I feel a lot of appointment-based businesses are like this. They’re trying to slot in as many services into one day as they can. Them making you wait is acceptable because they’re with another customer (Though I’m sure they wanna wrap it up with them quickly too). You making them wait is unacceptable because that’ll throw off their carefully timed appointment schedule.
It ain’t great but that’s the bitch of this damned money world huh
Them making you wait is also often a consequence of earlier patients showing up late or an appointment requiring more time than expected.
The options to solve it are less patients per day, but that leads to even longer delays before you even get to your appointment date, OR more professional staff in the office…but that would cut into profits of the people in charge so is immediately off the table in this damned money world.
In an ER, that’s understandable, but in a general doctor’s office there’s no reason that Docs should extend one patient’s appointment time just because they ended up late:
“Oh, you scheduled a 30 minute consultation because of a sore knee but now you’re asking for an ENT referral and blood work? You’ll have to schedule another appointment to go over that, we’re only covering what you told us the other day.”
You think someone should be penalised by having their diabetes review cut short because the traffic from their minimum wage job was unexpectedly slow?
Hyperbole indeed.
What about the 25 other patients who do not have a really, really important diabetes consultation, but a head cold or are just alone and need to talk?*
What about that one person who had their really, really important diabetes consultation at 6pm but was told to come back another day two hours later at 8pm once the other appointments were all stretched out ad infinitum, but can’t return anytime soon due to their boss not giving them any time off in their minimum wage job, who then DIES of diabetes? Come on, let’s not resort to hyperbole and made up scenarios - improvements are possible, and we should aim for those.
*Loneliness, in particular in elderly patients, is a real problem which I’m not trying to downplay. This needs to be solved, too.
It’s a hypothetical scenario. Penalising people for being late or for missing appointments has a higher adverse effect for people in poverty or with disabilities without actually addressing the cause. It’s why doctors in the UK are generally against introducing fines for missed appointments.
We need more capacity, yes.
Hyperbolic, made up scenario, but yeah pretty much. You get the time slot you scheduled and you should be held responsible for using it. Most offices ask you to check in at least a half hour early for a reason.
I could just as easily switch that around and ask if you believe some poor guy who finally got an extended lunch break from his minimum wage warehouse job should be fired because he had to wait an hour at the doctor’s office because some rich white lady spent 30 minutes past her appointment arguing about essential oils. Painting is pretty easy when it’s all black and white.
Half an hour early? That feels excessive. At my GPs it’s 10 minutes early
That sounds like an employment rights issue. Here we get as much time as required for health appointments.
OK cool don’t care and that didn’t even address half of my comment
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If the commenter you’re responding to is from the US then no. We have privately owned for profit hospitals and often they’re the only option in ones area.
People always get called out for assuming everything is about the US but Europeans do it just as much lol
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You mean the municipality, which you also are a part of, and pay tax to?
There aren’t very many hospitals or medical facilities owned by municipalities anymore. Most are either owned and operated by a private hospital network, or operate under a private trust.
The hospital I work at used to be owned by the state via the university, but our governor literally gave the campus away to a private trust that operates for profit. Super fun times.
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Doctors offices are. Hospitals are funded by thr government. Either way paid for by your tax.
I think we may be talking about two different countries…
Unless you are American? Things are fucked there
Ahh, yep. Definitely different countries.
Quite a few doctor’s offices are owned or ran by a management group, partly to share or reduce their costs due to bureaucratic insurance companies and HIPAA compliance. Those same management groups use the doctors like a cash cow and attempt to shovel as many patients at them as they can because a venture fund is running the group behind the scenes.
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That’s a funny name for an urgent care place, from the english “drop in appointment.”
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I hear you, I just thought it was a funny name from my American perspective. Du lutger dritgodt.
But the question I ask myself everytime is : how carefully timed is it really, if everyone has to wait so much ?
Dunno bout your PCP’s office, but I know some hospital workers and it seems like there’s a lotta time waiting for transport because they’re understaffed, underpaid. Also, lotta piss and shit related delays. Sometimes those compound.
