to complete Nos. 2 to 6 within 2 months as much as possible.

GCG has stage 4 pancreatic cancer (with liver metastasis).

As of May 2019, 2 months after she made her Intentional Life Plan, GCG has accomplished 1, 2, 3, 5, 6, 7, and 8. She is still finalizing No.4.

She has completed an advance health care directive staying that she does not want to die in the hospital and she does not want any form of life support system (she will just accept pain medications). She has made advance funeral and burial instructions (she wants cremation right away).



 

https://sites.google.com/site/rojocilonintentionalliving/certificate-for-grace-gatchalian

https://sites.google.com/site/rojocilonintentionalliving/certificate-for-marilou-torrecampo



END-OF-LIFE CARE
HOSPICE CARE
PALLIATIVE CARE

End-of-life care is the term used to describe the support and medical care given during the time surrounding death.

Hospice is provided for a person with a terminal illness whose doctor believes he or she has 6 months or less to live if the illness runs its natural course.

Palliative care is medical care for people living with a serious illness. This type of care is focused on relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.


What is terminally ill? definition and meaning

businessdictionary.com

Terminally Ill
A status assigned to a person who has been diagnosed with an illness and is expected to die within a certain time frame, usually six months.

Read more: http://www.businessdictionary.com/definition/terminally-ill.html#ixzz3wi5NDFbs

Terminal illness is a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a short period of time. This term is more commonly used for progressive diseases such as cancer or advanced heart disease than for trauma. In popular use, it indicates a disease that eventually ends the life of the sufferer.
Wikipedia

The status of a person expected to die within 6 months from a specific condition, and thus may need hospice care
Medical Webster Dictionary

 

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Breast Cancer Survivor Corazon Bermudez – 10 Years in Remission

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ROJ@20jan21

Posted in Breast Cancer Survivors | Leave a comment

ROJoson’s Practice of Medicine

ROJoson’s Practice of Medicine

 

When I am not in my clinic seeing patients,

When I am not in the operating rooms doing surgery,

When I am not in the hospital making rounds,

 

 

I am usually at home doing telemedicine:

Online consultation

Online medical teaching

Online medical writing

 

 

Part of my Intentional Living Plan.

Being productive!

Being compassionate to my patients and patients in need!

Continually strengthening my Education on Health Development in the Philippines Program!

Part of my Patient Empowerment Program!

Part of my Patient-centered Care Management Program!

 

 

Actually, been doing this in the past,

full circle, when I started my Facebook project in June 16, 2011.


ROJ@20jan9

Posted in Practice of Medicine | Leave a comment

ROJoson Medical Recordings in Clinic

Samples of usual ROJoson medical recordings in clinic

ROJoson’s Way

Done with a duplicate copy which is given to patient for keep, study and review.

With illustrations.

With explanations.

With instructions.

With signature as a sign of acknowledgement, understanding and informed consent.

With legible handwriting.

he 001

 

za 001.jpg

 

rojoson_way


ROJ@20jan8

Posted in Medical Recording | Leave a comment

Teaching patients on how to palpate for a lump

Patient Empowerment Program of ROJoson

Teaching patient and her husband how to detect or feel for a true lump using my lump on my left arm.

To enable them to detect surface lumps in any part of the body, particularly the breast.

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I also taught husband of patient so that he can assist his wife.
Above pictures taken 20jan7


I have a lump on my left forearm which I think is a lipoma.  It has been there for more than 20 years now.  Patients have been asking me why I don’t have it removed.  I always answer that I am using it to teach patients and medical students.

 



Slide25



ROJ@20jan8

Posted in Patient Empowerment Program | Leave a comment

ROJoson Medical Clinic Booked Appointment Performance – 2018


Year-end 2018 Summary Report

As I completed my last clinic for the year (December 22) [although I will still hold a special clinic session on December 27], here is a summary report on the performance of my booked appointment time system in ROJoson Medical Clinic for 2018.
 
1. I was late only once (1) in starting my clinic for the whole year in February 2018; I had a prolonged pre-clinic operation; and I gave advance notice to my patients that I would be late. Despite this, the mean waiting time in the session that I was late was still 52 minutes (within the target of no more than 60 minutes) with a range of 37-65 minutes.
 
