Pesky annoyances are hurting medical clinics — and they need to be solved | An Alternative View | Diana Diamond | Almanac Online |

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By Diana Diamond

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About this blog: So much is right — and wrong — about what is happening in Palo Alto. In this blog I want to discuss all that with you. I know many residents care about this town, and I want to explore our collective interests to help ...  (More)

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Pesky annoyances are hurting medical clinics — and they need to be solved

Uploaded: Feb 3, 2021
The medical profession tries to run customer-friendly efficient clinics, and in some areas — like phone call reminders of upcoming visits,— they do a great job. But there are many other patient frustrations that should be solved.

First example: making an appointment. Typically I telephone PAMF, and a female robot voice answers: “Good afternoon. Thank you for calling the Palo Alto Medical Foundation. Please say the name of the person or department you are trying to reach.” “Internal medicine,” I reply.
“I see we have more than one listing — Palo Alto Medical Foundation in Palo Alto, Palo Alto Medical Foundation in Los …” I interrupt: “Palo Alto.”

“I’m sorry, I can’t understand your reply. I see we have more than one listing…” I isay "Palo Alto” “again after the entire list is read. “You said Internal Medicine, Palo
Alto. Is that correct?” “Yes,” I reply. “I’m sorry. I can’t understand you.” “Yes,” I repeat. “I can’t understand you. Let me transfer you to the operator.”

I am transferred, usually wait for five to ten rings before pick-up, and then get a message that tells me, in essence, call 911 if this is an emergency, or if I have questions about flus or fevers press 3, or if I have questions about covid, press 4, etc. When I reach the department I get a repeated request to call 911 or “dial four for our information about covid-19,” and finally reach the department staff to make an appointment.

What if I was calling about an appendicitis attack?

I once called the president’s office at PAMF to complain, and was told “Someone will look into it.” Never heard back. And the long message never was altered.

Other medical clinics and facilities have the same telephone trials, but the Stanford system is quicker

Next issue: When I go to a dentist, I don’t make a six-month-in- advance visits, because I don’t know what I will be doing on August 15. So they send me a card two weeks away, I make my appointment and all is well. My son has a routine appointment with his car repair service a couple of miles away, and every six month gets a postcard reminder that something in his car needs routine maintenance.

But physicians don’t seem to do it that way. It’s the “Patient, you prompt the physician” problem. I love my doctors and their staff, but once I had a broken arm and was sent for physical therapy and never knew when — or if — I should report back to my orthopedist. Or I had a nasty infected laceration which my doctor treated, but I was not told to came back. A friend of mine had a cardiac problem, and was under routine care. Evidently he thought everything was okay, but then two weeks ago he had severe heart pains. The cardiac physician said, “I haven’t seen him in more than two years.” My friend said. “I didn’t realize I had to — the doctor never said I should make one.”

Miscommunication, for sure.

And now on to coronavirus, which all of us, I am sure, have stories of how poorly our system is working.

Two friends had vaccine appointments through Stanford Health Care, and when they each checked a day before, Stanford had no record of their making an appointment. In another instance, a friend made an appointment for her husband and herself at Stanford.When she called, the nurse said the appointment she made for her husband registered, but hers did not. First earliest opening is March 12. So she is waiting.

We all have too many similar stories. These vaccines, difficult as they are to be distributed around the nation, have had more problems than they should have. Kaiser patients are still extremely concerned that their facility has been very low on vaccines.

The problem starts at the national level and ends up at the state level. Clinics need to know in advance when they will get a supply of doses — and not just given a two-day notice as now occurs.

Why is the injection rate much lower in Santa Clara County than many other counties in the state? Why does California have the second lowest per capita inoculation rate than 49 other states in the country? One report I read said states are averaging a 10 percent per capita rate; California is at the 5.2 percent level while Mississippi, the lowest rating state, is at 4.8 percent per capita.

What is wrong? Who is going to fix all our medical glitches — and when?
What is it worth to you?


Posted by YentaThe Renter, a resident of College Terrace,
on Feb 3, 2021 at 12:59 pm

YentaThe Renter is a registered user.

Possible labor shortage, thinking brain shortages. Computers can't do it all and they need to be maintained. And glitches need to be understood. I believe we are soon to be facing very acute staffing shortages soon and in the future. As our schools fail to meet the grade, and if Immigration is impeded, we will be shooting ourselves in the foot in terms of our labor force. Competency dedication and hard work, come at a price...Perhaps future work or prospects are already taking their families away from Palo Alto giving especially the hostility to affordable housing. Every top needs a bottom and frankly we are seeing the bottom fraying.

Posted by Bob Ohlmann, a resident of Greenmeadow,
on Feb 3, 2021 at 1:09 pm

Bob Ohlmann is a registered user.

I'm sorry you had so much trouble with PAMF on-line application. I went onto their site and immediately reached the page to reserve a time for a vaccination as I'm over 75. So I had my first last week.

Posted by Bystander, a resident of Another Palo Alto neighborhood,
on Feb 3, 2021 at 1:18 pm

Bystander is a registered user.

