Not only are waits to get a doctor’s appointment long, but once you’re there, expect to spend more hours waiting.
The reason boils down to this: too many patients in too few time slots. As physician payment decreases, doctors respond by seeing more patients. It’s the fallacy of cutting physician pay in a fee-for-service world.
Doctors can either be on time, or spend time with you. You cannot have both. If you value being on time, choose a punctual doctor, but expect efficient visits. If longer appointments are your preference, expect delays.
CNN’s Elizabeth Cohen offers more tips to patients, such as seeing someone else.
However, that’s no incentive for doctors to change. As long as there continues to be a physician shortage and pent-up demand, for every patient that leaves, 10 more are more than happy to take their place.
With Baby Boomers entering Medicare age, demand will only increase. Expect the situation to get worse.
If you’re a doctor, access is valuable currency. If handled correctly, it is the most powerful marketing tool for your practice.
Related posts:
- Waiting hours to see a doctor, and patients billing physicians for lost time
- Female physicians and the Canadian doctor shortage
- Think you’re waiting long for a doctor now
- How much would you pay to e-mail your doctor?
- When was the last time you actually saw a doctor?
- E-mails and telephone calls to the doctor cut down on patient office visits
- Once you hit Medicare age, good luck finding a primary care doctor
{ 5 comments }
In my office, one of the most significant contributors to being behind schedule is the patient. Although encouraged to arrive early, many come in 5-10 minutes late for a 15 minute appointment. Frequently, they do not have their insurance information. Sometimes we have to change pcp designations, although the patient is advised to do so before coming to the office. Then there are those that do not have their copay, can they come by tomorrow or post date a check, and so on.
Then we have the laundry list, even though the appointment was for a cough. The patient frequenty has the attitude that “I am paying my 25 dollar copay, dammit, I want my money’s worth. You address all of my needs or I will go elsewhere. By the way, can you look in my kid’s throat too?”
And then there are the increasing beraucratic demands that clog up a primary care office, such as prior auths.
The whole system is inefficient. An insurance company has no motive to be efficient; quite the contrary, the less efficient they are, the less money they dole out. Forcing primary care offices into a “business” model is an awkward fit; we are not restaurants or convenience stores. The doctor-patient relationship is much more complicated than that of a consumer and a provider-of-a-service.
Let’s all be cooperative; if you are a little late to an appointment with me, I will assume your reasons are valid. Similarly, if my office is running behind schedule, do not assume we are all on a coffee break. We are all working as hard as possible to provide appropriate medical care to you and/or your family.
Signed, a family practitioner
Or the patient who just MUST answer their cellphone while you’re getting a history from them. This really burns me up, and holds up other patients.
I’m not shy to remind patients leaving through the waiting room not to use their cellphone during the next visit, so as not to hold up other appointments. This redirects waiting patients’ frustation to that patient, and at the same time reminds them not to do the same.
Kevin,
Good post about this issue. It’s a catch 22 IMHO. I am always on time for my doc appointments, but have to wait an average of an hour or more, while the “being seen” part, lasts all over 10 mins. How can a proper diagnosis be given in 10 mins? If the doctor knows the patient very well, I can understand how a diagnosis can be made quickly. However, for someone like me, who is in relatively good health (despite a love of food), going into the docs office with a problem is always a dice roll. If the doc doesn’t see me enough because of relatively good health, then how can a proper diagnosis be made in such a short time? That’s where the fustration lies in my opinion. You wait and wait and wait, get called in to an room only to wait about 20-30 mins longer. Then you’re poked and prodded for a couple mins, given a sheet a paper with some meds on it that will cost you about 40 bucks that might or might not work.
This is one of those arguments that will stand the test of time. People are always going to get sick. The only real solution is something you’ve pointed out in the past. We simply need more doctors – good doctors – to handle the influx of patients needing care.
Have you heard of a benefits service called Best Doctors – http://www.bestdoctors.com. I’d be interested in your feedback. Simply put, if your company has Best Doctors as a benefit, you as the employee can use them to review your medical records and help confirm a PC’s diagnosis, treatment, etc. A service like Best Doctors helps with this time issue because they will put a dedicated team in place to address your specific medical need and ask all the necessary questions that you can’t fit in during a 10 min visit.
Re: Best Doctors. They can provide a very valuable service, especially to patients who have seen at least a couple of doctors but who haven’t yet been diagnosed and treated to their satisfaction.
One caveat: expect a long turnaround time between your request and the eventual “Best Doctor” opinion on your case…especially if your case is complex, requires lots of records to be obtained from multiple providers, and involves re-reading of any films or pathology specimens.
The original blog is truncated in scope—it considered timeliness and quality as reciprocal–but leaves off price which is the real problem. The old adage is “Good, Fast, Cheap–pick two of three” You CAN provide Good service measured by amount of time and do so on time–if and only if you don’t try to do so cheaply. The real culprit here are price controls. More physicians are rejecting them and not taking Medicare or insurance participation agreements. You are always free to seek one of these physicians where you will usually find a relaxed non-rushed visit that is fairly timely. But you have to pay a fee that makes sense for a professional who has invested 2-3 times more time and energy in acquiring his skills than the lawyers and accountants that you buy services from.
By any international standard of physician supply, there is no shortage of physicians. Americans consume a great deal more medical care than most for a variety of reasons–one being, paradoxically costs. We have high total costs but the percentage out of pocket is actually much lower than most European systems. Price controls here, as always as a general economic rule, create shortages.
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