2. A total of 19 patients waited for than 60 minutes from the booked appointment time. Range: 62 to 80 minutes with a mean of 66 minutes and a mode of 68 minutes.
 
3. The range of waiting time from the booked appointment was 0 to 80 minutes. The overall mean waiting time (from booked appointment time) was 7 minutes.
 
I am happy with the system and my patients are also happy (I hope). The patients do not have to wait for a long time during a patient consultation with me.
 
I will continue with the refined system of 2019 and I will maintain the target in 2019 – no more than 60 minutes waiting time from the booked appointment time.
 
I hope those patients who have experienced my system of booked appointment time will validate my above report and give me a feedback.
 
Dr. Rey

Areas for Improvement:

 
In 2016, from October to December 2016, only patient waited for more than 60 minutes.  In 2017, 7 patients waited for more than 60 patients.  In 2018, 19 patients waited for more than 60 patients.


The number of booked patients in 2018 was about 30 more than in 2017. I don’t think this was a major factor.  
 
The major factor was a prolonged consultation time of some patients. 
 

RESOLUTION: I will be more vigilant in keeping track and controlling (to set a limit if needed) the long consultation time of patients.




Booked Appointment Performance – December 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

One (1) patient waited for more than 60 minutes from booked appointment time (62 minutes).   Reason: prolonged consultation time of previous patients.  

Overall, the range of waiting time was 0 – 62 minutes with a mean of 6 minutes. 

There were 4 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the sessions this month.

There were 15 lates and no shows of patients.  Have to issue reminders again.

December 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
1 1 1 0-50 11
4 2 1 0 0
6 2 0 0 0
13 3 2 0-58 9
15 3 1 0-12 1
18 1 1 0 0
20 1 0 0-62 28
22 2 1 0 0
         
8 15 7 0-62 6


Booked Appointment Performance – November 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time.  ACHIEVED!

Overall, the range of waiting time was 0 – 48 minutes with a mean of 4 minutes. 

There were 5 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 11 sessions this month.

There were 11 lates and 15 no shows of patients.  Have to issue reminders again.

November 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
6 0 1 0-48 10
8 2 1 0-5 1
10 0 0 0 0
13 2 3 0-45 16
15 0 0 0 0
17 2 1 0-10 1
20 1 3 0 0
22 1 2 0 0
24 1 4 0 0
27 1 0 0-20 10
29 1 0 0-24 2
         
11 Sessions 11 15 0-48 4


Booked Appointment Performance – October 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time. ACHIEVED!

Overall, the range of waiting time was 0 – 60 minutes with a mean of 6 minutes. 

There were 4 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 13 sessions this month.

There were 17 lates and 15 no shows of patients.  Have to issue reminders again.

October 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 1 2 0-32 7
4 0 2 0-2 1
6 3 2 0-12 2
9 0 0 0-46 21
11 3 0 0 0
13 1 3 0-27 6
16 1 2 0-7 1
18 0 2 0-22 7
20 2 0 0 0
23 1 0 0-60 16
25 1 1 0 0
27 1 1 0 0
30 1 1 0-43 15
         
13 Sessions 17 15 0-60 6

Booked Appointment Performance – September 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time. ACHIEVED!

Overall, the range of waiting time was 0 – 38 minutes with a mean of 3 minutes. 

There were 4 clinic sessions with zero waiting time.  

I was not late in coming to my clinic for the 8 sessions this month.

There were 13 lates and no shows of patients.  Have to issue reminders again.

September 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
1 0 2 0 0
4 0 2 0-18 3
6 4 0 0 0
8 0 1 0-10 1
11 3 0 0-38 15
13 0 1 0-5 1
18 4 1 0 0
20 0 3 0 0
         
8 Sessions 13 8 0-38 3

Booked Appointment Performance – August 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

Nine patients waited for more than 60 minutes from booked appointment time – 3 on August 2, 2018; 1 on August 4, 2018; and 5 on August 23, 2018.  My APOLOGY!  The unmet target of waiting time was due to prolonged consultation time of some patients.  The mean waiting times in these 3 days, however, were within target (39, 29, and 41 minutes respectively).

Overall, the range of waiting time was 0 – 76 minutes with a mean of 10 minutes. 