Believe it or not, lotsa “customers” in hospitals aren’t, like, operating at peak efficiency. So there’s a lotta small delays that occur for normal consequences of that. A fifteen minute delay here because a patient can’t move very quickly. A ten minute delay as a patient thinks they have to pee but no one can find a bed pan and they can’t use a toilet. Then they don’t have to pee. A thirty minute delay because they can’t find the right kind of stretcher for a particular patient. An hour delay because, while you were scheduled to get your outpatient test done at 4 P.M. sharp, someone else from the Emergency Room needed that sort of test done ASAP.
When that happens frequently, not scheduling time for it is shitty scheduling.
This is a different kind of issue, one I think a lotta people would be more familiar with. Management setting unrealistic goals and targets. Yes, those kinds of delays are so common they should be baked into the time expectations. However, that would result in fewer billable services forecasted per period. That bad. Want more money. While doctors offices should be immune to that kind of shitty behavior, they are still ultimately business and thus they gotta operate with that forever growing, profit forward behavior.
If it’s so carefully timed, why is it ok for them to mess up the timing? I’m a paying customer and I have shit to do, too. Maybe it’s not true in the case of doctors, but for other businesses, the only reason you’re able to have this business is because I’m here, paying money.
Maybe it’s not true in the case of doctors, but for other businesses, the only reason you’re able to have this business is because I’m here, paying money.
You hit the nail on the head there. Other businesses exist because they won your business in competition with other businesses. A doctor’s office exists because they got permission from the state to operate.
The incentive structure is different, leading to different strategies being used to stay open
In the US at least you could easily find a different doctor, unless you live in a rural area with no other doctors in it
I left two different practices because of schedule fiascos and stuck with the 3rd because they never make me wait.
Because life is unpredictable. They can’t know in advance if they’re going to have delays, so sometimes you just have to deal with it. This goes for any appointment based service.
But should the same courtesy and understanding be extended to the customer?
Yes, which is part of why they end up running late.
I imagine it’s unlikely the doctor’s office “messed up the timing” such that the doctor isn’t doing work and simply making you wait for funsies, but rather the patient before you needed an unanticipated amount of extra time for one thing or another. This is “acceptable” to the business as the doctor is still performing a billable service. It’s not preferable, as it would be better if the doctor was performing MORE billable services per day, but acceptable. In hospitals, the number of services performed per day can be used as a KPI, for example. It’s “unacceptable” to have the doctor waiting around not performing billable services as that doesn’t make money.
If they’re messing up the schedule in a way that you both have to wait and no one is performing a billable service, something has seriously gone wrong.
I started to just leave when this happen. There are a lot of good people who follow the schedule properly, i take my business to them instead.
but that’s the bitch of this damned money world
This isn’t a result of money. It’s a result of having insufficient medical providers and them therefore being guaranteed business no matter how much they suck at customer service.
If money were the most powerful thing in medicine, new players would enter the market given its ridiculous revenue levels, and those new players would introduce competition and suddenly medical providers would be facing a world where their flow of customers is not guaranteed, and they would have to learn to respect and be grateful for their customers.
That’s how it would work if it were actually a “money world”. But medicine doesn’t run on money. It runs on government permission to exist, and that permission is always kept below demand levels, meaning once a provider gets a spot they don’t have to worry about someone else taking it.
Because money is fickle. To get money to come your way you need to provide good service consistently. If you stop, the money stops coming.
But a government license to operate is not fickle. Nobody can take that from you merely by offering better service. A government license to operate, in a market with severely limited supply, is a license to treat your customers like shit and see them crawling back for more.
It runs on government permission to exist, and that permission is always kept below demand levels
This is the first I’ve ever heard of this. Got anywhere I can read more about it? Sounds uncompetitive if not outright corrupt.
Airports work like this. You arrive two hours before takeoff only to find out like half an hour before takeoff that the flight is delayed because there’s no plane.
I spent 3 days in an airport because storms near Chicago caused a ripple of delays and cancelations all over the country, I was constantly being told “okay your new flight leaves in 5 hours” and I was in a city over 100 miles away from home with no transportation.
Overall I had tickets and replacement tickets for 9 flights. Honestly given some of the times we found out there was no plane, I didn’t believe we would get to board even as they were calling boarding groups.
