What it’s about
The term “realaverism” describes the tendency to deny or ignore unpleasant realities and often externalise them. In German medical practices, this realaverism manifests itself, for example, in the way in which the phenomenon of no-shows, i.e. the absence of patients from agreed appointments without prior cancellation, is dealt with.
The example of “no-shows”
The non-appearance of patients at agreed appointments not only causes direct and indirect costs due to unutilised resources, but also impairs the planning and efficiency of practice operations. The intuitive reaction of many doctors to this is outrage and calls for sanctions such as cancellation bills. However, this reaction is a classic example of realaverism, as it ignores the underlying causes, which often lie in the practice management itself.
Analysing the causes
Ignorance of the frequency of cancellations
Many doctors do not have precise data on how often appointments are actually cancelled. Estimates are inaccurate and cannot accurately reflect the scale of the problem.
Irrelevance of the outages for the business
In quite a few cases, cancelled appointments do not significantly affect practice operations. In some cases, doctors and staff are actually relieved about the cancellations, as these help them to cope with the daily patient rush, especially when scheduling is done without adequate buffer times.
Lack of punctuality in the practice
If patients regularly experience long waiting times despite fixed appointments, the signal is sent that punctuality and appointments are not a high priority. This reduces patients’ motivation to be punctual themselves.
Lack of communication during no-shows
There is often no feedback to patients who miss appointments without an excuse. Without a direct approach, patients cannot be made aware of or learn the importance of turning up for appointments.
Inadequate emphasis on punctuality
Too little emphasis is placed on the importance of punctuality in communication, both in person and impersonally.
Low use of appointment reminders
Modern practice management systems make it possible to send appointment reminders automatically. However, this function is underutilised in many medical practices.
Example of “bureaucratisation”
It is crucial that doctors overcome realaverism and recognise the real causes of no-shows in their practices, for example. Another example is the complaint about work overload and lack of time due to bureaucratisation in the healthcare sector. The fact that it exists is undisputed and it would be desirable to curb it. But as long as only just over half of the best practice standard of practice management is implemented in GP and specialist practices, even a reduction in bureaucracy cannot solve the problem for practice owners. This validated guideline describes all regulations, instruments and behaviours that are essential in the areas of practice management, from planning, market research, organisation, management, patient care and marketing to controlling, for work to function smoothly even under changing requirements. A practice only starts to work efficiently when the degree of implementation reaches 60%.
Conclusion
The first step towards overcoming realaverism is therefore to recognise that problems are often not to be found (solely) in the conditions for action, but in the practices themselves.
R2049 