This week I had a doctor’s appointment at a major, well-respected hospital in Boston. Prior to the appointment, I met a friend for lunch and made sure to excuse myself in time to get to my appointment. I arrived promptly, checked in with the receptionist, and took a seat. And then I waited. And waited. After some time, I noticed the two women on either side of me had not been called either, fidgeting in their seats, so I assumed things were running behind. An hour passed. And then another 30 minutes. No communication from anyone in the office. I started to get antsy and I texted my husband. “This is insane. I think I am going to leave.” He “talked me off the ledge” and then I thought about the situation and the fact that if I rescheduled I could be dealing again with the same waiting on another day. I should stick it out. So, I stayed. After 2 hours I was called into the exam room. The nurse brought me in and said “Sorry about the wait. It has been a crazy day.” My knee-jerk reaction was to say “It’s ok. I understand.” But is it really ok?
This is not the first time this has ever happened to me. I have been in similar situations many times. My family and friends have been in similar situations also. I bet we all have. Most recently, friends of mine texted me after they woke at the crack of dawn to drive 3 hours into Boston. They had a series of back to back appointments that depended on their prompt arrival. Driving into Boston on any given day can be stressful because the traffic is so unpredictable so the drive was not the most relaxing. They made it in time, a bit frazzled, but relieved they made it. And then they sat, and waited, and waited, for one hour for the doctor to show.
Most times it doesn’t feel good to sit and wait. We are sitting and wondering. Did they forget I was here? Am I going to be able to get back to work in time for my next meeting? Sometimes we are receiving critical information from the doctor and each minute that goes by with uncertainty creates more anxiety.
I once had an appointment with a doctor and I waited for 40 minutes for her. The next time I returned for a follow-up I had an issue with the train. Typically I drive my car but that day I had to be in multiple places around the city and didn’t want to pay several times for parking. I had given myself double the time to get to my appointment and even so my train broke down and I was stranded. I finally made my way into town, got off at the closest stop to the hospital which was still about a bit of a walk. I started running, seriously running, to my appointment. I called to let them know what had happened with the train and I would be late. My heart was beating out of my chest and I thought I was going to have a heart attack. I arrived at my appointment 15 minutes late. They sat me in the waiting room for 10 minutes and then told me that my doctor would not see me because I was late. She had another patient and then a meeting. Oh, and by the way, she only works one day a week at that location so they could reschedule me for the following month. Really? So, I can wait for her repeatedly but when I am late all bets are off.
I have painted a picture and you may have your own stories. Sometimes we feel our time is not respected in the way we would like. That it isn’t a two-way street but a bit one-sided.
As I have done work in patient advocacy in a medical setting I understand both sides of the issue. Patients want to be seen in a timely manner and physicians are not always able to meet those expectations.
From the doctor’s perspective, there are many reasons for wait times. Sometimes patients show up late for their appointment. There are unforeseen emergencies. Doctors sometimes spend extra time with a patient. I have some great relationships with my clinicians and sometimes we are just chatting about life, our summer plans, our families, while the next patient may be looking at their watch in the waiting room. I had one doctor who regularly would make you wait 1-2 hours. His point of view was that he spends as much time as a patient needs and never stays on schedule. I agree I felt valued when I was actually sitting face to face with him. But I would cringe at the thought of having to return for a follow-up visit to once again sit in the waiting room for hours.
So, now the question is whether or not we should just accept a long wait time because we know there are many variables. We know there are many reasons for delays and need to be understanding. That said, everyone’s time is important and valuable and I don’t believe we should feel like we are being held hostage.
Here are some of my thoughts and suggestions.
We are consumers of medical services and paying larger sums than ever before. If we repeatedly wait too long at a restaurant or too long for our hairdresser we don’t go back. We find someone else. With medicine, we often feel differently, in less control of the situation. We may value the doctor and their expertise and not want to switch to someone else. So we put up with the long wait times. But should we? I actually left the doctor that would regularly make me wait 1-2 hours in the waiting room.
Hospitals and other healthcare facilities should take wait times seriously. Creating a culture that is patient-centered and values patients as customers will lead to a focus on reducing wait times. Wait times directly impact patient satisfaction. Today hospitals should be concerned about patient satisfaction in a newly competitive environment.
We should demand better communication. I made the mistake of saying “It’s ok. I understand.” I should have given feedback that the experience could have been managed better with some form of communication. In my opinion, it is all about communication. If a doctor tells me they are running behind or there is going to be a wait, I am much more understanding. I am much less likely to go on any type of rant. On one occasion, I arrived at my appointment and as I sat down in the waiting area, my doctor approached me to say she was running late. She told me she had a least one person ahead of me and told me to go to the cafeteria and have a cup of coffee. That made all the difference to me.
Doctors and hospital staff need to be trained on how to communicate with patients. A hospital should have a standard policy so to ensure all doctors are following the same protocol and there is a process in place to let patients know in advance if an appointment is delayed. This is common courtesy. In no other industry would it be acceptable to keep a customer waiting for 2 hours, especially without some type of communication. Can you imagine if you were 2 hours late for a client meeting but never called the client to tell them? You would be fired. Why is it acceptable in the medical community?
Clinicians should tell us what we can expect! I know some hospitals are hard at work trying to fix the problem but while you are sitting in your back rooms with graphs and charts all we ask is that you to give us information about our visit. The graphs and charts don’t matter to us. It can be a simple as the physician or a staff member giving a patient an estimated wait time when they check in. Some institutions have white boards with wait times or computerized screens with numbers assigned. I say we use technology to make the experience better. Text us before we get to our appointment if there are significant delays as many of us are traveling from somewhere to get to the appointment on time.
We need to demand better care and I believe this is the key to change. Today hospitals are in a competitive environment like never before and they need to find ways to improve in order to remain competitive. Patients are customers, and as customers, they have the right to choose where to go for their medical care. Determine your doctor’s philosophy and attitude. My oncologist was incredibly disciplined and in the 26 years, I saw him I rarely waited more than 20 minutes. That doesn’t happen by accident. I know he was concerned about wait times and I always felt respected. It is a balancing act. Giving patients the time they need while not alienating those who have to wait.
Take control of what you can control. Make appointments early in the day which may be better than later in the day where there can be backups. Speak up. Call in advance to check to see if the doctor is running to his/her schedule.
The nature of healthcare services is inherently variable and sometimes unpredictable. For that reason, this can be a complicated issue to fix entirely. Even in a perfect world, there may be unforeseen circumstances that may lead to a longer wait time to see a clinician. I believe the change we desire will come from patients demanding it.