After waiting two hours to see her doctor for a scheduled appointment, Elaine Farstad got angry. She went home, calculated her hourly pay and sent a bill to the doctor for her time.
“It’s ludicrous – why would I wait for free?” Farstad told CNN in a recent story for its Empowered Patient series. Over the years she has billed six doctors who were more than 30 minutes late; half of them paid her.
Few things rile up patients more than long waits at the doctor’s office. For years, most people simply complained and put up with it. But when patients like Farstad start sending invoices for their time, it seems the balance of power decidedly is changing. Especially if the physician actually agrees to pay the bill.
It’s not clear what to make of this trend, if it indeed is a trend. CNN talked to a doctor in New York who gives patients $5 in cash if they have to wait longer than 15 minutes for their appointment. Another physician in Oregon gives gifts of handmade soap or lotion whenever patients have more than a 10-minute wait to see her. Is this the norm? I doubt it (although it sounds nice).
The debate might seem simple. Beleaguered patients vs. greedy doctors. Hard-working doctors vs. demanding, self-entitled patients. If one thing emerges from the discussion, though, it’s that both patients and doctors are frustrated by the wait-time issue.
Do doctors often keep patients waiting? Of course they do, for a variety of reasons they can’t necessarily control. Dr. Emily Gibson writes:
The patient who is angry about waiting for me to arrive in the exam room can’t know that three patients before them I saw a woman who found out that her upset stomach was caused by an unplanned and unwanted pregnancy. Perhaps they might be more understanding if they knew that an earlier patient came in with severe self-injury so deep it required repair. Or the woman with a week of cough and new rib pain with a deep breath that could be a simple viral infection, but is showing signs of a pulmonary embolism caused by oral contraceptives.
Patients themselves can contribute to the doctor’s lateness by showing up tardy for the appointment, rambling instead of answering the doctor’s questions directly, raising too many issues to address in a single appointment, and waiting until the doctor’s hand is on the doorknob to bring up their most important concern.
The other side of the story? Some practices are disorganized and inefficient, resulting in a physician who’s consistently behind schedule. Sometimes appointment slots are double- or even triple-booked. Some organizations seem tone-deaf to patients’ frustrations with long waits – for instance, clinics like this one, who don’t book appointments for X-rays and thus force patients to literally stand in line waiting their turn. And what about practices who charge patients a late fee if they don’t show up on time, yet don’t hold themselves to the same standard?
Some of the research on patient satisfaction suggests it isn’t the lengthy waiting time that upsets patients; it’s lengthy waiting times with no information. Studies on this issue have found that when patients know the doctor is behind schedule, they want to be told – and they also want to be given the option of coming in later or rescheduling the appointment.
In anotherÂ study, researchers analyzed patient satisfaction data that included wait times and the amount of time spent with the doctor. Their conclusion: Although long wait times are associated with lower patient satisfaction, what seems to matter most is the quality of time spent with the doctor. Patients who spent a long time in the waiting room and then were hurried through their appointment reported the lowest satisfaction. But when patients felt they had adequate face time with the doctor, they were more likely to view a longer wait as an acceptable tradeoff
What do readers think? At what point does the wait become too long – 20 minutes? Half an hour? Do you think it’s acceptable to bill the doctor for your time? (For what it’s worth, I think this is a bad idea – sure to tarnish the relationship and put the physician on the defensive, as well as being a poor use of health care dollars.) Share your thoughts in the comment section. If there are any clinicians out there, I’d be interested in your reaction as well.
Photo: Wikimedia Commons