100 miles from home
Bro, you could have walked home in that time. Benefit of restrospect.
My destination was not to home (although in reread I an see how it reads that way), it was several states away to get to basic training. Won’t be making that Great Mistake(s) again…
Well that’s fair enough then. I bloody hate flying and airports!
Agreed
My favorite was receiving a text notification at 5:30AM thar my 8AM flight was canceled. Ruined my entire vacation
Better to be stuck on the ground than to be stuck in the air in a plane that needs maintinence, or in bad weather.
I was on a lay over and was lined up ready to board and they cancelled the flight. Was told to go to customer service to find another flight. Conveniently two other flights were canceled around the same time so they were over 900 people in the customer service line. After waiting about 45 minutes in line and moving about 20 spots forward and asking multiple airline employees that had no idea what was going on. I get a text message that my flight had been rebooked to a flight that had been delayed earlier in the day and it has finally showed up but it’s leaving in 15 minutes and it’s in a different terminal. I booked it over there and made the flight. Anyway, it was a mess. Extremely unorganized, handled terribly and it was just an all around piss poor experience. Did I get compensation for the inconvenience and time wasted? Of course not. Airline are allowed to charge hundreds of dollars and fuck things up without consequences.
There is no plane because everyone on board the inbound flight died when your 737 MAX crashed because of an MCAS failure and also all the bolts fell off.
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Uhm, if 6 patients were 10 minutes late each, you’d be 10 minutes late total.
Hey he’s a doctor not a mathtor
Yeth, mathtor
Whath ith thy bidding?
It actually really fucks you up. You end up rereading charts and notes because your wires keep getting crossed.
And what about the doctors who are half an hour late for the very first appointment of the day. How is that possible?
If they’re on call it might just be they just finished working on 4 am in the morning due to some emergency. Anything is possible ¯\_(ツ)_/¯
In A+E, I get it. But a local GP surgery where you HAVE to have an appointment? I’m not buying it.
Not to mention people would arrive at their 10 minute appointment with a list of 5 completely separate medical issues that they’d been saving up for months. So either you do a full history, examination, diagnosis and treatment plan +/- prescription in 2 minutes for each problem, or the 10 minute appointment just becomes a 20 minute appointment. And then you document everything in your lunch break or after you’re supposed to have gone home 🙃
Here in the US, the last time I went to a doctor’s office they had signs posted saying that those under free healthcare could only discuss a single issue per billed visit. Which sure, saves the medical staff a ton of time and scheduling problems, but also means the most vulnerable (and least able to take time off to visit the doctor) have to prioritize health issues and let minor ones go untreated/undiagnosed until they become major ones.
Healthcare is a mess.
How do you even know what a single issue is?
How the heck are you supposed to know if your abdomen hurting, and shitting blood are related? Is the itching related? How about the Hives, or the headaches?
Apparently you’re the doctor now.
10 minute appointment
5 completely separate medical issues
Something, somewhere, isn’t working in public health.
Yes public funded health care has many issues, congratulations on being so astute. Where I live you can book longer appointments if you need them, you just have to actually ask for the extra time. People often have let small issues add up before getting them sorted because procrastination, small issues that most people with private healthcare systems could not afford to go to the doctor to have checked out.
Most important of all, when someone feels ill they don’t have to factor a medical bill into the equation when deciding whether or no they should go to the hospital or possibly fucking die.
I’m in favour of publicly funded healthcare. My family is still with me thanks to the NHS. The problems that exist within it are because of privatisation and neglect by government across ALL areas. If my elderly parents have to fit 6 months worth of bodily problems into a 10 minute consultation with someone who has no accountability then I’m gonna get a bit upset. If you work in the NHS then thanks but more importantly if you work in government then get fucking real about what everyone needs.
I can only speak from my experience with the Canadian healthcare system. Getting a family doctor is a huge struggle right now but if you have one you can book as many appointments as you want for free. (and there are always walk-in clinics which are also free)
I’d see about a discount for those on time, reward the desired behavior.
At one point I setup an appt with a doctor, 3 weeks set date, and to be the first one in the morning, like 9AM, he cannot be late, right? I left at 11:30AM without seeing him.