There were 5 clinic sessions with zero waiting time.  

I was not late in coming to my clinic for the 12 sessions this month.

There were 25 lates and 14 no shows of patients.  Have to issue reminders again.

August 2018 Late No-show Range of  Waiting Time (From Booked Appt Time) Mean Waiting Time
2 1 0 0-75 39
4 1 0 0-69 29
7 1 0 0 0
9 1 4 0 0
11 6 4 0 0
14 1 1 0 0
16 3 2 0 2
18 3 0 0-55 4
23 1 2 1-76 41
25 4 1 0 0
28 1 0 0-12 2
30 2 1 0-9 1
         
12 Sessions 25 14 0-76 10


Booked Appointment Performance – July 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

Three patients waited for more than 60 minutes from booked appointment time.  

July 17, 2018 – My apology goes to F. Alcales and L. Laporteza who waited for more than 60 minutes from their booked appointment time (8 and 20 minutes longer). The long waiting time was partly contributed by the floods and rain on that day that somehow disrupted the flow of schedule (5 cancellations and no-shows) and prolonged consultation time of some patients.

Despite this, the range of waiting time on that day was 0 to 80 minutes with a mean of 45 minutes (still within the target of 60 minutes).

 

July 28, 2018 – My apology goes to J. Catacutan who waited for more than 60 minutes from her booked appointment time (3 minutes longer).  The long waiting time was contributed by a prolonged consultation time of a patient prior to her (56 minutes consultation time).

Despite this, the range of waiting time on that day was 0 to 63 minutes with a mean of 21 minutes (still within the target of 60 minutes).

My APOLOGY!

Overall, the range of waiting time was 0 – 80 minutes with a mean of 10 minutes. 

There was 1 clinic session with zero waiting time.  

I was not late in coming to my clinic for the 12 sessions this month.

There were 27 lates and 18 no shows of patients.  Have to issue reminders again.

July 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
3 2 1 0-15 7
5 1 2 0-34 14
7 3 1 0-48 9
10 1 1 0-38 10
12 3 0 0 0
17 1 5 0-80 45
19 4 2 0-28 7
21 2 3 0-8 1
24 1 0 0-24 5
26 4 1 0-17 1
28 3 0 0-63 21
31 4 2 0-6 4
         
12 Sessions 27 18 0-80 10


Booked Appointment Performance – June 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

ACHIEVED.

Overall, the range of waiting time was 0 – 45 minutes with a mean of 8 minutes. 

There was 1 clinic session with zero waiting time.  

I was not late in coming to my clinic for the 11 sessions this month.

There were 26 lates and 18 no shows of patients.  Have to issue reminders again.

June 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 1 4 0-7 1
5 3 1 0-45 15
7 3 1 0-22 7
9 4 4 0-37 12
14 1 1 0-20 4
16 7 0 0-45 31
19 3 0 0 0
21 0 2 0-27 13
23 1 2 0-30 3
28 1 3 0-6 1
30 2 1 0-23 3
         
11 Sessions 26 18 0-45 8

January to June 2018: Only 6 patients waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – May 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

One patient waited for more than 60 minutes from booked appointment time (74 minutes – 14 minutes beyond).  This was due to prolonged consultation time of some patients before this patient.   Resolution:will be more vigilant in keeping track and controlling (to set a limit if needed) the long consultation time of patients.

Overall, the range of waiting time was 0 – 74 minutes with a mean of 9 minutes. 

There was 1 clinic session with zero waiting time.  

I was not late in coming to my clinic for the 11 sessions this month.

There were 18 lates and 16 no shows.  Have to issue reminders again.

May 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
3 1 4 0-13 1
5 1 1 0-13 2
8 1 1 0-28 13
15 0 1 0-39 13
17 2 1 0-22 4
19 2 1 0-20 3
22 3 2 0 0
24 4 1 0-74 18
26 2 2 0-60 37
29 2 0 0-31 6
31 0 1 0-20 7
         
11 Sessions 18 16 0-74 9

Booked Appointment Performance – April 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

One patient waited for more than 60 minutes from booked appointment time (65 minutes – 5 minutes beyond).  This was due to prolonged consultation time of some patients before this patient.   Resolution:will be more vigilant in keeping track and controlling (to set a limit if needed) the long consultation time of patients.

