Waiting in the Waiting Room
J. Greene
Q: I would like to know if anything can be
done about doctors who can’t keep their appointments. I waited over two hours to see
a doctor the other day. None of the staff informed me of anything except that I would be
next. How long should a patient wait before saying something?
A: What? You had something else to do
during those two hours, like maybe get back to work or pick up the kids from school? It
almost sounds like you think your time is as valuable as the doctor’s!
A
shocking thought, but one that more patients are having as they realize they need to look
out for themselves when it comes to health care. Going to the doctor isn't like visiting
an old, trusted friend and adviser anymore — it's like going to the car mechanic, and
if he or she kept us waiting two hours while finishing someone else's brake job, we'd
screech out of there without a second thought.
Just because you're going to see the town's
highest-rated cardiac surgeon who just had his picture on the cover of "Time"
for performing six heart transplants at once, is no reason to cower before his office
staff. You — and, hopefully, your insurance company — pay this physician for his
services and you should expect reasonable customer service. That's not a concept that was
emphasized in medicine in the past, but it's slowly starting to creep into doctors'
practices as they find they must compete for patients with other doctors on a health
plan's list.
The average patient waits 19 minutes for a scheduled
appointment with a doctor, according to the American Medical Association's latest figures.
That number varies by specialty: You're most likely to be left flipping through the May
1983 "National Geographic" in the waiting room of an orthopedic surgeon than any
other kind of doctor; 25 minutes is the average wait. If you want promptness, get a polyp
in your throat, since otolaryngologists are the quickest, at 16 minutes, to get you in the
door. In general, surgeons and obstetricians are most likely to leave you waiting because
they are often called to the hospital for a patient with complications or to deliver a
baby.
Given those averages, you might use this rule of
thumb: If you're hanging around more than 15 or 20 minutes past your scheduled appointment
time, walk up and bug the receptionist. Be firm, but pleasant; there could be a good
reason why you're waiting. Besides, being rude to the office staff won't get you anywhere.
But it may be even more smart to ask upon your
arrival whether the doctor is working on schedule that day. If you have to be some place
in an hour, let the staff know. If they have an inkling that you won’t be in and out
in that time, it might be better to reschedule the appointment.
Another
strategy is to call ahead before you leave for the doctor's office and find out if a wait
is likely. Use this technique if your doctor is chronically late, is a surgeon or if you
have an important place to be soon after the doctor's appointment. Maybe you can show up
20 minutes late and use that time to your advantage.
Meanwhile, some doctors are getting a clue about
customer service, according to Deborah Walker, a consultant to the Medical Group
Management Association (MGMA). Walker has seen offices that provide telephones and laptop
computers to allow busy patients to get some work done while they're there. One even
provides beepers to patients so they can walk across the street and shop until the
doctor's ready for them. She urges medical practices to change the name of their lobbies
from "waiting room" to "reception area," to get away from the idea
that it's natural to make patients wait interminably for the busy physician.
Others are trying out more sophisticated scheduling
plans so waits are less likely. It seems simple enough: Why don't doctors just schedule
the amount of time they expect to spend with each patient — a few minutes for someone
who just needs an explanation of test results, or 30 minutes for an elderly person with a
multitude of complex health problems? Because patients aren't very good about telling the
scheduler over the phone why they want to see the doctor, says Elizabeth Woodcock, another
MGMA consultant. "Maybe a third of patients will tell you one thing, and when they
come in they didn't want to tell the scheduler what it really was," Woodcock says.
"Some physicians just throw up their hands and say, 'I'll just schedule people every
15 minutes.' "
And keep in mind, from the doctor's perspective, he or
she doesn't get paid based on how long you're seen, but on whatever illness is diagnosed.
So, for instance, if he or she spends 15 minutes discussing ways to reduce your high blood
pressure, and you want to spend another 10 minutes talking about the pros and cons of
liposuction, she gets paid for only the 15-minute office visit for hypertension. The other
10 minutes, from her perspective, are off-the-clock.
That's not to say you shouldn't ask questions. Just
plan ahead — write down your questions, and make them succinct and meaningful.
There are other ways that, as patients, we can make
the process go smoother. For instance:
