If you’ve been to the doctor’s office, you know what it means to be late. One medical professional laments this problem, with some lessons for the rest of us.
A piece by Sanaz Majd, MD explains why your doctor is always late:
I am late – 10 minutes, 30 minutes, sometimes even an hour. And what’s worse? It happens on a daily basis. Yes, I’m late almost every single day as a primary care doctor.
This makes me feel overwhelmed and frustrated. It’s the one aspect of my profession I truly wish I could fix.
But I’ve had to accept this unacceptable situation as the reality of working in primary care in the United States. It’s a complex problem that is out of my control and it’s a hard pill to swallow.
The piece—which is a transcript of Dr. Majd’s podcast—characterizes almost all of the reasons as variations on a single theme: trying to fit unpredictable patients and medical requirements in a strict, 20-minute appointment block schedule.
Consider these all-too-real characters who enter her waiting room:
- Mr. Never-Goes-to-the-Doctor, who arrives on-time for his visit, but fails to arrive early to complete the special paperwork required for a first appointment.
- Ms. Stroke, whose hospital paperwork is too extensive to be read in the limited time window.
- Ms. High-Copay, who is trying to save money by cramming four separate medical concerns in just one visit.
Plus, there’s the interruption of an abnormal EKG from the nurse clinic that the doctor needs to interpret, and later another time when a different patient has a critical lab value and needs to be admitted to the ER. As that person’s primary care physician, the doctor must convince him to go into the emergency room despite the financial burden.
We’re not here to discuss whether the healthcare system is broken (although, we’ve reviewed outstanding medical office systems as well as the potential for electronic medical records. But what can the rest of us glean from the hectic schedule of a doctor in general practice?
Beware the Rigid Block Schedule
Unless the work is highly regimented and has low variability, you don’t want to structure it into short, rapid bursts that are all the same length. The problems with this approach are all implied in the article: you can’t deal with interruptions, provide urgent advice, or effectively interact with people who have a wide range of emotional needs.
A straightforward, regimented time block is great if you’re working in a factory or processing information that is consistently structured, but it’s a terrible strategy the rest of the time.
Beware of Serving Multiple Masters
A primary care physician doesn’t just see scheduled patients who come in through the waiting room. They are often also responsible for supporting a clinic, which may have urgent needs. And on top of that, unscheduled patients are calling in for prescriptions and specialists may need consultations. A doctor doesn’t just have the people on their schedule, they have other responsibilities that are competing for their time.
Of course, every job has this problem to some degree. But if you’re a manager, one of your most important responsibilities is to minimize the amount of task switching your employees need to do. Family practitioners do have supervisors, but this is a challenging problem to address.
Beware of the Assumption of Perfection
The “assumption of perfection” is when we figure that everything is going smoothly because that’s what we’d prefer. A doctor’s office is a chaotic place because people are sick, and because being unwell is unpredictable. One of the smarter moves you can make–to ensure that you don’t end up waiting around–is to call a few hours before your appointment and ask if the doctor is running ahead or behind of schedule. In fact, Sanaz Majd includes this in a list of tips for spending less time waiting for the doctor.
Beware a Lack of Sympathy
We all have stakeholders who we are trying to engage. They may be customers, patients, supervisors, members, or colleagues. If we take the time to try and understand the environment from the other person’s perspective, we are more likely to be able to help the schedule flow more smoothly. Kudos to Dr. Majd for sharing her experience and being sympathetic to what people see from the other side of the waiting room.
The key is not to prioritize what’s on your schedule, but to schedule your priorities.” -Stephen Covey
For more, read her follow up article about how doctors and staff can improve patient satisfaction.