Overall, the range of waiting time was 0 – 65 minutes with a mean of 7 minutes. 

There was 1 clinic session with zero waiting time.  

I was not late in coming to my clinic for the 11 sessions this month.

There was deterioration in the number of LATES (from 9 last month to 30 this month) and NO-SHOWS (from 9 last month to 11 this month).  Have to issue reminders again.

April 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
3 2 0 0-65 27
5 3 2 0 0
7 1 6 0-10 0
10 2 1 0-9 2
12 3 2 0-8 2
14 4 0 0-18 13
17 3 2 0-35 18
21 3 2 0-17 1
24 4 1 0-15 4
26 1 5 0-15 3
28 4 0 0-18 2
         
11 Sessions 30 11 0-65 7


Booked Appointment Performance – March 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

Three patients waited for more than 60 minutes from booked appointment time (all at 68 minutes – 8 minutes beyond).  One was due to starting late in my clinic session because of a hitch in clinic use.  Two were due to prolonged consultation time.   The range of waiting time in the 2 sessions where there was prolonged waiting time of patients were 0-68 minutes with a mean of 9 minutes (1st session) and 18-68 minutes with a mean of 42 minutes (2nd session).

Overall, the range of waiting time was 0 – 68 minutes with a mean of 8 minutes. 

There were 2 clinic sessions with zero waiting time. 

I was never late in coming to my clinic.

There is improvement in the number of LATES (from 21 last month to 9 this month) and NO-SHOWS (from 14 last month to 9 this month).  THANK YOU FOR YOUR COOPERATION.


Appeal to patients who book for appointment in ROJoson Medical Clinic to reduce the number of lates and no-shows:

PLEASE DO NOT BE LATE! Be at the clinic at least 30 minutes before the booked appointment time.

PLEASE CANCEL YOUR APPOINTMENT AT THE LATEST ONE DAY BEFORE SO THAT IT WILL NOT BE COUNTED AS NO-SHOW!

Thank you.

Dr. Rey

March 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
1 0 2 0-7 1
3 0 1 0-35 3
6 1 2 0 0
8 0 0 0-37 8
10 0 0 0-8 1
13 1 0 0-36 20
15 1 1 0 0
17 2 1 0-39 11
20 1 0 0-68 9
22 0 0 18-68 42
24 1 1 0-16 2
27 2 1 0-16 4
         
12

Sessions

9 9 0-68 8


Booked Appointment Performance – February 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

One patient waited for more than 60 minutes from booked appointment time. I was one-hour late in that clinic session because of a prolonged operation. The range of waiting time in that session was 37-65 minutes with a mean of 52 minutes.

Overall, the range of waiting time was 0 – 65 minutes with a mean of 11 minutes. 

There were 3 clinic sessions with zero waiting time. 

As mentioned above, I was late in one session because of prolonged operation.  I called up my secretary to tell patients I would be late.

Have to keep reminding patients on LATES (21) and NO-SHOWS (14).


Appeal to patients who book for appointment in ROJoson Medical Clinic to reduce the number of lates and no-shows:

PLEASE DO NOT BE LATE! Be at the clinic at least 30 minutes before the booked appointment time.

PLEASE CANCEL YOUR APPOINTMENT AT THE LATEST ONE DAY BEFORE SO THAT IT WILL NOT BE COUNTED AS NO-SHOW!

Help me reduce the number of lates by 50% in March 2018 from 21 in February 2018 to 10!
Help me reduce the number of no-shows by 50% in March 2018 (from 14 to 7)!

Thank you.

Dr. Rey


February 2018 Late No-show Range of  Waiting Time (From Booked Appt Time) Mean Waiting Time
1 2 1 37-65 52
3 1 0 15-39 6
6 1 2 15-44 26
8 1 3 0-35 13
13 3 0 0 0
15 4 2 0 0
17 3 1 0-12 1
20 4 1 0 0
22 0 0 0-24 10
24 2 4 0-26 3
         
10 Sessions 21 14 0-65 11


Booked Appointment Performance – January 2018

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time.  The range of waiting time was 0 – 31 minutes with a mean of 3 minutes. 

