Patient Engagement Or Long Office Visit Wait Times – You Choose

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[tweetmeme source="Healthmessaging" only_single=false]Recently I found myself sitting in a retinal surgeon’s office.  I was there as a new patient.  I wanted to get a second opinion…with the intent of switching doctors for an upcoming surgical procedure.

doctor patient communication2As I was filling out my forms I would listen to established patients as they would register at the front desk and ask if the doctor was running behind.  Nothing is really private in waiting rooms…everyone I am sure was listening for the reply.  The receptionist whispered that the doctor was running 2 and ½ hours behind.   Yikes!

Eventually I was ushered into an exam room where a Medical Assistant did her “new patient” thing and confirmed the long wait to see the doctor.  The MA administered some medication to dilate  my eyes for the medical evaluation and had me wait in an area where you could see (and hear) all the action.   The first thing I noticed was how quickly the doctor was moving quickly between patients.  He was clearly very busy…too busy as it would turn out.

The Unintended Consequences of Long Waits

I was a bit surprised at how the waiting and clear demands on the physician’s time affected me.   After all I have written about physician-patient interactions for some time now.    Here’s what I mean.

Beginning  several days prior to my visit, I had begun making a mental list of what I wanted to discuss with this physician.  I mentally checked off my “visit agenda” along with the questions I wanted to ask.  I was prepared to get the most out of this visit come hell or high water.   But the longer I waited, and the more tired I got just sitting there, I started eliminating agenda items and questions from my list.  This guy was way too busy.

I did eventually see the doctor but by the time I finally got to talk…I had significantly narrowed down my list of questions and concerns.   I didn’t want to take up anymore of this doctor’s time than I had too.  I was surprised at myself – I am not normally one to so easily giving  up on things I want to learn.

The Point?

It occurred to me that long wait times not only have a negative impact on patient satisfaction…but they also impact the quality of care.  Here’s how.   The long wait caused me to limit:

  1. How much information I gave to the doctor in the interest of economy of time
  2. The number of questions I had about my upcoming procedure.

Don’t get me wrong I am not blaming the doctor for my reluctance to take up his time.  What I am saying is that my experience showed me how a long wait inhibited my normally proactive health behavior to the point where it could easily had consequences beyond my satisfaction with the “office experience.”  By the way, I was so turned off by this busy specialist that I am going back to my original surgeon.

My Suggestion

Everyone recognizes that “waiting” is inevitable in most doctors offices. However, physicians that actually want to encourage patient involvement in the office would do well to go out of their way to:

  1. tell patients upfront when they sign in that the doctor is running behind
  2. acknowledge (I didn’t say apologize) long wait times when they occur
  3. encourage patients to fully describe the reasons for their visit, including their symptoms, and ask all their questions without feeling constrained about taking up the physician’s time.   Not only will you have a more satisfied patient but you will also make a better diagnosis and encourage great patient adherence.

 

That’s my opinion. What’s yours?

5 Comments

  1. Danielle Casher says:

    That is a really interesting relationship, Stephen, that I had not thought of. I am a pediatrician and try very hard to stay on schedule and not keep patients waiting. They do wait, however, and I do apologize. I always knew they would be in a crankier mood after waiting (especially with one or more bored children) but had not thought about the impact on patient engagement. One improvement (besides trying to schedule patients more appropriately for the actual number that can be seen in a given amount of time) would be to try to solicit the patient concerns ahead of the visit. A nurse or medical assistant could start this process. Some who work in patient centered medical homes do this.

  2. Rich says:

    I don’t go to doctor’s offices very often. Fortunately, my health is good so only about once a year. In the future when I have an appointment, I will call ahead and ask if the doctor is running late and how long I will have to wait to see him. If for example, he is running an hour late show up an hour late? Does that work, or are patients seen first come first served?

  3. jtc says:

    Great point regarding the impact on quality of care. Outside of emergency/acute care settings, have there been any large studies characterizing the relationship between wait times and quality of care (or MD-pt interactions)?

    in our specialty care pediatric hospital, clinic wait times are often quite long. We do provide the families with visual pagers (similar to what you get at a large chain restaurant) so they can at least use our other facilities and not feel trapped in the waiting room. Not a solution, of course, but a modest improvement in their experience.

  4. One way of reducing patient wait times and yet answering all their questions is to use technology to provide Information Therapy. Most specialists have a very good sense of the common questions and doubts their patients have – and they can answer these proactively.

    You might find my post on How I Prescribe Information Therapy in my practise to keep my patients happy at http://blog.drmalpani.com/2011/09/how-i-prescribe-information-therapy-in.html of interest !

  5. Carolyn says:

    It depends. I’ve had an endocrinologist and neurologist whom you do have to sometimes wait for – BUT – it is well worth the wait, because when it is your turn, it’s your turn. They both take whatever time is necessary to assess the/your situation.

    On the other hand, a primary care office that I went to for somewhere between 15 and 20 years has gotten to the point that it is seriously like a fast food drive through lane. They spend a ridiculously small amount of time with each patient, and though I went there for years when I had no significant health issues, they dropped the ball big time when I did eventually end up quite ill. Needless to say, I don’t and wouldn’t trust them to treat me for anything more serious than strep throat or a sinus infection. For that, they will do. They are adequate. But for life or death decisions and treatment? Um, no. No thank you.

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