Jeez, how is that even possible? Like did some other asshole sneak in and get seen for some crazy disease somehow?
He is a surgeon and was in the hospital nearby, I guess saving life, so it’s ok :)
Ahhh that makes much more sense! I thought it was just a regular clinician type of doctor.
Those are often the same people. I work exclusively in the OR, and we occasionally need to pull a doctor from their clinical hours to do an emergency surgery, which means some patient who’s expecting a clinical appointment just got fucked.
This comes down to staffing issues, but every hospital on the planet is apparently running a skeleton crew right now, so we work with what we got.
The last time I took my daughter to the doctor’s, we had the 8:30am appointment. First of the day.
I was feeling pretty optimistic that we would be in and out by 8:45.
So we arrive at 8:20 and take our seats in the waiting room. 8:30 rolls around, no call. 8:40, no call. 8:50 no call. At 8:55 a side door opens and 8 doctors stroll out with coffees in hand and make their way to their individual consulting rooms.
At 9:10 we got the call to go in.
I get that they might need to have a morning meeting to get setup for the day, but 8 doctors each wasting 40 minutes, and the entire appointment book playing catch-up for the rest of the day, seems like a colossal piss take.
Why not, like, have your meeting earlier…?
Dickheads. My grandpa was right back in the 90s when he said the country is going to the dogs. A Tory! In a way I’m glad for him that he isn’t around to see how badly his descendants are getting rinsed.
Because every patient before you was 10-30 minutes late for their appointment so now you have to wait an hour.
Or, more likely in my experience, the doctors office is overbooked and anything more than 10-15 min/patient puts the whole schedule behind.
Not really overbooked, so much as you put down you had a sore throat which takes about 10-15 minutes but now you’re here can you have your ear looked at and also your stomach hurts but it started about six years ago and you think you might have ADHD so could you get a referral for an evaluation?
And it’s like that every other patient.
I’d argue that if that’s consistently happening, you’re overbooked. If you book more people than you can reasonably expect to serve on time, that’s being overbooked.
I see that as no different as the shitty companies that have an IBR that repeatedly tells you about ‘higher than normal call volume’ no matter when you call and anytime you call for months/years. At some point you know your normal and aren’t staffing or booking at proper levels.
I work for a psych clinic where the head doctor rarely turns down same-day appointments, while his schedule is fully-booked to see multiple patients/15-20 mins. We’ve slowly bled providers over the course of the last 3 years and haven’t really replaced any of them. Turns out, it’s hard to hire when you have a reputation for low salaries and nefarious contract negotiations.
Each specialty may have their own story, but we definitely see constant issues of being overbooked AND understaffed.
Once I had to wait more than 30 minutes even though I was the very first patient in the morning.
Their time is actually more important than yours
I’ll have you know I have 27 cats at home which depend on me. My time is precious
Just bring them with you, duh.
That’s way too many how silly. Only bring half of them at a time. Being the others on a second trip.
Should I cut the remainding cat in half across the chest or from front to back?
I think veterinary offices are the only places I can understand. Everyone there is underpaid, working hard, enduring trauma, and doing it because they love animals. Although I’ve never seen them get upset at someone for being late!
veterinary offices are the only places I can understand. Everyone there is underpaid, working hard, enduring trauma, and doing it because they love animals.
Boy do I have some news about basically everyone in healthcare…
Pretty much everyone is making less than previous generations, and that’s not even accounting for inflation. I am a specialty provider and the salary for my position hasn’t increased in decades, all while licensing and education costs have skyrocketed.
Healthcare isnt the get rich quick scheme people seem to believe it is. It’s basically hundreds of thousands of dollars of debt for near a decade of school, just for the privilege to basically work for free for several years.
Pretty much any person in healthcare under 40 is there because they love people and want to help them. Nowadays it’s just too difficult and thankless of a job for any other real reason other than empathy. There are plenty of easier and more profitable ways to make money.
The reason you may have experiences that run contrary to this is the same reason you’ve prob had to wait in a room for over an hour. The providers are not the ones in charge of their schedules, and are probably experiencing burnout.
