Doctor late

Recently, a friend of mine posted a note on her Facebook account about being upset that she was at the doctor’s office and she had to leave after waiting for an hour. And, though, I do empathize with her because I dislike waiting, I do have a different perspective because I have been in health care management for over 25 years.

Certainly, there are cases that the physician has poor management skills or may not have the ability to achieve closure of an office visit with patients. Perhaps, the practice has a poor scheduling system. In defense of medical offices, there are many reasons for physicians running late that are beyond the physician’s control and not the intention to create dissatisfaction to the patient. The top one is due to the inception of managed care, physicians are forced to see more patients in a day. Physicians would prefer to spend more time with patients to make sure that the patient has the physician’s undivided attention and to create a relaxed atmosphere rather than one that is rushed. Many physicians enjoy the teaching perspective and would prefer to educate their patients on prevention and/or management of their condition.

Secondly, the front office staff tries their best to find out what the patient needs to be seen for and schedule appropriately. However, patients don’t feel that they need to tell the front office what their issue is and say it’s something minor. Then, when they get into the exam room, the doctor comes to find that it is not minor and the patient really needed a thirty-minute appointment instead of the fifteen-minute appointment. We have heard many times, “It’s none of your business.” or “It’s personal.” Patients need to understand that we need this information to help prevent delays and by making sure that the physician is prepared to deal with the problem (equipment or supplies) prior to the patient’s arrival.

In addition, patients oftentimes throw in that “Oh, by the way…” which also adds to delay for other patients down the schedule. Many times, the patient comes in for a minor problem and when the physician asks if there is anything else, in an attempt to close the visit, the patient will add “While I am here…I’ve been having this chest pain for the past three days!”

And, lastly, we can never tell when there is an emergency that will delay us and we are not able to conveniently schedule them late in the day. Case in point, we had to have the ambulance come and pick up a patient who was scheduled for a 15 minute appointment for a medication check. The patient did one of those “Oh by ways…” which led the physician to determine that the patient was probably having a heart attack and the physician was not going to leave the patient’s side to see another patient.

Physicians are starting to limit appointments by telling patients that they can only have two concerns addressed, or they tell them that they were scheduled for A and that they only have time to deal with A, so they have to schedule another appointment to deal with B. This upsets patients even more than the delay.

Ideally, staff should communicate with patients about any delays as soon as they arrive to check-in for their appointment, or as soon as they realize that there is a delay. This gives the patient an option to stay or reschedule the appointment. Though, patients still may not react favorably to this news, they would much rather have the opportunity to make that decision.