Why we practitioners sometimes run late

So you, the patient, arrive on time, check in, and are placed in an exam room, patiently waiting to be seen.  For about ten minutes.  Then fifteen.  After twenty, you are pretty frustrated, right?  Yeah, I would be too.  By the time I come, seemingly strolling in, smiling, you are about to strangle me with my stethoscope.

Before you think I’m being careless with your time (and mine, because, after all, no matter how many patients the phone room shoehorns into my schedule, I can’t leave until every last one has been seen), let me tell you what likely occurred before you facebooked  your dismay to your 358 closest friends.

My day typically starts with an 0800 patient, followed by a new one scheduled every fifteen minutes. That’s right, fifteen short minutes to query your ailment, take a look and listen, review your allergies and medications, and decide with you what the best course of action would be.  If it were up to me, I’d have 25 minutes per patient but the poor payments by insurance companies dictate the only way we can keep our doors open would be to fit 20-25 patients in per day, which translates to shorter visits than practitioners would like.

This past Tuesday here’s how my day went: The first patient was a run-of-the-mill sore throat.  The second was a new patient.  New patients are typically half an hour visits, meant to be meet-and-greets and not much else.  They are not meant to be acute or chronic illness visits.  However, I walked in to a man about my age who burst into tears.  He profusely apologized but his son had died in his arms a few days prior from a heroin overdose.  This father had tried everything he could to help his twenty year old son yet heroin won out.  It was heartbreaking.  And even half an hour was not going to be enough to help this man.  If it were you, would you want me to look at my watch and hurry you along out the door?

The next patient made an appointment for an earache.  Simple enough.  Surely, I could get back on track.  But she kept adding, “and while I’m here, could you look at…” questions.  As did the next three patients.  I felt compelled to look at their various complaints as they were loyal patients and the complaints could have turned out to be serious.  You’d want me to take a few extra minutes to address yours, right?

And so it went.  And that is how us providers sometimes arrive in your room woefully behind.  It is not that we are not mindful of your time (or ours).  I’ll remind you that we cannot leave until every patient has been seen.  Every phone call has been returned.  Every pharmacy question has been responded to in a timely manner.  And every urgent lab has been addressed.  So long after every patient has gone home, we are still there, working hard for our patients because we love, love, and truly love what we do.  And we care.  That sense of caring and loyalty is WHY we sometimes run behind.  It is not a lack of awareness as to the time or schedule.  It is that sometimes one or two patients have an emergency so urgent that we cannot run on time.  What about the patient who fell last week in the waiting room because he had forgotten to take his blood pressure medication?  If it was your father or grandfather, would you want me to call 911 and send him on his way or would you want me to interrupt the train of patients to properly assess and comfort him before deciding whether a trip to the hospital was even necessary?

I love what I do.  I often tell my patients that I feel guilty calling it “work”.  I feel like I am going somewhere but it doesn’t feel like work.  However, if I am running late, as the patient, please understand it doesn’t happen all the time.  But when it does, it is likely because a patient deeply needed me to give them more time.  Or a few patients only made an appointment for one ailment but added multiple complaints once they got into the exam room.  If you have multiple unrelated complaints, please be honest when scheduling your appointment.  I’d much rather know up front so that I can have my staff adjust my schedule accordingly.

But above all, know that I truly and absolutely love my profession and want to give you, my patients every ounce of caring and excellent care possible.