The people making the schedules have no idea how much time is appropriate for the patient care the person is coming in for. All they know is management wants less down time and faster turnaround. So they just pile as many patients as they can schedule, and then utilize the patient’s understandable agitation as a stick to prod the provider along.
Did you respond to the wrong person?
“Healthcare isnt the get rich quick scheme people seem to believe it is. It’s basically hundreds of thousands of dollars of debt for near a decade of school, just for the privilege to basically work for free for several years.”
I never said this nor do I think this, I’m so confused lol. OP asked about other services that are similar, and I responded.
They assumed that when you said “veterinary offices are the only places I can understand” that you meant you cannot understand this happening at doctor’s offices.
Ahhh thanks, that was a flippant remark. I meant “veterinary offices are the only place I can think of in the moment that are similar”.
Still a little bit confused by the jump they made even if it was meant the first way, because I wouldn’t blame the poor wait times on an average staff worker but the hospital owners, drug makers, equipment patents, etc making millions a year and incentivizing lower pay for the average worker and a fast turn around time.
I had this happen when I was at my Dr’s appt. I needed a script for oxygen. Prior to that, I watched several people walk in, get called to go to one of the examination rooms almost immediately. The thing is that each one of the other patients was obviously in far worse shape. When I finally was seen, my Dr started apologizing profusely. I told her that I know what triage means and to not worry about it. Stuff happens. If I was one of the others, I would want relief too.
This is the reality. A doctor is trying to see as many patients as possible who want to be seen. Not every condition requires the same amount of time. They do their best to estimate, but ultimately, if a doctor is willing to give you extra time, then the price is usually paying it forward by waiting longer in the waiting room for fellow patients. If you’re late when they are ready, then you drop the efficiency of the entire day. If you’re ready when they’re not, well, yes, their time is actually more valuable in this case.
Reading the comments in this thread just indicates to me that we need more doctors. The supply of doctors is definitely artificially restricted
For real. At least in the US medical school is incredibly expensive (on top of undergrad being really expensive too). Going to school is a huge risk, because if you find you can’t handle it half way through, you’ve got all that debt,without the job to actually pay it. We’ve got so many incredible potential doctors and nurses that just can’t afford to go to school
It also takes 2x longer than most of the world to get licensed.
Yep, that AMA is proof the licensing organization shouldn’t also be the union.
We need to pressure schools to open more seats.
Our patient visits are set as 15 minute slots standard.
This isn’t enough time to practice good medicine for anything much more than something like a flu or strep throat. How does one squeeze in an entire rooming process followed by a solid HPI, physical, poc testing and then plan review with pt in 15 minutes?
They don’t.
But with how medicine works (in the US) it’s the how clinics make enough money to stay open.
For clarity: I work at a Federally Qualified Health Center, not a for profit clinic.
But with how medicine works (in the US) it’s the how clinics make enough money to stay open.
This is the truth. PCP offices in particular have razor-thin margins and insurance reimbursement goes down every year while supply, fixed, and staff costs go up every year. This is an insurance industry and healthcare system problem. Your doctors’ offices are just doing everything they can to stay open.
Fortunately CMS is rethinking the role of primary care and realizing we can save money if we’re able to provide high quality preventive care like we’re supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.
I think this is a cross-disciplinary issue.
My last optometrist appointment was wicked fast. Eye test speed run. I think it took 15 minutes for the examination and the optometrist was using the time it took for a patient’s pupils to dilate in response to those horrid drops to do the initial exam on another patient, so they always had two patients “being seen” at a given time.
Buck wild. Seems like a bad trend for quality care.
Agreed.
There’s an argument that more appointment slots means more access but if it’s access to poor quality medicine what’s the point?
Buck wild. Seems like a bad trend for quality care.
On the one hand, yeah holy shit.
On the there, though, eye exams aren’t exactly something that couldnt be administered in a group setting to help speed things along a bit
In my ideal world they’d have a machine for it at Walmart like they do blood pressure that just flips the prescriptive lenses in front of you and asks all the same questions, then sends the results to an optometrist to confirm
exams aren’t exactly something that couldnt be administered in a group setting to
Anyone else imagining a Democratic: Does 1 or 2 look better?
Sorry Alex. Looks like everyone else voted 1 so you’re getting the wrong prescription.
