Playing the Doctor Office Waiting Game

As if the doctor-patient relationship isn’t one-sided enough, the subservience patients often feel can be made even worse when you must wait way beyond the appointed time for your consultation.

For some patients, time is money, and for all patients whose doctors assume the doctor’s time is more important than yours, extended waiting is disrespect. One study last year pegged the average wait time at doctors’ offices in the United States at 24 minutes.

Everyone understands that medicine is fraught with emergency, and sometimes a physician simply must accommodate an unexpected patient. But some doctors are never on time; for them, running late is business as usual.

Others are told by superiors and insurance companies to book consultations at 15- or 20-minute intervals; if one patient has more than one problem, or a complication arises that requires 30 minutes’ time, every patient after her will be seen late. So, does the doctor cut off the appointment in order to maintain the schedule, or does she meet the medical need at the risk of making everyone else late?

As doctors are increasingly besieged with paperwork demands and lower fees from Medicaid and Medicare, is it fair for patients to expect prompt service? Apart from making a scene, is there recourse when your 10 a.m. appointment begins just before lunch?

Some patients, according to several recent reports including one on CNN, are turning rude behavior into financial penalty. They’re invoicing tardy physicians for time spent cooling their heels in the waiting or exam room. And physicians are paying.

Not too long ago, doctors would have scoffed at the idea of reimbursing patients for time spent waiting. But some told CNN they give patients money or a gift, sometimes even without being asked.

“I love this!” Dave deBronkart, co-chair of the Society for Participatory Medicine, told the network. “It’s magnificent that some physicians are valuing patients’ time. It’s a commitment to designing a practice that truly serves patients.”

Others … not so much. One woman left her doctor’s office at 8:40 when the gynecologist hadn’t shown up for her 8:00 a.m. appointment. Encountering the doctor in the parking lot, the patient asked about the delay. “The doctor told me she had a little one and she was never in the office until ten to nine,” she remembers. “I asked her why she scheduled appointments at 8 a.m., and she said to give the patients time to do paperwork. I was so mad I was shaking. I never went back to her.”

DeBronkart blogged at E-Patient Dave when he waited 45 minutes for an X-ray. He told CNN that the head of the radiology practice later called and acknowledged the need to change how they scheduled patients.

Some physicians have seen the patient-waiting light, and are doing their best to ensure it isn’t red. MedPage Today reported about one who offers Starbucks gift cards and text messages patients if he’s running behind. Another, who practices boutique medicine, books only about 10 patients per day for at least 30 minutes each and charges a $125 annual fee per family for the convenience. If he is late, he pays $25.

The MedPage story makes clear that it’s easier for some practices, such as surgery, to run more efficiently than a primary care office. Offices at greater risk of being late can address the problem and possibly mollify patients by:

  • offering wireless Internet;
  • ensuring good cell phone service, and providing space where waiting patients can talk privately;
  • texting, emailing and/or calling patients if they’re running late.

One patient who tries to turn waiting time into work time is concerned that if billing tardy doctors becomes fashionable they will start charging everyone more. They should focus on prevention, he says.

As a patient, you can minimize your likelihood of a shortened fuse from a longer wait by:

  • scheduling your appointment at the beginning of the day or right after lunch;
  • locating doctors with demonstrable on-time practices via an organization such as Ideal Medical Practice, which identifies superior practices; and
  • putting a value on your time and invoicing your doctor for an unreasonably long wait.
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