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Why Doctors Often Run Late

By Dr. Moghissi - June 2008

Recently, I walked into an exam room and found it empty.  I asked my staff what happened to the patient.  They said she left quite angry, saying she had waited too long to see me.  I looked at my appointment screen, hers had been 7 minutes earlier; I had thought I was doing great.  Apparently, she had arrived more than 30 minutes prior to her appointment time, so she had actually been waiting 40 minutes.  She knew she was early, but did not take that into account. 

We try our best to stay on time, but have many factors working against us.  I thought you might find it interesting to see how we schedule at our office, so one morning I noted the times when patients arrived, were seen, and when I left the room, compared to what time their appointment was scheduled.  I hope you find it interesting, and maybe someone can figure out a better way of doing this!

First, some information: This is a typical schedule for me; I book every 15 minutes, with 30 minutes for physicals.  This is unusual, in this day of declining reimbursements most primary care physicians book every 10 minutes, and/or double and triple book those appointments.  Also, moving a patient through the office quickly takes a lot of cooperation between the reception and back office (nursing) staff.  Some patients need time to fill out paperwork, or just chat.  It is not always easy to move things along, even before they get to the exam room.  If I am in the back waiting for someone to complete paperwork, everyone after that person will most likely have to wait.

On to the schedule, with patients listed in order of appointment time. 

  1. The 8 am appointment was scheduled to last for 30 minutes, she arrived at 8, was seen at 8:05, and finished by 8:35.  Not bad, except the next patient didn’t arrive for another 14 minutes (#3), putting me 19 minutes behind.   My schedule was already screwed up.
  2. The 8:30 called to say he was stuck in traffic and would be late. He arrived at 8:57, at the same time as 2 others.  I saw the others first, and he was seen after #5 at 9:34, out at 9:54.
  3. The 8:45 had an urgent problem and was worked in, couldn’t be seen later due to another appointment.  Arrived 8:49, seen at 8:50, out by 8:58.
  4. The 8:45 arrived at 8:57 (no explanation) seen at 8:58, out by 9:12.
  5. The 9 am appointment was scheduled for 30 minutes, arrived at 8:57, seen at 9:13, and out at 9:33.  We would have been doing great, except I still haven't seen see patient #2.
  6. 9:30 appointment arrived at 9:32, seen at 10:08, out at 10:34.
  7. The 9:45 also arrived at 9:32, seen at 9:58, out at 10:41.  I knew a test would need to be run for this one, so started here, took care of #6, then came back to finish.

Now it was 10:41, and I was about to go in to see my 10:00 appointment.

  1. The 10:00 patient arrived at 10:00, seen at 10:41, out at 10:54.
  2. 10:15 appointment was scheduled for 30 minutes, arrived at 10:24, seen at 10:54, out at 11:13.
  3. The 10:45 arrived at 10:42 (would have been perfect, if I had not been running behind), was seen at 11:14, out at 11:32.
  4. The 11:00 appointment arrived at 11:13, was seen at 11:41, out at 11:57.  They arrived late for their appointment, so were put behind #12.  This one also needed a test, so I started here, went to #14, and then returned to finish.
  5. The 11:15 arrived at 11:04, was seen at 11:33, out at 11:40.
  6. The 11:30 arrived at 11:45, was seen at 12:15 out by 12:30.  Was seen after #14.
  7. The 11:45 also arrived 11:45, was seen at 11:45, out by 12:10.  Was seen after #11.  Then I needed to change the computer's battery, got a quick snack , and went to see #13.
  8. An 11:45 appointment was added onto the schedule at the end (work in) and arrived at noon, was seen at 12:32, done by 12:55.

At this point I was very tired and hungry, and glad to be done with the morning!  I finished the morning about an hour after expected.  Only 7 of 15 patients arrived at or before their appointment times.  Of those that arrived on time 2 were seen immediately, 2 within 15 minutes of their appt time, 2 within 30 minutes of their appt time, and poor #8 was seen 41 minutes late.  Frankly, those who arrived late have no reason to complain about a wait, many places would charge them a fee and tell them to reschedule (and after looking at this – for good reason!). 

I realize not everyone will read through this schedule (it makes my head spin just looking at it!).  I did want to make a point though.  We all hate to wait, and most doctors hate running behind, but our schedules are often beyond our control.   Even carefully planned schedules go out of whack.  We are dealing with humans, and they and their problems are unpredictable.

I hope this gives you some appreciation for why you may be waiting next time you come in.  My goal is to have no one wait (I love finishing on time!), but unfortunately, that is often impossible.

Jasmine Moghissi, M.D.

