The problem is the waiting period from scheduled appointment time to actual visit time with the physician. There is no doubt about it, many people have to wait long periods of time to see their doctor and this causes significant irritation.
However, there is more to this subject than perhaps one might realize. To best explain, I need to go back to the first few years of establishing my private practice in my hometown after returning from seven years of training following medical school education.
I was thirty-two years old, fully trained and anxious to get started. At first my waiting room was often empty and my patient load in the hospital light. For those few patients who did make appointments, I found myself sitting down, on time, and discussing many aspects of medical care with them for extended periods of time.
Those few patients returned home to tell their friends that not only did I see them on time, but they were able to spend much time with me during their visit. Thus, my practice grew. Suddenly, I found that as the number of patients expanded, although I was still seeing them with almost no waiting period, I had to somewhat shorten our visits together.
Still, the number of patients grew. In an effort to handle this situation I extended my office hours to include additional time. Finally, as happens to most young physicians, I reached a point where I had to make a decision; would I insist on patients being seen on time and thereby shorten even further the time spent with patients or would I allow for an increased waiting time and yet maintain a caring, thorough, thoughtful, educational experience for our visit together when it did occur.
I chose the latter. I set up my practice so that once a patient was seen, the patient would leave feeling that she had spent enough time with me to get her questions answered and her medical needs met. This was my ultimate goal.
Yet my practice continued to grow and my duties and responsibilities expanded. Emergency deliveries, operations and procedures of my increased number of patients grew to a point where I was finding it difficult to keep the waiting time within a reasonable time frame.
To maintain control over this seemingly uncontrollable situation, I informed my secretary to limit the number of patients in my practice. However, in spite of this ploy, my secretary kept coming to me to tell me of a patient who was a friend of a friend or a relative of a relative or the wife or daughter of a colleague, or just someone who really needed help. What could I do?
Many of my patients were now waiting 30-60 minutes to see me for their medical care. I was frustrated, they were frustrated. My choices were becoming more and more limited. In addition to all this, I found myself feeling guilty during office hours. I knew my patients were waiting and I felt I was letting them down, adding to their already overburdened lives.
Despite what you may think, chances are, your doctor is just as upset at having to make you wait as you are upset at waiting. All I could do was make sure once the patient and I were face to face that I gave them the very best medical care possible and helped them feel it was worth the wait.
Although doctors can reduce the patient load somewhat, modern economics of medicine comes into play. Before opening the door of an office, my colleagues are saddled with large medical malpractice fees. Add to this the cost of office space, secretarial support, equipment, and nurses, and it is understandable that physicians must either continue to see as many patients as possible or raise fees for those who are seen.
Insurance companies and managed care groups, however, make the latter option impossible since they refuse to pay for additional charges.
In all fairness, medical care cannot be compared to other lines of work. Matters of life and death and good physical and mental health are at stake and are not comparable to taking a car to the shop or a financial problem to an accountant.
Yes, we must work on trying to keep the waiting time for our patients as short as possible, but we must also take care of patients when they are ill. So as I sat waiting for my physician, the clock ticking away, I was glad I had freed up the next few hours. I knew my waiting meant my doctor was handling the needs of the patient ahead of me.
It was then I realized that doctors wait, too.
(Frank H. Boehm, MD is a professor of OB/GYN and Director of OB at Vanderbilt Medical Center in Nashville, TN. He can be reached at his web site http://dr-boehm.com. Dr. Boehm resides in Boca).