California is doing so much worse at getting the vaccine out and about to other States. I have friends who according to their Facebook status have finished with their shots and these are not healthcare workers or seniors.

News that a vaccine was coming was not a surprise to anyone since the media and politicians had been talking about it almost immediately the shelter in place started. The fact that there was no Statewide system for dealing with getting the shots into the arms shows lack of leadership at the State level. If other States have managed it, why hasn't California?

As for the discrepancies between 65s and 75s, one facility and another, one insurance and another one provider and another, keeping up with the news on this is very much a daily game of all change.

The squeaky wheel gets the oil is part of the problem as those who are persistent and call each and every day, or turn up in the hopes of getting one, some to be getting them. Those of us who are patiently waiting our turn, or are waiting for an announcement that "our group" is next in line, are just getting further and further down the heap.

Personally speaking, I think I will just wait until the frenzy is over and I can walk in on spec. I am sure that day will come, one day.

Posted by KOhlson, a resident of Old Palo Alto,
on Feb 3, 2021 at 1:22 pm

KOhlson is a registered user.

There is a lot of information on Covid. Sometimes trusted sources seem at odds, and other times it depends on how you slice it. But one of the sources I use for all things covid is the post. This table, updated daily I think, shows California doing somewhat better than next to last.
Web Link

And a core problem seems to be delivery into arms - making an appointment is part of this - not supply. But the situation changes everyday, and there are lots of places where things can fall off the rails.

Posted by Jennifer, a resident of another community,
on Feb 3, 2021 at 1:25 pm

Jennifer is a registered user.

"Lack of leadership at the state level" is correct. I saw on the news last night that Newsom's approval rating is down to 46%. If he's not careful, he's looking at a re-call. They did it with Gray Davis, and I hope it happens to Newsom. The vaccine distribution in California so far is pathetic.

Posted by Consider Your Options. , a resident of Another Palo Alto neighborhood,
on Feb 3, 2021 at 1:46 pm

Consider Your Options. is a registered user.

The fundamental mistake you are making, Diana, is the assumption that they care about customer service. Businesses today, including medical clinics, are using computers to offload their work on their customers. They are happy to inconvenience you with a long wait in order to force you to use their Byzantine computer system to make your appointment and fill out their forms for them. They believe they are saving their staff time and personnel costs by wasting your time. They don't care about your time.

Customer service is DEAD. American business leaders are all about collecting and using your private data to maximize their profits. That's all. Customer service is is a label they slap onto data collection.

Posted by Victor Bishop, a resident of Another Mountain View Neighborhood,
on Feb 3, 2021 at 3:55 pm

Victor Bishop is a registered user.

[Post removed.]

Posted by Victor Bishop, a resident of Another Mountain View Neighborhood,
on Feb 4, 2021 at 7:56 am

Victor Bishop is a registered user.

Regarding vaccinations, there are many issues

The initial proposed California plan was too complicated with tiers and sub tiers. Now all of a sudden they are saying 65+ should have priority. Did they just realize deaths are mainly among the elderly?

Lack of,product. That is a national issue. But why has SCC dispensed such a small percentage of their vaccine?

All that said, the state, the county and individual health care provides has months to set up,plans for this. Did they not realize phone lines would be overwhelmed.

Some of the problems are not the state's fault, but too many are.
Hopefully in the next month or so we will have more vaccines available and that will alleviate some of the issues., but the state and county need to do better.

Posted by rsmithjr, a resident of Duveneck/St. Francis,
on Feb 4, 2021 at 12:07 pm

rsmithjr is a registered user.

Our medical providers are doing exactly what most of us are doing: we all want to go back to "normal" but we all do not want to sacrifice any part of "normal" in order to get better.

The medical providers (many of which are "non-profits") don't want to lose their business, and certainly don't want to spend money on non-profitable vaccinations. They are minimally willing to accommodate their standard customers but certainly don't want to waste money on "underserved communities" that won't be coming back for plastic surgery. They furlough staff to save money instead of redeploying them to the pandemic.

The irony of this is that the medical providers realize that they only way we get back to anything like "normal" is by making exactly the kinds of investments that they (and everyone else) do not want to make.

How much of its huge savings does our Palo Alto City Council want to give to vaccination efforts? Ideally, nothing. Just like everyone else. Someone else can pay. The congressional Republicans felt that the states and communities should pay. Everyone is pointing the finger at everyone else.

In fact, this was all completely predicted. Dr. Fauci and others were telling us 6 months ago what would happen. Based on expert opinions, I was telling everyone last summer that we would have 400,000 deaths in the US by February.

It is time for the government at all levels to step up to the plate. Our medical facilities need to be forced to do a better job, and not just for their rich clienteles.

Posted by GaryB, a resident of Greenmeadow,
on Feb 4, 2021 at 12:38 pm

GaryB is a registered user.

1) It's pretty obvious that everybody should just be getting one dose until the population is covered and then move on to second doses. We would be solving the pandemic twice as fast.

2) The order of vaccination is completely opposite, young people should be vaccinated first because they are the spreaders and then go up the age chain.

