Please, doctor, don’t rush on my account


I recently consulted a specialist at a major medical center in New York, and a few days later, here came a questionnaire in the mail. “How much time did I spend in the waiting area?” it asked. How long was I kept waiting in the examining room? How close to my appointment time did the doctor see me?

The one thing it didn’t ask was whether I cared.

There’s no mystery about why medical centers pay so much attention to wait times: patients demand it. During the months I underwent cancer treatment, I often overheard fellow patients complaining bitterly that they’d been sitting there for an hour, dammit.

I wonder if they’ve thought that through. When I was first diagnosed with cancer, a surgeon I desperately wanted to see gave me an appointment on only two days’ notice. My medical oncologist spent extra time with me whenever test results required explanation; and when the possibility of a secondary blood cancer arose, a hematologist squeezed me in at 7 a.m. on the next business day.

Each time one of my doctors makes time for me, other patients have to wait. When they make time for other patients, sometimes I have to wait. To me, there’s no contest: knowing that my doctors will be there for me when I most need them means far more than having them be prompt. Because, of course, they can’t do both. Responding to emergent needs is fundamentally incompatible with maintaining a rigid timetable, and cancer just doesn’t schedule well.

I said some of that to a retired colleague who’d walked out of his doctor’s office after waiting half an hour. “They shouldn’t take so many patients!” he protested. “Then they wouldn’t be so backed up!”

It reminded me of times when, as a college professor, I had some students begging to get into a course so they could graduate on time, while others complained that the class size was too large. If my surgeon and medical oncologist had been trying to shorten their wait times by turning patients away, I wouldn’t have made the cut myself, since my diagnosis is widely considered inoperable, and I live outside the usual radius for chemotherapy patients.

There’s an old saying, “Be careful what you wish for, because you might get it.” If patients keep focusing on wait times, presumably our doctors will indeed be pressured into staying on schedule. So they won’t squeeze us in on short notice — after all, we can always go to the emergency room, to be seen hours later by a doctor we can only hope is familiar with the chemotherapy we’re taking or the surgery we’ve had. Doctors won’t accept us as new patients, no matter how badly we want to see them, if they’re already reached their limit; nor will they spend extra minutes with us when there’s a decision to make or news to absorb.

Perhaps there’s no way to turn back the tide of clock-watching and bean-counting that physicians write about every week on KevinMD. If so, we’re facing a decline in the quality of American health care that no miracle drug or cutting-edge technology can compensate for. No matter how rarely I needed a quick appointment or extra time, simply knowing that my doctors would respond if a problem arose meant that I wasn’t out here all alone, adrift in an impersonal medical system.

Now that I’m healthy and in remission, I’m classified as a patient who can wait — for hours, if need be — while more urgent cases are seen. I don’t mind. Sipping hot tea in a comfy chair in the waiting room, reading a book, I’m just grateful that, today, the emergency isn’t me.

Joan DelFattore writes about single life, including handling illness without a partner.

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