Patience by Patients Sometimes Has Its Limits

by Bob Kieserman

Have you ever walked into a doctor's office, signed in at the front desk, sat down, found a magazine, and within five minutes, a voice calls your name to take you back to the examination room? Pretty sweet. No wait. Things are looking up today.

You are escorted to the third room on the right, your vital signs are taken, the medical assistant asks why you are here today to see the doctor, and you explain. She then utters those familiar words of encouragement, "The doctor will be in to see you shortly", and she closes the door behind her.

Fifteen minutes later, you look at your watch. Ten minutes after that, you realize that you have been sitting on the examination table for over 25 minutes waiting for the doctor to walk in.

Patients should not have to wait for the doctor. Often, we have made the appointment days or weeks or months before, and we have arranged our entire schedule to accommodate the appointment. We have either asked someone to give us a ride to the appointment, or we have taken mass transit, or we have driven and maybe had to park in an expensive lot that charges by the half hour. We may have taken off a day from work and we are using a precious personal day. Patients should not have to wait for a doctor.

So what are the solutions for this age-old problem? Better scheduling by the office staff? The doctor spending less time with each patient? Maybe and absolutely no. The best model for scheduling patients can be thrown off by just one or two patients needing more time in the examination room than expected. And once the doctor enters the room and it is you and the doctor, that doctor should not leave the room until a full and complete examination has been performed and every question that we have as a patient has been answered.

Perhaps one solution to resolving the anxiety of waiting for a doctor running behind schedule could be to make the patient aware of delays. Studies have shown that patients are more tolerant and understanding when they are told that the doctor is running late. Perhaps more physician assistants and nurse practitioners could be used, when appropriate, to allow the doctor to focus on more demanding cases. Perhaps patients should remain in the waiting room with updates on the doctor's progress until the doctor is almost ready for that patient, and then taken to an examination room. Perhaps, and I offer this suggestion with a complete understanding of how our private practices and hospital practices realistically work from a business perspective, less patients should be scheduled for any given half hour so that a backup is less likely.

There is a story about an elderly man who came to see his cardiologist. He had not been feeling well. He arrived early for his appointment, was called from the waiting room within 15 minutes of arriving, and escorted to the examination room. The nurse told him to change into a gown and that the doctor would be in to see him shortly. She closed the door behind her. Thirty minutes later, the doctor finally knocked on the door and entered, only to find the man dead from heart failure. He had died while waiting for the doctor, and no one in the office was aware of it because no one had checked in with the man after the nurse initially brought him into the examination room. That practice now has a strict protocol to check all occupied examination rooms, to knock and enter every 10 minutes, if the doctor is running behind schedule.

We all need to be proactive patients. One of the proactive things we can do when the medical assistant or nurse tells us that the doctor will be with us shortly is ask how soon, realistically, will that be. If we get an honest answer, which I hope we do, the next request we could make is that "if the doctor is going to be delayed, would you kindly knock on the door every few minutes and give me an update".

If we need to wait, then for certain, when the doctor finally knocks on the door and enters the room, we should expect that we will now have the doctor's full attention, that the examination will not be rushed, and that we will have the opportunity to fully understand the diagnosis, the treatment plan, and that any question we came with and any new question that we have in response to what the doctor has just told us, will be fully answered.

Patience is indeed a virtue, but patience by patients sometimes has its limits. It is up to us as patients to make sure that we are treated with respect and that our time is valued by the doctor just as we have valued the doctor's time and availability.   

Bob Kieserman was Senior Lecturer in Healthcare Administration at the Arcadia University School of Global Business where he was the Program Director of the Healthcare Administration Program for over 20 years. He is now a practicing medical librarian focusing on consumer health information librarianship. Prior to joining Arcadia, Bob was the CEO of one of the country's leading continuing medical education companies and prior to that served as Assistant to the Deans of the Temple University School of Medicine. He was also a Special Lecturer in Medical Practice Management at Howard University College of Medicine and the Temple University School of Podiatric Medicine. Highly respected by both clinicians and administrators throughout the country, he is the author of four books on medical practice management. Bob's passion is educating patients about their rights and empowering patients to be better consumers of the healthcare delivery system.