Is the Waiting Room Necessary?

I spent 40 minutes waiting to begin diagnostic tests preparatory to seeing my ophthalmologist. What a waste of my valuable time! And my calculations from data from the American Time Use Survey suggest that this is a standard problem: the average adult American spends four hours per year waiting for medical or dental care, with each wait averaging around 45 minutes.

Pricing this time out at even half the average wage rate, the cost amounts to about $5 billion per year. Seems like a lot, and very inefficient, but what is the alternative?

The only way that every medical provider could ensure no waiting would be for the provider to have downtime herself, in order to have unutilized resources, both of her time and the services of the capital stock used in the practice. I’m not sure what’s the right mix of provider and customer waiting; but as annoying as my waiting is, the current system may be economically efficient.


Trevor L

Just an off the cuff theory: wouldn't an easy option to take care of this problem would be to offer some sort of "express" option? I bet many patients would be willing to pay some extra dollars in order to ensure that they don't have to wait (as long as the price is lower than their opportunity cost). Doctors, who now have extra profit, can limit the amount of patients they take on during (or directly before) the extra-paying customers' time slot. Assuming the doctors do not lose money I bet that they would be more than willing to do it (they essentially would be getting paid to work less).

RZ

I don't mind waiting so much as I mind not being told that I would probably have to wait around X minutes. It's amazing how clerical staff won't tell you if the doctor/dentist is running behind and that your wait might be longer than the normal few minutes. I once had a dentist apologize to me for making me wait 30 minutes while I was in the patient's chair already. That was nice of her, but it would have been more useful to have the clerk tell me that I'd likely be waiting for 30 minutes. I'd have been more prepared to wait rather than wonder what was going on.

I try to get around waiting by taking the first or second appointment of the day - at that point, the doctor/dentist is usually not running behind by much.

David

How much would you be willing and able to pay for no wait? What if your dr. had a "coach" and "elite" level of service. If you're elite, you don't wait or wait less. Perhaps they already do but hide it in some way.

peter

We do not tolerate such waits from any other professional - attorney, investment advisor, hair stylist - with whom we engage.

You're the client and the payor, reimbursed or not.

Find another doc!

Ken Davis

I'm reminded of the cartoon with the receptionist explaining, "Your appointment with the doctor is at 10:00 a.m. The doctor's appointment with you is at 11:45."

Jon Luke

I think the last thing they need is another signal as to how much more their time is worth than ours.

Perhaps, at some point, there will be a point where enough people with gadgets like the iPhone will access WebMD and diagnose themselves, just like the jurors who have been informing themselves of their cases.

I think the risk of the slippery slope is far worse than a mistrial.

Jonathan

There are two 'waits' in seeing a doctor. The waiting to get an appointment, and the waiting in the waiting room.

Your proposal would indeed reduce the waiting in the waiting room, but would increase the waiting for an appointment.

Of course if you had more doctors, then that would definitely work!

Randy

they could pay you for wait -- like the Cosean post earlier. :) or, "mechanical turk" work to waiters, like confirming appointments, transcription, and let you earn your copay at $10 an hour.

Kimota94

We have the same scenario in Canada, and I've long thought that what we need is some system whereby the medical / dental office can update you, in real-time, as far as how things are running. If I'm at work at 4:00 and have a 4:30 dentist appointment, I'd love to know that they're running 25 minutes behind so that I can plan to show up at 4:45 (let's say), instead of a few mins before 4:30. That alone would save me 15 mins. Maybe Twitter or something like that could be used to accomplish this?

Milton Recht

Actually, studies of ways to reduce wait times for doctors were done.

"Allowing patients to make appointments in the morning to see a physician later that day is the right prescription for efficiency, according to a new study by researchers at Cornell University's Johnson School."

It reduces waiting time and doctor idle time from no shows.

http://www.johnson.cornell.edu/news/Robinson_appts.html

Kendall

Economically efficient or not, it would be interesting to see how much people would pay in order to expedite their waiting-room time. It would be like putting a waiting-room express-lane in. We could see how much people were willing to pay in order to avoid wasting their time waiting. It would demonstrate how valuable people feel their time is... not to mention healthcare would make a killing (because they don't rip the public off enough aready).

Jake

How about text messages as to the status of your appointment. In some cases I've called the Dr.'s office to see if he is on schedule or 2 hours behind. I'm not waiting for more than 30 minutes without getting upset.

As a side note, this is also a reason to not go to the Dr. - they are time sucks. FYI I'm healthy, but from their point of view they could probably bring in more revenue if they kept on schedule. Just a thought.

tracy

Reminds me of the time we went to the Cheesecake Factory in Beverly Hills (yeah, we're touristy people). You can walk up, talk to the seating hostess to see if a table is open, if not, she'll give you a pager that will page you when it is/will be soon.

Not sure though how to make sure people don't run of with the pager.

I think, mentally, waiting your appt, pre-conditions your mind regarding your relationship with the doctor and how the appointment will go: he's the more impt/smarter/superior bet the two of you so you should follow him.

Edward

There are many lean solutions to this problem. One answer is to use paperwork (that has to be done anyway) as buffer time.
Instead of scheduling a patient every 15 minutes, you schedule a patient every 20 minutes and give the doctor 5 minutes to do paper work at the end of each session (If he doesn't he will have to do that paper work at the end of the day).

If he is going slower than expected, then he takes that out of his paper work time - and that paper work is moved BACK to the end of the day.

Same number of patients get seen with less waiting time and the same (or sometimes better) efficiency for the doctor.

M.B.

There is no incentive for them to be efficient right now or even to bill correctly or code appropriatly.

Saumya

I think we are all forgetting about the limits of a physician.

What about insurance companies? They dictate how much time a physician may spend with each patient and which medical costs will be covered and which will not. With the insurance companies submerged in the doctor patient relationships and the rate of malpractice claims always rising, it is very difficult for physicians to put off any paperwork. A single sheet of paper not signed right away can possibly result in a lawsuit.

There are also not enough resources for the amount of people who need treatment. If you go to any inner city emergency area, you will see a perpetually crowded waiting room. Many of these patients cannot pay for their services, either. This causes many health care facilities to either scramble for money or limit the patients they see.

It is all about limits. With the way our system is right now, this is the most efficient way.

Read more...

ML

Plan for waiting times (then they aren't actually just wasting time waiting).

1. Keep a paperback in your car, pocket or purse.

2. Always have an audiobook on an MP3 or iPhone in your purse or pocket.

3. Take care of your email on an iPhone or other gadget.

a student of economics

Here's a simple solution, Dan:

I bring a book or something else I want to read to the waiting room (and anywhere else I may have some down time). An iPhone or Kindle make this even easier to do.

Time spent reading is never "a waste of my valuable time!"

Dennis Rice

I find this thread very interesting. Here in Canada, while we have free healthcare, we wait an eternity to get it, so we're used to the wait. I know that when I go to the doctor I'll be there for a while, so I bring a book, listen to music, or even bring a file from the office to work on. Why get upset?

Having said that, if I was paying for service myself, I may expect better.

Linda

My favorite dentist was always right on time. His assistant scheduled appointments so that "on time" was the rule, not the exception. (Apparently, there is a way to do this.) When I complimented him his response was - "Why should I think that my time is more important than yours?" I feel like I must have dreamt the whole experience considering the way we're usually treated by medical and dental professionals.