One of my doctors clearly has it this way. When I’m there in the afternoon, there are dozens of people waiting because each person takes longer than the appointed slot and so everyone moves back in time… but at least they have good managing there and the receptionist will tell me when I arrive whether it will be 30 or 50 minutes to wait.
My eye doctor, on the other hand… I arrive 15 minutes before my appointment and there are only three other people there, two of whom arrived at the same time as me. How the hell does it take an hour for me until I can go in? What are they doing in there that every patient takes 20-25 minutes for an eye exam?
The best way to fix this is to cancel the appointment if they make you wait. If enough people did this the clinic loses money which should cause change. Unfortunately, patients are largely a captive clientele, having already waited months and canceled work and with few if any alternative providers.
The next best thing is much more realistic. Plaster the internet with reviews complaining of the wait. If your doctor (or more likely your doctor’s employer) does not respect your time, let everyone know.
Many of the other comments are also correct. I have worked in clinics in government, military, academic centers, venture capital, physician owned, and even free community health centers, all in the USA. Doctors running late is going to happen. I’ve kept patients waiting while in the operating room, while telling someone they have cancer or are losing a limb, and by my burnt out underpaid government scheduler incompetently overbooking. I will also tell you that when I have at least a little control over my own schedule, I’ve never made a patient wait an hour, even with the above happening. It can be done, it just isn’t because for decades timeliness has not been a financial incentive.
Make it one. Name and shame on google, yelp, zoc doc, wherever. Do it gracefully and sensitively, recognizing that there is a high chance the delay is not the doctor or nurse’s fault. Done right, you’ll do them a favor when their employer feels the sting of lost patients.
You need a doctor, not otherwise.
Man, I resonate with the meme here in the UK where it’s free to go to the doctors but HAVING TO PAY FOR IT AT THE SAME TIME?!
Except then they send you a bill for services not rendered and act like that’s legitimate.
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If they do not have your SSN - and why would they? Leave that shit blank on the forms.
They can’t do much other than refuse to let you book again.
Yeah…which is hard when they’re the only doctor who treats your condition in the area
Yikes - I have not had that problem. I am rural but not that rural.
I’m sorry you have to deal with that.
Thanks, I appreciate it
I joined a private medical group that has annual fees, purely to avoid this shit. They don’t overbook. I’ve never had to wait, unless I got there early (and even then sometimes they were happy to see me early).
Don’t forget waiting for hours, going to the toilet for a leak and returning to see you’ve been skipped
I had this discussion recently and my friend pointed out that this also happens with utility workers on in-house visits, I guess cause of the demand there is on their work. At least where I live.
But I can’t take it with doctors man. Also it’s the only business where you can pay to get insulted or diminished, yet not diagnosed, repeatedly from different specialists (true story)
I had appendicitis for 18 months.
I’m not going to kill that doctor. But he is 45 years older than me and some fresh graves just scream out to be pissed on.
Highfalutin fuck with his own practice and a fireplace in the lobby couldn’t diagnose and treat what a chick in her 20s with a nose ring working the night shift at Halifax caught in an hour.
I’m not going to kill that doctor. I ain’t gonna go looking for him. If I encounter him again and he isn’t cold in his urn, I’m gonna hurt him in a way medical science can’t fix.
What?
One night, I was about 20 years old or so, I woke up in severe abdominal pain. Very nausea, such vomiting. Couldn’t stand up right. Go to the hospital, given Maalox. Throw up the Maalox. Given…something else that put me out cold.
This happened over and over again for a year and a half, once or twice a month. Went to the doctor about it, “there’s nothing we can do.”
I go off to university out of state. It happens there. Young night shift doctor has the bright idea to put me in a CT machine while it hurts. Can you say “2 AM appendectomy?” Never had another one of those bouts of pain and puking again.
I apparently had appendicitis for 18 months.
And I’m not going to be a very nice person to the doctor that repeatedly didn’t do anything about it.
Try 3 hours, it’s the reason I bought a miyoo mini plus, just to take it to doctor’s offices.
wow, that looks cool
I got a gamesir x2 pro for my appointments, changed my life, carry the little fucker everywhere now.