There were 4 clinic sessions with zero waiting time.  

NO late in coming to clinic – ROJoson

Have to keep reminding patients on LATES (33) and NO-SHOWS (15).

January 2018 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
4 0 4 0 0
6 4 0 0-24 5
11 1 3 0-5 3
13 0 1 0-30 6
16 1 1 0-14 2
18 4 0 0 0
20 4 2 0 0
23 7 1 0-31 8
25 4 1 0 0
27 3 0 0-26 11
30 5 2 0 0
         
11 Sessions 33 15 0-31 3

 


ROJ@19dec21

Posted in Waiting Time in Clinic | Leave a comment

ROJoson Medical Clinic Booked Appointment Performance – 2019

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2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero. 

RESULT:

January to December 2019 Performance – so far only ONE (1) patient waited for more than 60 minutes from booked appointment time.

There were 137 sessions up to December 21, 2019.

The range of waiting time from the booked appointment time was 0-69 minutes.

The mean waiting time was 5 minutes.

2020 Resolutions:

WILL CONTINUE THIS NO QUEUING – NO LONG WAITING OF PATIENTS IN MY CLINIC POLICY IN 2020 (started in 2015).
WILL CONTINUE TO STRENGTHEN AND REFINE MY LEGACY OF No Queuing – No Long Waiting Time in Clinic.
In 2018, only a total of 19 patients out of more than 1000 patients waited for than 60 minutes from the booked appointment time. Range: 62 to 80 minutes with a mean of 66 minutes and a mode of 68 minutes.
The range of waiting time from the booked appointment was 0 to 80 minutes. The overall mean waiting time (from booked appointment time) was 7 minutes.
In 2019, the target number of patients waiting for more than 60 minutes was not more than 10, if not zero. Only one patient waited for more than 60 minutes from the booked appointment time. Range: 0 to 69 minutes with a mean of 5 minutes and a mode of 5 minutes.
2020 – Will maintain the 2019 target: not more than 10, if not zero.
HOPE ALL PHYSICIANS WILL DO THEIR BEST NOT TO BE LATE IN STARTING THEIR CLINICS AND NOT TO MAKE PATIENTS WAIT, IF PATIENTS HAVE TO WAIT, NOT MORE THAN ONE HOUR.




Booked Appointment Performance – DECEMBER 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 47 minutes with a mean of minutes. 

There were four (4) clinic sessions (out of 8 sessions) with totally zero waiting time.  

I was not late in coming to my clinic for the 8 sessions this month.

There were 37 lates and 7 no shows of patients.  Have to issue reminders again.

December 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
5 6 1 0-22 10
7 4 0 0 0
10 4 2 0 0
12 4 2 0 0
14 4 0 0-46 14
17 8 1 0 0
19 1 0 0-47 7
21 6 1 0-40 26
8 sessions 37 7 0-47 7

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero. 

January to December 2019 Performance – so far only ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – NOVEMBER 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 60 minutes with a mean of minutes. 

There were four (4) clinic sessions (out of 11 sessions) with totally zero waiting time.  

I was not late in coming to my clinic for the 11 sessions this month.

There were 27 lates and 17 no shows of patients.  Have to issue reminders again.

November 2019 Late No-show Range and Mean Waiting Time (From Booked Appt Time) Mean Waiting Time
5 3 2 0 0
7 1 0 10-40 24
2 2 1 0-60 25
12 4 3 0-45 24
14 2 0 5-36 13
16 2 3 0 0
19 2 0 0 0
21 4 2 0-21 5
23 4 1 0-45 8
26 0 4 0-10 2
28 3 1 0 0
11 sessions 27 17 0-60 9

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero. 

January to November 2019 Performance – so far only ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – OCTOBER 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 50 minutes with a mean of minutes. 

There were nine (9) clinic sessions (out of 14 sessions) with totally zero waiting time.  

I was late in starting clinic on 2 occasions (out of 14) because of prolonged operation before clinic but just 2 minutes and 5 minutes late on the 2 occasions.

There were 31 lates and 12 no shows of patients.  Have to issue reminders again.

