Confused about this interview question

[aldol16]

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I mean that's just interviewing for the sake of conversation at that point. Nothing wrong with that, but it can get a bit carried away into some fantasy world.

Well, it depends on what the question is. Some scenarios are very far-flung, but a straight answer to them provides insight into the candidate's moral compass. Usually an applicant's true ethical and moral standards can be revealed only in black-or-white situations that are highly unlikely to occur in real life.

 

[vendtex]

Again why? It makes absolutely no sense at all, because it's the actual number of patients seen and billed that matters. The 15-min rule is there because ideally in a workday, you'll see 28 patients in 7 hours + a noon break. It's the count that matters.

This is also assuming that there aren't cancelled appointments, and somehow each patient takes 15 minutes or longer.



Ideally, i would really just spend most time with each patient regardless of time of day, but facilities apparently close by the end of the workday, so the necessary tests can't be done until the next day.

Ok but until you assess the patient you don't know if tests are even needed.


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[MDProspect]

Again why? It makes absolutely no sense at all, because it's the actual number of patients seen and billed that matters. The 15-min rule is there because ideally in a workday, you'll see 28 patients in 7 hours + a noon break. It's the count that matters.

Okay, you are expected to see 28 per day. You took longer than 15 min per visit. Now you are not meeting your quota. Assuming that you cannot stay past closing, how would you explain it to the management?

Edit: "It's near closing time that becomes an issue, and we would have to prioritize accordingly (who waited longest, severity of conditions, regular checkup vs first time etc.)" I would never come back to your office, if I wasted my time waiting for my appointment only for someone to tell me that, I am sorry but we have someone else who needs our services more than you do.

 

[vendtex]

https://depts.washington.edu/bioethx/toc.html

Sorry I don't see anything relevant to the question you were asked.


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[Lawpy]

Well, it depends on what the question is. Some scenarios are very far-flung, but a straight answer to them provides insight into the candidate's moral compass. Usually an applicant's true ethical and moral standards can be revealed only in black-or-white situations that are highly unlikely to occur in real life.

Even with straight answers, you will still get quizzed with several more questions regarding opposing scenarios as attempts to undermine your position.

Ok but until you assess the patient you don't know if tests are even needed.


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All patients scheduled that day will be assessed. It's just that it becomes more difficult to completely and thoroughly assess them at the end of the day, because of closing facilities. So they would most likely have to schedule a followup

Okay, you are expected to see 28 per day. You took longer than 15 min per visit. In the 8 hours of the work day, you used up more than 15 min, so now you are not meeting your quota. Assuming that you cannot stay past closing, how would you explain it to the management?

A little confused. If i can't stay past closing time and each patient takes longer than 15 minutes, i won't be able to see 28 patients that day. Why did it take longer than 15 min per patient? Because all the patients i saw had various medical conditions, and i had to refer them to carious specialists, prescribe additional medications, order new tests, etc. These will all contribute to the billing in the end. Insurance companies would be happy, and indirectly so will the practice and management.

 

[vendtex]

Even with straight answers, you will still get quizzed with several more questions regarding opposing scenarios as attempts to undermine your position.



All patients scheduled that day will be assessed. It's just that it becomes more difficult to completely and thoroughly assess them at the end of the day, because of closing facilities. So they would most likely have to schedule a followup



A little confused. If i can't stay past closing time and each patient takes longer than 15 minutes, i won't be able to see 28 patients that day. Why did it take longer than 15 min per patient? Because all the patients i saw had various medical conditions, and i had to refer them to carious specialists, prescribe additional medications, order new tests, etc. These will all contribute to the billing in the end. Insurance companies would be happy, and indirectly so will the practice and management.

It's a fake scenario unlikely in real life. Don't fret it.


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[salemstein]

If the 15-min rule was official policy, I would A) See if the patient's condition necessitates the extra 15 mins (from my experience shadowing docs, many times what a patient perceives as threatening is far from what really is going on, and vis versa) B) Consider if the patient has an underlying condition that does not favor having him/her to delay to a later date. Kinda extreme but if the patient is showing symptoms of a heart attack, I'm certainly not going to send him off and be like "times up, see you next time for further diagnosis, good luck" C) I need to know my schedule after treating this patient.

Predictably, this is when the interviewer may interject with new information, and here is how I will respond to each case:
Case 1: You have a light schedule -Duh, I'm gonna spend the extra 15 mins. I can easily make up for it later.
Case 2: You have a heavy schedule - I would refer back to A and B. If his condition is a "non-issue" AND (b/c I'm a good physician who previews my cases before starting the day) if my later patients have a higher probability for having something that necessitates serious attention, I would defer.
Case 3: You have a light schedule, but mgmt is really anal about the 15 min rule - I would detract from the 15 min rule if the patient is suffering from something that requires additional attention. Also, my light schedule gives me an easier time playing "catch up"
Case 4: heavy schedule, anal mgmt - See case 2, but I would also put more pressure on myself to really care for patients in a shorter amt of time, even if it sacrifices a bit of the bonding. I'd also apologize to mgmt for what happened, while explaining the rationale behind my decision.

 

[dwgrubbs1s]

I would say it would depend on several factors. Keep in mind that not every patient you see will require the maximum 15 minutes. (Depending on where you work). So sometimes, spending extra time with a certain patient would not throw the schedule off because the next patient may require far less time. Personally, I would never say "Times up, see ya later". However, depending on the situation and how much extra time would be needed, common sense has to be used. Spending an hour with someone just because your determined to figure out what is wrong that day (unless it was an urgent scenario or could do great harm to the patient not knowing what was wrong in a very short time) would not be feasible. I would personally answer the question by saying that I would void the time, and then explain the logic behind why you would void the time. Taking care of patients is the first priority, but you also have to be smart about how you do so, and do it in a feasible manner.

 

[Petrichor1]

Firstly, I don't know if I would want to sign up for an organization that mandates only 15 minutes with a patient (I get it if they 'recommend' that to me). But that's not the question.

My decision: I would probably learn how to pace conversations through my rough days. During training time, it is expected that you will often trip up on the hours and work longer because you don't have the skills. However, as you become more experienced, understanding questions that make people talk and open up more on their history is vital. In a way, even though the organization is treating you like a computer (inputting and outputting data) it is teaching you a very vital lesson. I would probably learn about where I need to be in the first 5 minutes mark. Then if things don't change at the 10 minute mark, I would start setting up a longer appointment at a day that is convenient for the patient. I would order the labs that would best target with the patient's health and when those return, I would make the patient come back with a more well established time range. This is just like scanning a situation. You don't just rush into things. It gives both you and the patient time to understand what is the problem. What is more important in that visit is your establishment of an understanding that the patient needs to make their health a priority. That what is happening cannot be solved immediately and that you are now signed-up to help them look into things deeper. You need to also make that first visitation look and be productive. Ordering labs for a cursory look and providing different options is a wonderful start to the patient's care. Utilize the last 5 minutes to answer any questions and really understand how much time this patient will need for the next visit.