Access - Short Take on Access

What - In health care, lack of access boils down to waiting – waiting to get an appointment, waiting in the reception room, waiting in the emergency room, waiting for a diagnostic test, waiting for an operation, waiting for test results, waiting for the doctor to come to the phone.

Why – Waiting may be due to inefficient scheduling, over-scheduling, overcrowding in inadequate facilities, doctor shortages, office mismanagement, misinformed patients, or simply sloppy personnel policies. Whatever the cause, people are growing sick and tired of waiting for health care.

When – No one knows. Waiting times and limited access continue to grow.

How – To expand access and limit waiting times, doctors are addressing the problem through open scheduling, wave scheduling, longer hours, greater use of physician assistants and nurse practitioners, scribes accompanying doctors in emergency rooms to take notes and document encounters, patient generated computer histories, and opening of worksite clinics, in-store clinics, urgicenters, multispecialty ambulatory care centers in doctor-short rural areas; and borrowing of Disney World techniques in crowd control.

Where - Everywhere. This would seem to be inefficiency and linkage problems across the health system, but is most noticeable and manifest in emergency rooms, primary care offices, and hospitals operating at overload.

Who - Slow access effects patients in distress, but also overworked, overburdened doctors who can only handle one patient at a time, and only so many in any given day.