If you want to save the maximum lives, You stop the spreaders first, Not some old people hiding in a room. Also there is no blame that young people spread the virus, asking them to not be social is like asking fat people not to eat. Yeah and theory this works, but human nature does not allow it.

Posted by Chris, a resident of University South,
on Feb 4, 2021 at 6:24 pm

Chris is a registered user.

The county will now vaccinate everybody, even if they are PAMF or Kaiser patients. Compared to other providers and states, they have many older patients that are pushy about getting vaccinated.

Initially, there was a problem with the distribution system. But now that they have ramped that up, there is not enough supply to support it.

They should put out the appointments for smmaler age groups at a time. By going 65+ all at once, they swamped any system with too many people to be handled efficiently. For most reasonably healthy seniors, it does not matter whether they get vaccinated in February or March.

Why do so many people think they are entitled to be FIRST in line?

Posted by susan, a resident of Leland Manor/Garland Drive,
on Feb 5, 2021 at 12:13 pm

susan is a registered user.

For vaccines at Stanford - keep on checking the website; earlier appointments open up. My husband moved for March 10 to Feb 5. You need to be persistent in checking.

As to making appointments at PAMF - the phone is awful. I have heard that message too many times to count. It is easier to use MyHealth online - you can ask questions of your providers and make appointments.

Posted by Duveneck, a resident of Duveneck/St. Francis,
on Feb 5, 2021 at 2:19 pm

Duveneck is a registered user.

It's too bad that you have had problems making appointments with PAMF via the phone. As a PAMF patient, I go online and can request an appointment for a specific day/time with my physician. Within 24 hrs, usually, I receive an appointment. No phone. No waiting. If there is an emergency, an oline directive request that you immediately call EMERGENCY.

Posted by Online Name, a resident of Embarcadero Oaks/Leland,
on Feb 6, 2021 at 9:26 am

Online Name is a registered user.

PAMF recently changed their phone system to a new one everyone hates -- as per my GP's assistant when we finally spoke. My sad saga: I email my CP for a video appointment, his office calls to set it up. I miss the call but return the call to his direct number as requested. The woman who answers can only schedule IN-PERSON appts and can't TRANSFER my call to his office even I called the GP's DIRECT number. She'll have him call.

I wait and wait to avoid more phone tag loops. We finally confirm the video appointment ON my computer, not on my cell where I've had problems.

Next day I get an email asking if a med student can join my video appt which must be done via cell. I cancel via email, complain about the phone tag and say ok let's do the in-person appt I'd tried to avoid..The PA calls to apologize: We've got a new phone system which everyone hates but Sutter says it saves them SO much money. We make the in-person appt.

Distracted by the PAMF phone nonsense, I ignore my partner's sensible suggestion to get an early jump on a PAMF covid vaccine appt. Several days later, still no PAMF vaccine appts.

I waste several days on the county site from which I'm repeatedly bounced at the last step confirming a Mounntain View appt No "fill in the CAPTCHA" screen showing you're not a robot screen ever appears. Is it me, my browser, my privacy settings as they suggest, my computer?? My partner tries and says the site's screwed up. I try calling. They say "1 hour wait" so I put the phone on speaker and wait. It repeatedly disconnects after 35 minutes.

I give up and call County Supervisor Joe Smitian's office. His intelligent staffer says, "You're the 4th person to call about the web site. WE told the County. They're working on it now." I tell her about the dropped phone calls. "Oh, We'll tell them."

Whatever happened to error messages and systems testing???

PS: I'm still waiting for my password resent info for the PA City Manager Citizen Survey.

Posted by Online Name, a resident of Embarcadero Oaks/Leland,
on Feb 6, 2021 at 9:34 am

Online Name is a registered user.

PS: I did finally score a PAMF vaccine after giving upon the county site and the Walgreen's site.

I read with some amusement the city's Covid bulletin and articles in the SF Chronicle and the SJ Merc giving out the county website and phone info without checking whether they work.

Posted by, a resident of Midtown,
on Feb 6, 2021 at 1:10 pm is a registered user.

I have been a patient at PAMF for over 35 years since Stanford days when I was transferred from Cowell. They have gone downHILL since the old days at the Lee Building.

I think their specialists are great. Their primary care doctors are now apologists for Sutter. This last year has been the worst. No Covid testing unless you half dead. No antibody is not useful - we know what is good for you. No vaccine at PAMF HQ...fridges too expensive

I am moving to Stanford they have done best overall during Covid .
Best communication best results. At least they try. Sutter is all about money. Can we colonoscopy you now. How about a specialist test. WELLNESS that's last years bogus strategy etc

Posted by Longtime Resident, a resident of Old Palo Alto,
on Feb 9, 2021 at 3:56 pm

Longtime Resident is a registered user.

A few years ago, Stanford charged my medical insurance over $1,000 for a well patient check. The doctor spent the entire time reading old medical data from PAMF records about me, while I just sat there. I could have easily told the physician if I had any past issues like high blood pressure, diabetes, etc.
Total rip off by Stanford - that non-profit company/university.

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