When a full waiting room means business is bad
Better scheduling means happier patients
If your office typically has patients who sit in the waiting room for more than a few minutes or has a backlog of patients waiting for an appointment, act now to alleviate the problem before you lose your patients to a more efficient provider or you lose your contract with a health plan that emphasizes access to care.
When patients fill out patient satisfaction surveys, they often complain of waiting too long for appointments and spending too much time in the physician’s waiting room.
For instance, in a recent survey conducted by Consumer Reports magazine, one-fourth of readers responded that their primary care provider "typically kept me waiting too long."1
"All over the world, and specifically in this country, patients tell us a very consistent story about what they want from their health care providers," says Mark Murray, MD, MPA, of Murray, Tantau and Associates, a Sacramento, CA-based consulting firm that deals with health care efficiency and scheduling issues. Murray has worked as an independent consultant and on projects with the Boston-based Institute for Healthcare Improvement.
He says the things patients value most are:
• the opportunity to choose their primary care doctor;
• a chance to get an appointment at the time they choose;
• a good experience in the physician’s office. This means a short waiting time and a good relationship with their provider.
If a physician office is crowded all the time, the problem should be addressed, says Randolph D. Smoak Jr., MD, president-elect of the American Medical Association.
"The office should run on time. It’s a problem that should be addressed, whether it’s because of scheduling or because the physician is always late getting back from the Rotary Club," he adds.
Value patients’ time
Smoak cautions his fellow physicians to remember that a patient’s time is valuable, just as a physician’s time is valuable.
"Some patients have to lose time at work to make an office visit, or they may have a ride only at one certain time. There are many reasons why it is important to them to be seen on time," he says.
"You can improve patient satisfaction by decreasing patient waiting time. At the same time, you also increase productivity so that patients can get in to see the physician sooner for non-urgent care," says Julie Elmore Jones, MBA, MHA, a consultant with Atlanta-based Gates, Moore, and Co.
In the managed care environment, an increase in productivity is a major goal for most practices, and providers should take steps to achieve efficiency, Jones points out.
The problem could be scheduling, poor use of staff time, or not enough personnel. (For a list of potential causes of patient backlogs, see story at right.)
Whatever the cause, the adage "a stitch in time saves nine" could apply to solving the problems of patient waits. If you get behind this week, the problem could snowball so you’ll be even more behind in the future. If it does get worse, you could lose patients, who will choose another provider who doesn’t make them wait, or you could lose a contract with a health plan that puts a high premium on access to care.
Doug Hough, PhD, a partner with Arista Associates in Fairfax, VA, provides this scenario that illustrates the snowball effect of patient waiting time:
The physicians get behind, and patients have to wait for their appointments. Eventually, the patients start coming in late because they know they’ll have to wait when they get there. Then, the physician office overbooks to compensate for the late patients. "And if everybody shows up at once, they’re in big trouble," Hough says.
Or, if you have problems with an appointment backlog, the problems will only get worse unless you take steps to solve it, adds Murray.
When a patient calls a primary care physician whose schedule is completely booked, the staff may refer the patient to an urgent care center, Murray says.
Many times, the patient wants to be seen again by his or her own doctor after the urgent care visit. This increases the cost of treatment and causes a lot of dissatisfaction, he notes.
"When patients have to be referred to an urgent care center because the schedule is backlogged, this means practices have failed to develop a system that ensures that patients see their own doctor when they are ill," Murray says. "The result is additional cost to the patient or the insurer and ill will toward the physician."
Reference
1. Rating the HMOs. Consumer Reports 1999; 64:23-28.
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