What’s your wait time to see your doctor?

What’s your wait time to see your doctor?

Angie’s List member Susannah Nuriel of Tacoma, Wash., says excessive wait times to see podiatrist Dr. Philip Yearian forced her to find a new foot doctor. “He seems like an excellent doctor,” she says. “But it was such a dramatic wait, I will not return. I had to wait over an hour for six out of seven appointments.”

Nuriel says she was OK with the hourlong wait at her initial appointment because it was an emergency visit for a broken foot. The doctor performed surgery the same day. “I understand emergencies happen — I was one of them,” says Nuriel, who applauded Yearian’s technical skills, bedside manner and communication. Despite that, she says she switched to a new podiatrist.

Yearian, who has an overall D grade based on three Angie’s List reviews, admits patients can wait up to an hour to see him but says he’s a podiatrist surgeon who performs complicated reconstructive and amputation surgeries. He says many of his patients need procedures that are unknown when they schedule a visit. “I prefer to take care of the patient the same day rather than having them return for an additional appointment with an additional charge,” he says.

Nuriel’s situation may sound familiar to Angie’s List members who have played the doctor’s office waiting game. The average patient wait time to see a doctor last year was about 21 minutes, according to Vitals, which gathers and analyzes consumer health care information. But of the 1,008 members who responded to a recent online Angie’s List poll, 65 percent estimate they’ve waited an hour or more to see their health care provider. Even more alarming: 37 percent say if they’ve waited a long time to see a doctor, they’re less inclined to ask questions.

David Gans of Medical Group Management Association, which works to improve the performance of medical group practices, says studies show long waits may be hurting the overall care patients receive. “If the patient isn’t listening or feels too rushed to ask questions, then the doctor isn’t communicating and patients don’t know their role in managing their conditions,” Gans says.

Improving wait time at the doctor's office

 

Unfortunately, health care experts and providers interviewed by Angie’s List expect wait times to increase, citing reasons such as not enough doctors to meet demand and more patients expecting same-day appointments. Gans says the fee-for-payment model that dominates the U.S. health care system incentivizes doctors to see as many patients per day as possible and plays a role. He says declining insurer payments also can be blamed for overbooking. But Gans adds many doctors double book appointment slots because some patients don’t show up for appointments. “Once you have a patient that doesn’t show up ... you never get that time back,” he says.

Member Belynda Williams of Amarillo, Texas, says she gets frustrated because she often can’t get same-day appointments with her son’s pediatrician Dr. John Young, who has an overall D on two reviews. When she does see the doctor, William says they wait up to an hour and says Young is less engaged than she’d like. She vows to find another provider. “When you feel like your doctor doesn’t have time to spend with you or your child and he doesn’t remember you after 21 months of service, something just isn’t right,” she says. Young did not respond to requests for comment.

Highly rated glaucoma specialist and cataract surgeon Dr. James Heltzer of Champlain Ophthalmology in Bethesda, Md., says he allots time in his schedule for new patients, diagnostic testing, emergencies and leaves up to 20 minutes of each hour open for delays. Nonetheless, Heltzer says he often gets behind because routine exams evolve into surgical discussions, or because patients are late or come in on the wrong day and he accommodates them. “Each day, we do our best to balance these issues,” Heltzer says. “[Patients] are not waiting because we don’t care.”

 

Worth the wait

At times, patients are willing to wait, particularly when they’re trying to find the best care. According to a 2012 report from the National Center for Health Statistics, patients wait longer on average to see specialists, but their satisfaction is higher, too. Atlanta member Melanie Koening has waited up to a year to visit Dr. John Reed of highly rated Southeastern Endocrine & Diabetes. Koening says it’s worth the wait for Reed, who she feels is one of Atlanta’s top endocrinologists. Each appointment, she adds, takes up to two hours from the time she signs in until she leaves the office. “His willingness to spend that much time is the reason for the excellent quality of care,” she says.

To help patients put the wait to good use, Reed says his office supplies educational health reading materials and videos. He says visits are lengthy because they may include an appointment with a registered dietitian, patient educator for counseling on medications, as well as in-house lab testing.

Now that the Patient Protection and Affordable Care Act emphasizes keeping patients well rather than seeing them primarily when they get sick, wait times could get longer, says Dr. Rebecca Jaffe, a highly rated family care physician in Wilmington, Del. Under the law, which aims to increase the percentage of Americans with health care insurance and the quality of care they receive, doctors must update medical history at each visit and encourage patients to get preventive care.

“The shift [to patient-centered care] requires more time,” says Jaffe, who is also a board member of the American Academy of Family Physicians. “I feel like I apologize all day for walking in a few minutes late. But [patients] get my full attention and I don’t short-change anyone the time they need.”

The Angie’s List member poll on wait times revealed 68.5 percent weren’t informed their provider would be delayed seeing them and more than 55 percent say they didn’t receive an apology. Experts recommend calling ahead to see if your doctor is running late, or if the tardiness bothers you, politely ask what’s planned to improve the situation.

To reduce wait times at Jaffe’s practice, she says her staff asks patients at check-in to state their reason for the visit and agree to focus on that topic. “If you called for a visit about an ear ache, don’t expect to talk about your bunion,” she says.

If you need a same-day appointment and have difficulty getting into your primary care provider, larger practices can offer appointments with another physician, says Mary Jo Goolsby, a nurse practitioner and past vice president of research and education for the American Association of Nurse Practitioners. She says nurse practitioners can also offer primary care. “We know that nurse practitioners spend on average 21 minutes with each visit and [patient] satisfaction is high,” Goolsby says of an AANP study.

A new approach

Some doctors, dissatisfied with wait trends, are turning to concierge service. Two years ago, highly rated Dallas internist Dr. Cyrus Peikari says he switched to a concierge model to help improve his connection with patients. Now he limits his practice to 200 patients and eight to 10 appointments per day. Peikari says patients pay $365 a month, plus a $4,875 registration fee to gain 24-hour access to him. “It’s a refreshing change from the cattle call of factory medicine,” he says.

Dallas member Jennifer Lobb says concierge service has been worth it because she doesn’t feel rushed. “I’ve noticed appointments go on for a bit. I’m usually saying ‘I’ve kept you too long, I need to go,’” she says. But Peikari says this time allows him to get to know his patients and provide the best treatment. “Medications have their role, but the more I learn, the more it seems that it’s the sacred relationship between patient and doctor that heals,” he says.

Martine Ehrenclou, an Angie’s List member and patient advocate, has interviewed more than 400 providers for two books about how to get the best medical care. She says patients can alleviate long waits without buying concierge service. Ehrenclou recommends booking the first morning appointment or right after lunch, and arriving early.

Patients trying to get their first visit with a busy doctor, Ehrenclou adds, should find out who schedules appointments, stay in contact with that person and ask to be put on a cancellation list. “Try to stand out as a human being. Chat up [the scheduler] and explain why you need to get in sooner,” she says. Also consider an urgent care center or retail clinic for routine sick appointments when your doctor isn’t available. Some patients decide to switch doctors to decrease wait times. If you do, interview the staff and ask if patients are usually seen at appointed times, and if not, how long, Goolsby says.

Ultimately, doctors and patients will have to work together to improve wait times. “It’s all about teamwork and trying to be respectful of everyone under all the circumstances,” Jaffe says.

— additional reporting by Brittany Paris


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