Thursday, May 7, 2009

Expectations - Time is Important for Patients, Too

The supply of time is totally inelastic. No matter how the demand, the supply will not go up. Moreover, time is totally perishable and cannot be stored. Yesterday’s time is gone forever and will never come back. Time is, therefore, always in exceedingly short supply.

Time is totally irreplaceable…Everything requires time. It is the only truly universal condition. All work takes time and uses up time. Yet most people take for granted this unique, irreplaceable, and necessary resource.

Peter F. Drucker, 1909-2005

Time is important for doctors. If they’re paid fee-for-service, time with patients is what they’re paid for. Lack of time is why some doctors must see 25 to 30 patients a day to make ends meet and pay the staff and bills.

Time is important for patients too. Indeed, too much waiting is often patients’ chief complaint about American doctors. Too much waiting for elective procedures is what people complain about in nationalized systems like Great Britain, Canada, and Sweden.

Time was important to me the other day when I was a patient in a cardiologist’s office. After nurses had gathered the preliminary information, I sat on the edge of the examining table for 25 minutes in my Johnny, my bare feet dangling from the end of the table, facing the blank door, waiting for the cardiologist. I had things to do, a blog to write, a conference call to join, a trip to make to go home to field the call. Where in the hell was he? Why didn’t someone tell me how much longer I would have to wait?

A few days later, I received notice of a 2009 survey of physician wait times conducted by Merritt Hawkins & Associates in 15 major metropolitan markets In cardiology, average appointment wait times exceeded 14 days: Minneapolis(47 days), Miami (29 days), San Diego (22 days), Boston (21 days), and Washington, D.C (18 days).

What can physicians do to ease the pain of waiting? How can the address the underlying feeling among patients, who want to cry out, “Doctor, my time is important now?”

Well, doctors can do the obvious, improve scheduling, including an open access day; give the patients something to do while waiting, like installing a telephone line for local phone call; making waiting more comfortable, with soft music, relaxing chairs, tea, or coffee; provide fun things to do, or watch, see, or read.
Or you can follow nine rules of advice offered by Susan Keane Baker in her book, Managing Patient Expectations; The Art of Finding and Keeping Loyal Patients.

1. Make a good first impression by hiring a smiling receptionist.

2. Keep your reception area spotless and comfortable.

3. Provide appropriate and updated reading material.

4. Establish a budget for flowers, mints, and other amenities.

5. Provide relaxing distractions – stationary and stamps for writing letters.

6. Call your waiting room the reception room.

7. Sit in your own waiting room and view it from the patient’s perspective.

8. Keep the patient informed about delays.

9. Apologize for delays.

10. Offer discounts, restaurant coupons, or gift certificates, or rescheduling for excessive delays.


As a doctor, be sensitive about delays. Sensitize your staff about the pain of waiting. Time is important to patients, too. Lost time is irreplaceable. And don't let your patients face a blank door in the examining room awaiting your arrival. A blank door is a pain in the access.

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