“There are systemic and clinician issues contributing to this problem, and I personally believe the systemic issues outweigh the individual ones,” Dr. Szostek says. “The greatest issue is that we have no time between patient appointments so there’s no margin of error. There are so many ways to get behind, and so many responsibilities outside of simply seeing patients—lots of unseen work.” And it only takes one thing going wrong to throw off an entire day’s schedule.
Dr. Szostek and Dr. Devine say that documentation plays a big role in all of the delays. Ideally, right after a provider sees you, they’ll update your record and keep the billing process moving…but doing that takes time, and it’s not accounted for in their schedule. If they are already running behind, this step makes everything worse; alternatively, if they don’t stop to complete it right away, then they’ll end up with a huge backlog.
Health care providers are also dealing with the same annoying and beyond-their-control complications most of us encounter at work these days: Glitchy software; meetings that could have been emails; inefficient-but-somehow-impossible-to-change workflows; coworkers who slow things down; and unreasonable expectations for output driven by late-stage capitalism. “They’re not sitting there checking what they’re going to do this weekend and googling stuff and watching Netflix and hanging out—there really is active work happening,” Dr. Devine says.
If your appointment is running late, it’s also worth keeping in mind that the person across the hall from you might be receiving bad, intense, or just complicated health news. “I try to be on time for all of my patients, but if they have to wait, it usually means a patient before them is having a rough day,” Dr. Vasagar says. “I would want extra time to ask my physician questions if I was finding out I had cancer or navigating dementia, and I think most of my patients would want the same.”
Dr. Devine agrees: “Sometimes this is serious stuff you’re going over, that’s very important and could be life-threatening, that you need to be able to address and take care of,” he says.
There are a couple of things you can do to avoid long wait times.
If long wait times are a big issue for you and are keeping you from getting necessary preventive care, try this strategy, which all three doctors I spoke with recommended: Whenever possible, book the first appointment in the morning or the one immediately after lunch, as these are the most likely to be running on time. You can also ask when you first arrive at the office (and again when you’re put in a room) what the wait time that day is looking like—and let them know at that point if you have a hard out.
And all of us should do our part to practice good appointment etiquette: Show up on time (or early, if that’s requested), and confirm during check-in how much time you’re scheduled for. If it’s only 15 or 20 minutes, be economical with it. Plan to give your doc a quick rundown of everything you want to go over when they first come into the room so they can calibrate accordingly; doing this also gives them the ability to tell you up-front if something necessitates a separate follow-up. “We would love to spend as much time as we can with every single person, but that would mean that we would never leave the office,” Dr. Devine says. “So we do our best to try to get those visits within an appropriate time frame.”
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