October 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
 1 3 0 0 0
3 4 0 0-6 1
5 5 1 0 0
8 3 0 0 0
10 0 0 5-33 16
12 0 3 0 0
15 3 2 2-35 21
17 1 3 0-15 3
19 4 0 0 0
22 0 1 0 0
24 4 1 0 0
26 3 0 0 0
29 0 1 0 0
31 1 0 0-50 25
14 sessions 31 12 0-50 5

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero. 

January to October 2019 Performance – so far only ONE (1) patient waited for more than 60 minutes from booked appointment time.
 


Booked Appointment Performance – SEPTEMBER 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 60 minutes with a mean of minutes. 

There were two (2) clinic sessions (out of 6 sessions) with totally zero waiting time.  

I was not late in coming to my clinic for the 6 sessions this month.

There were 13 lates and no shows of patients.  Have to issue reminders again.

September 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
3 2 0 0 0
17 3 3 0-60 34
19 4 0 0-25 4
21 0 3 0 0
24 3 1 0-13 1
26 1 0 0-15 3
6 sessions        

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to September 2019 Performance – ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – AUGUST 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 30 minutes with a mean of minutes. 

There were seven (7) clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 14 sessions this month.

There were 39 lates and 24 no shows of patients.  Have to issue reminders again.

August 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
1 3 1 0 0
3 1 6 0-5 1
6 2 3 0 0
8 0 0 0-20 6
10 3 0 0-15 5
13 4 1 0 0
15 4 0 0 0
17 5 1 0 0
20 5 0 0-21 3
22 1 1 0 0
24 3 3 0 0
27 1 2 0-9 2
29 2 2 0-30 8
31 5 3 0-19 1
         
14 Sessions 39 24 0-30 2

 

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to August 2019 Performance – ONE (1) patient waited for more than 60 minutes from booked appointment time.

 



Booked Appointment Performance – JULY 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 55 minutes with a mean of minutes. 

There were four (4) clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 13 sessions this month.

There were 36 lates and 20 no shows of patients.  Have to issue reminders again.

July 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 2 3 0-22 7
4 4 1 0 0
6 4 3 0 0
9 1 1 0-14 8
11 5 0 0 0
13 3 1 0-45 19
16 1 1 0-15 3
18 1 3 0-5 1
20 1 1 0-14 3
23 1 1 0-35 23
25 2 2 0-27 5
27 3 3 0-10 0
30 0 0 0 18
         
13 Sessions 36 20 0-55 7

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to July 2019 Performance – ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – JUNE 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 43 minutes with a mean of minutes. 

There were two clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 12 sessions this month.

There were 20 lates and 13 no shows of patients.  Have to issue reminders again.

June 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
4 0 1 0-15 3
6 1 2 0-14 4
8 1 2 0 0
11 1 0 0-43 19
13 1 1 0 0
15 2 1 0-30 17
18 2 0 0-7 2
20 3 0 0-18 2
22 1 1 0-16 3
25 2 1 0-41 10
27 1 2 0-28 10
29 5 2 0-10 1
         
12 Sessions 20 13 0-43 5

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to June 2019 Performance – ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – MAY 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time

Overall, the range of waiting time was 0 – 54 minutes with a mean of minutes. 

There were 5 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 13 sessions this month.

There were 30 lates and 16 no shows of patients.  Have to issue reminders again.

May 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 1 3 0 0
4 6 2 4-15 3
7 1 1 0 0
9 2 0 0 0
11 2 2 0 -9 2
14 1 0 0 0
16 2 4 0 -11 4
18 3 1 0-6 1
21 2 1 0 -30 8
23 5 0 0-33 12
25 1 2 0-17 2
28 2 0 0 0
30 3 0 0-54 27
         
13 Sessions 32 16 0-54 5

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to May 2019 Performance – ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – APRIL 2019

Target: NO patient will have a waiting time for more than 60 minutes from booked appointment time.

ONE (1) patient waited for more than 60 minutes from booked appointment time. REASON: Prolonged consultation time of previous patients. 

Overall, the range of waiting time was 0 – 69 minutes with a mean of minutes. 

There were 6 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 10 sessions this month.

There were 24 lates and 17 no shows of patients.  Have to issue reminders again.

