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Tradeable hospital appointments

buy or sell your hospital appointment to the highest bidder
  [vote for,

Hospitals in the Netherlands have the problem of 'no shows'. People make an appointment with a specialist and then don't show up. Afterwards they demand another appointment at a later time. This is costly because the expensive specialist is just sitting there waiting for the next patient (who shows up on time). It affects about 20% of all appointments. It makes waitinglists longer and wastes taxpayers money.

An alternative unacceptable to people is to just make them show up for a long timeslot and let them wait for their turn. People refuse to waste time and wait that long or something.

The proposed (costly) solutions now are: SMS notifcations, reminders by snailmail, telephone confirmations etc.

If only the hospital would facilitate patients to exchange appointments among each other.

You would make an appointment to see the specialist and from that moment your file and everything is ready. The appointment is weeks or months in the future like now, but when you go to the waiting room you just ask: 'anyone selling their appointment?'

People with money and no patience can then walk right from making the appointment to being treated by the specialist on the same day. They pay for it.

People with time and patience sell their appointment to the highest bidder. They can even put it up for sale on the wall of the waitingroom or the hospital's website. They earn while waiting.

The seller gets the appointment of the buyer.

rrr, Jun 17 2003

Coutesy Call http://www.alphacomm.nl/courtesycall/
SMS reminder about hospital appointment [rrr, Oct 21 2004]


       Nope. This would just encourage people to make spurious appointments in the hope of selling their slot on. It would just make matters worse.
DrBob, Jun 17 2003

       DrBob, you can only make an appointment with a specialist for a treatment if he sees a medical need after an examination. And before you can make that first appointment with the specialist you need a referral from your doctor first. Enough validity checks. You might see old/ poor people hanging around in the waiting room, constantly trading their appointments and neglecting their own health. But then they will end up at the ER. Before that happens there will surely be a chance that they can't sell their appointment.
rrr, Jun 17 2003

       I work in a major medical facility in the US. We have patients cancel appointments often as well, but we handle it like this: patients are free to drop in and ask if there are any cancellations, and they are referred to as 'checkers' (because they are checking to see if there are openings). If there are, they are ushered in if the patient with the next time slot is not right there waiting (with time slots an hour apart, most times the patient is not there- not everyone wants to come in early and have to sit and wait that long). If there are no open slots right then, they may put their name on a list and sit and wait for a no-show (if they leave for coffee and a no-show occurs, they don't get the slot if they're not there waiting). No cost to the patient requesting the open slot, and the clinic doesn't lose $ on that appointment that was otherwise empty. I would not want to have to BUY an open slot, when I can go get one for free in our current system.
Mamamoose, Jun 17 2003

       Mamamoose, your solution is better. It also favours those with time and patience. A combination of both systems would be even better. Those with no patience are treated quickly (at a price) and those with patience can even earn money with selling their appointment. In other words: rich guy walks in and says 'I buy your appointment' and doesn't wait a bit. Anyone else can just hang around as a 'checker' waiting for a free slot to open before the fixed appointment. The checker can even sell such an opening if a buyer walks in and does not want to wait for an opening.
rrr, Jun 17 2003

       Make people pay for an appointment; if they show up (or cancel with more than 24 hours notice), the payment is refunded. (It's a problem in UK as well.)
angel, Jun 17 2003

       Angel, that is only a stimulus but will not result in 100% 'shows'. You will also see aggressive people harrassing the staff because they were in a traffic jam or whatever lame excuse they have for not showing. With aggression against the staff more employees will take sickleaves which will make the waitinglists longer. In a combination of my and Mamamoose' solution people will have most free choice. People like that, it makes them happy and they are more likely to accept the situation. Sitting there waiting and thinking 'I am making money now'.
rrr, Jun 17 2003

       I don't think your plan will result in 100% shows either. In fact, I think it may result in a decrease in shows. There will now be professional scalpers that make as many appts. as they can during the day and sit around and wait for someone to pay them for a spot. If nobody pays for a spot, it goes unused. Of course now there are a bunch of appt. spots that are taken just for the purpose of selling, making those of us who show up for appts. have to make our appts. further in advance.   

       End result: if I want to see a doctor, I can either wait for months or go in today and pay the scalper a premium for an appointment.
Worldgineer, Jun 17 2003

       I've heard too many horror stories concerning hospital staff mixing up people and procedures to ever be comfortable with this. I've even heard of hospitals misplacing people entirely. Give 'em all GPS transponders, I say.
RayfordSteele, Jun 17 2003

       Worldgineer, it is not possible to make more than one appointment. The specialist won't let you. You can't make 'false' appointments because you personally have a medical need to get the appointment. Unless you damage your own health first to get an appointment or you fake the symptoms to fool the specialist (difficult). And why go through all that trouble for the 50 euros max (my guess), someone *might* be prepared to pay you? After all, there is no guarantee that you can sell you appointment, in most cases you'll just have to use it for yourself. I don't expect people to use this to make money, but as a nice bonus that may happen to them while they are waiting. Already *the chance* that someone might walk in and start bidding for their appointment will make them feel better while waiting. They might even want to show up an hour in advance for it, which decreases the number of no- shows! We are talking about the Dutch here, remember that. The tiniest incentive to get a little money can move the masses. Loyaltycards, supermarketstamps etc are very popular here, more than anywere else, nearly the national religion. If already supermarket offers with only a few cents to win can make the Dutch bike 3 blocks extra to go to another supermarket, then surely this *chance* to 'win' an extra 10 or 30 euros in the hospital waitingroom will make their hearts beat faster!
rrr, Jun 18 2003

       RayfordSteele, the appointment is in not connected with the case and treatment of the patient. As Mamamoose wrote, it is already common practise to take other people's appointments. When you finally get to see the specialist, you have to identify yourself and he looks up your files. If sending SMS-reminders is already too expensive, then GPS surely is. And what's the purpose of knowing where the missing patient exactly is? He is not in the waitingroom, that is what matters.
rrr, Jun 18 2003

       Reensure, there is no financial gain there, no matter how much information you give them. Reminders are only effictive because it appeals to the consience of people.   

       There are no-shows because people decide they have something better to do and it costs them nothing to get another appointment. That's the basis of this accessible health care system.   

       The irony is that the same people that cause the no-shows are also angry that *other* people don't show up, because it wastes their taxpayers money. They personally want the privilege to not show up, but they want everyone else to behave normally and not waste taxpayers money. Therefore only a design with rewards instead of punishments will work.
rrr, Jun 19 2003

       I am just thinking of a torturous situation for the average Dutchman in the waiting room in such a system.   

       He can sell the 15:00 o'clock appointment he made 3 months ago, so he shows up at 9:00 with his own sandwiches, coffee, paperwork etc. to spend the day in the waitingroom. Waiting for someone to walk in and buy his valuable 15:00 appointment. Then suddenly there is a no-show for the 13:00 appointment. He is allowed to take it because everyone (also the 'checkers' with no appointment for that day) arrived after him. But then he would loose the chance that he could sell his appointment if a last moment buyer would walk in between 13 and 15... Should h give the no-show appointment to the next checker in line or take it and then go home? He already took the whole day off from work because it's for a hospital visit, so he sits there in 'free' time (you are allowed to skip work an x-number of hours per month for it). What to do?
rrr, Jun 19 2003

       who will buy my fishbone?
neilp, Dec 23 2003

       who will buy my fishbone?
neilp, Dec 23 2003


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