I imagine we can all relate to this scenario.  You schedule a doctor’s appointment for 10am. The nurse tells you to arrive at 9:40 for check in.  You arrive at 9:35. The front desk person waits to check you in until 9:50. The nurse brings you back at 10:05.  He/she checks your vitals and asks you some random questions until 10:10. Then you wait until 10:20 before you see the doctor.  Forty-five minutes pass before you meet the person you came to see. We’ve all been there before. Why does it happen all the time? 

I want to share a behind the scenes look from a doctor’s perspective.  We hate being late. I haven’t met a doctor that feels ok with making people wait.  We feel guilty. We try to do what we can to prevent this from happening, but, oftentimes, it is unavoidable. 

From my experience, I have identified the top 5 reasons why the doctor is late:

1. The doctor was spending extra time reviewing your case before seeing you

2. The patient before you had an urgent/emergent situation that took the doctors time

3. The patient before you showed up late

4. The process to check you in takes too long

5. The doctor’s office is poorly run

1. The Doctor Was Reviewing Your Chart

I believe that most patients have a common misconception: if the doctor is not talking with me, then he/she is not helping me.  I want to dispel that belief. For example, a common type of visit I have is a hospital follow up. At this visit, I will make sure the patient is doing ok, their discharge plan is in place and going well.  It is important for me to review the hospital notes during this visit. This could take 10-20 minutes depending on what went on in the hospital. I will spend that time in the beginning of the visit to familiarize myself with my patient’s chart instead of just walking into the room and ask them: “what happened in the hospital?”. 

2. The Patient Before You Had an Urgency

Perhaps the patient before you came in acutely ill and is requiring IV fluids.  Maybe a patient is being transferred to the hospital via ambulance. Perhaps an elderly gentleman came in for a routine check up.  At the end of the visit he mentioned to me that he is having new chest pain that started this morning. I have to rule out a heart attack before he leaves.  It’s possible that your doctor had to answer a few emails or phone calls in between patients. The doctor’s office is such a variable place. Any visit could be as quick as a 7 min strep throat or as long a 35 min family meeting.  Doctors have to adapt their days based on who walks in, and that isn’t always easy. Bottom line is, when we are needed urgently or have an emergency, we have to handle that first, regardless of what that will do to the rest of our schedule. 

3. The Patient Before You Showed Up Late

Even though you show up on time, your doctor likely has patients that show up late.  And while it is not fair, these patients that arrive late can cause your doctor to be late for every appointment for the rest of the half day.  Most offices have a late policy. For example, my office late policy is 15 minutes. If my patient arrives for a 10am appointment at 10:14, I will still see them.  The problem is that I will likely not get to see them until 10:25 due to the time it takes for them to check in and get roomed. So by the time I see them, 25 min of their 30 min appointment have passed.  And if you are my prompt patient scheduled for 10:30, then unfortunately you will have to wait. In these situations, I feel like the late patient is stealing my time from the patients that arrive on time.

4. Standardized Rooming

This is a new process that is taking a lot of office time away from patients and doctors.  This is the process that you go through from the time you arrive until the time you see the doctor.  This will typically consist of the following steps:

1) You check in (sometimes twice)

2 The nurse comes to get you

3) The nurse will take your vital signs

4) They will ask you a brief synopsis of why you are here

5) They will ask you a lot of questions that have nothing to do with why you are here

6) Then they alert the doctor that you are ready to be seen

This process did not previously include step 5.  Step 5 questions will include: do you feel safe in your home?  Have you fallen down in the last month? How much alcohol do you drink?  These are screening questions that have been implemented by regulatory agencies, insurance companies, large medical institutions, etc.  They are meant to screen for other issues, but in the end they take away time that you could be spending with your doctor. We do them because we are required to in order to get reimbursed by the insurance companies, the government, etc. 

5. Poorly Run Office

The final reason that I want to discuss today has nothing to do with patients.  The doctor’s office could be poorly run. Perhaps they are short on support staff like nurses and receptionists. Maybe the doctor has his patients booked too close to one another.  It is possible that the doctor is burned out and arrived late to the office or took a long lunch. Whatever the reason is, there are some cues that you can pick up on to tell if a doctor’s office is poorly run. 

1. The staff are rushed and flustered.  A doctor’s support staff can communicate how an office is running without speaking.  If you pick up on an annoyance or perhaps experience rude manners, this is a good indication that the office is not running well. 
2. The doctor is unapologetic.  If your doctor’s office is poorly run that means that either the doctor doesn’t care, or doesn’t have any power (i.e. someone else runs the office without consulting your doctor).  At any rate, a doctor who doesn’t care or have control will likely be frustrated and not apologize for your wasted time.
3. The doctor obviously has not done any research in your chart. 
4. Every time you go, the waiting room is a busy packed mad house, without exception. This means that your doctor may be booking people too close together.

If you pick up on these things and your doctor is always >15 minutes late, then perhaps it is an office issue. 

So besides the last exception, we are mostly late because we are trying to take care of our patients in the best way possible.  I know this does not make waiting for the doctor any more pleasant, but I wanted to give you our perspective as to why this occurs with such frequency.  I think it is important to communicate your frustrations and concerns with your doctor regarding wait times. We will not think you rude, most good doctors will respect and want your feedback. If you get a negative response from this course of action, then perhaps your doctor was late for the last reason we mentioned. If that is the case, then I would consider changing doctors.