Focus - Health Tips » Why Doctors Often Run Late

Why Doctors Often Run Late

By Dr. Moghissi - June 2008

Recently, I walked into an exam room and found it empty.  I asked my staff what happened to the patient.  They said she left quite angry, saying she had waited too long to see me.  I looked at my appointment screen, hers had been 7 minutes earlier; I had thought I was doing great.  Apparently, she had arrived more than 30 minutes prior to her appointment time, so she had actually been waiting 40 minutes.  She knew she was early, but did not take that into account. 

We try our best to stay on time, but have many factors working against us.  I thought you might find it interesting to see how we schedule at our office, so one morning I noted the times when patients arrived, were seen, and when I left the room, compared to what time their appointment was scheduled.  I hope you find it interesting, and maybe someone can figure out a better way of doing this!

First, some information: This is a typical schedule for me; I book every 15 minutes, with 30 minutes for physicals.  This is unusual, in this day of declining reimbursements most primary care physicians book every 10 minutes, and/or double and triple book those appointments.  Also, moving a patient through the office quickly takes a lot of cooperation between the reception and back office (nursing) staff.  Some patients need time to fill out paperwork, or just chat.  It is not always easy to move things along, even before they get to the exam room.  If I am in the back waiting for someone to complete paperwork, everyone after that person will most likely have to wait.

On to the schedule, with patients listed in order of appointment time. 

  1. The 8 am appointment was scheduled to last for 30 minutes, she arrived at 8, was seen at 8:05, and finished by 8:35.  Not bad, except the next patient didn’t arrive for another 14 minutes (#3), putting me 19 minutes behind.   My schedule was already screwed up.
  2. The 8:30 called to say he was stuck in traffic and would be late. He arrived at 8:57, at the same time as 2 others.  I saw the others first, and he was seen after #5 at 9:34, out at 9:54.
  3. The 8:45 had an urgent problem and was worked in, couldn’t be seen later due to another appointment.  Arrived 8:49, seen at 8:50, out by 8:58.
  4. The 8:45 arrived at 8:57 (no explanation) seen at 8:58, out by 9:12.
  5. The 9 am appointment was scheduled for 30 minutes, arrived at 8:57, seen at 9:13, and out at 9:33.  We would have been doing great, except I still haven't seen see patient #2.
  6. 9:30 appointment arrived at 9:32, seen at 10:08, out at 10:34.
  7. The 9:45 also arrived at 9:32, seen at 9:58, out at 10:41.  I knew a test would need to be run for this one, so started here, took care of #6, then came back to finish.

Now it was 10:41, and I was about to go in to see my 10:00 appointment.

  1. The 10:00 patient arrived at 10:00, seen at 10:41, out at 10:54.
  2. 10:15 appointment was scheduled for 30 minutes, arrived at 10:24, seen at 10:54, out at 11:13.
  3. The 10:45 arrived at 10:42 (would have been perfect, if I had not been running behind), was seen at 11:14, out at 11:32.
  4. The 11:00 appointment arrived at 11:13, was seen at 11:41, out at 11:57.  They arrived late for their appointment, so were put behind #12.  This one also needed a test, so I started here, went to #14, and then returned to finish.
  5. The 11:15 arrived at 11:04, was seen at 11:33, out at 11:40.
  6. The 11:30 arrived at 11:45, was seen at 12:15 out by 12:30.  Was seen after #14.
  7. The 11:45 also arrived 11:45, was seen at 11:45, out by 12:10.  Was seen after #11.  Then I needed to change the computer's battery, got a quick snack , and went to see #13.
  8. An 11:45 appointment was added onto the schedule at the end (work in) and arrived at noon, was seen at 12:32, done by 12:55.

At this point I was very tired and hungry, and glad to be done with the morning!  I finished the morning about an hour after expected.  Only 7 of 15 patients arrived at or before their appointment times.  Of those that arrived on time 2 were seen immediately, 2 within 15 minutes of their appt time, 2 within 30 minutes of their appt time, and poor #8 was seen 41 minutes late.  Frankly, those who arrived late have no reason to complain about a wait, many places would charge them a fee and tell them to reschedule (and after looking at this – for good reason!). 

I realize not everyone will read through this schedule (it makes my head spin just looking at it!).  I did want to make a point though.  We all hate to wait, and most doctors hate running behind, but our schedules are often beyond our control.   Even carefully planned schedules go out of whack.  We are dealing with humans, and they and their problems are unpredictable.

I hope this gives you some appreciation for why you may be waiting next time you come in.  My goal is to have no one wait (I love finishing on time!), but unfortunately, that is often impossible.