April 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 2 1 0 0
4 1 3 0 0
6 3 0 0 -20 3
11 4 3 0 – 8 1
13 1 2 0 – 45 32
16 3 2 0 0
23 3 2 0 0
25 2 2 0-69 34
27 4 1 0 0
30 0 2 0
         
10 Sessions 24 17 0-69 7

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to April 2019 Performance – ONE (1) patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – March 2019

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NO patient waited for more than 60 minutes from booked appointment time.  ACHIEVED!

Overall, the range of waiting time was 0 – 30 minutes with a mean of minutes. 

There were 4 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 12 sessions this month.

There were 39 lates and 14 no shows of patients.  Have to issue reminders again.

March 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 4 2 0-17 5
5 2 1 0-10 1
7 3 0 0 0
12 5 0 0 0
14 5 3 0 0
16 6 2 0 0
19 4 0 0-27 5
21 1 0 0-30 6
23 3 1 0-17 4
26 2 2 0 -6 1
28 2 1 0-14 2
30 2 2 0-15 2
         
12 Sessions 39 14 0-30 2

 

2019 Resolution: The number of patients waiting for more than 60 minutes will not be more than 10, if not zero.

January to March 2019 Performance – still ZERO number of patient waited for more than 60 minutes from booked appointment time.


Booked Appointment Performance – February 2019

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NOpatient waited for more than 60 minutes from booked appointment time.  ACHIEVED!

Overall, the range of waiting time was 0 – 25 minutes with a mean of 3 minutes. 

There were 5 clinic sessions with totally zero waiting time.  

I was 15 minutes late once in coming to my clinic. This was due to a difficult operation that I experienced before start of clinic. However, this did not cause any patient to wait for more than 60 minutes during this clinic session.

There were 37 lates and no shows of patients.  Have to issue reminders again.

February 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
2 2 0 0-30 5
7 1 2 0 0
9 8 1 0 -20 4
12 2 1 0 0
14 3 0 0-25 12
16 1 1 0-25 7
19 2 0 0 0
21 2 0 0 0
23 9 0 0-23 3
26 2 1 0 0
28 5 1 0-6 1
11 Sessions 37 7 0-25 3


Booked Appointment Performance – January 2019

Target: No patient will have a waiting time for more than 60 minutes from booked appointment time.

NOpatient waited for more than 60 minutes from booked appointment time.  ACHIEVED!

Overall, the range of waiting time was 0 – 55 minutes with a mean of 3 minutes. 

There were 4 clinic sessions with totally zero waiting time.  

I was not late in coming to my clinic for the 13sessions this month.

There were 27 lates and 12 no shows of patients.  Have to issue reminders again.

January 2019 Late No-show Range of Waiting Time (From Booked Appt Time) Mean Waiting Time
3 0 0 0 0
5 2 2 0 -5 1
8 1 1 0 -8 1
10 2 0 0 0
12 1 2 0-16 21
15 4 0 0 -36 4
17 1 1 0 0
19 2 1 0 0
22 2 1 0-55 35
24 3 1 0-12 2
26 2 2 0-25 4
29 4 0 0-43 18
31 3 1 0-21 3
13 Sessions 27 12 0-55 5



2019 Resolutions:

 
WILL CONTINUE THIS NO QUEUING – NO LONG WAITING OF PATIENTS IN MY CLINIC POLICY IN 2019 (started in 2015).
WILL CONTINUE TO STRENGTHEN AND REFINE MY LEGACY OF No Queuing – No Long Waiting Time in Clinic.
In 2018, only a total of 19 patients out of more than 1000 patients waited for than 60 minutes from the booked appointment time. Range: 62 to 80 minutes with a mean of 66 minutes and a mode of 68 minutes.
The range of waiting time from the booked appointment was 0 to 80 minutes. The overall mean waiting time (from booked appointment time) was 7 minutes.
In 2019, I will try my best to decrease the number of patients waiting for more than 60 minutes to not more than 10, if not zero.
HOPE ALL PHYSICIANS WILL DO THEIR BEST NOT TO BE LATE IN STARTING THEIR CLINICS AND NOT TO MAKE PATIENTS WAIT, IF PATIENTS HAVE TO WAIT, NOT MORE THAN ONE HOUR.

ROJ@19dec21

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