Jeff Segal, MD, JD, FACS
One of the most common complaints patients have is about waiting times.
Doctor Smith was fantastic, he saved my life, but I had to wait 45 minutes for my appointment.
The WSJ reported that some health systems with multiple ER’s are implementing unique actions to address this common complaint – posting waiting times so that patients can choose the facility with the shortest queue. In fact, Akron General Health System in Ohio began streaming waiting times for 2 of its ER departments on highway billboards. The idea is that patients with minor needs can choose the facility with the shortest wait times; reducing “left-without-being-seen” rates and improving patient satisfaction.
But does this innovation come with a down side?
One immediate concern is that patients may not realize the severity of their condition. Someone experiencing chest pains may think they are OK to drive an additional 10 minutes to a farther facility; when in fact, they need to get to the close ER possible and be “fast tracked” into care. Doctors are also concerned that the posted wait times don’t accurately portray life in the ER. Dr. Jack Mitstifer, chair of emergency medicine at Akron General Health reported that the hospital system stopped posting wait times for its downtown facility when those times “didn’t reflect reality.”
The over use of emergency rooms – more specifically, patients using the ER for general practice care – is a huge burden on our health care system. Will posting waiting times incentivize more people to use the ER for non-critical care?
I’ve had this nagging cough for a couple of days, Hey, look there, only 15 minutes to see a doctor in the ER, think I’ll drop in.
Medicine is complicated. And innovation is difficult. We can all agree that methods that reduce patient waiting times are beneficial. We just want to make sure that those innovations don’t create more problems than they solve.
Patients who complain about waiting times should be examined as to how long they put things off concerning their health care.
I had a new patient who was a bit put off with the wait she incurred in my office. The wait was justified. When I was finally able to sit down with her and address her medical history, it was clear that she was a last minute utilizer of health care. She had neglected to have a mammogram, a pap smear or any gynecological care for over 3 years, despit having risk factors for ovarian cancer, breast cancer and cervical cancer. Furthermore she was obese, hypertensive and most likely diabetlic. I rather tactfully drew the comparison to her “impatient teritiary care behavior” and her seemingly “oblivious approach to preventitive care”. This gentle, but firmly made point made her quite a bit more humble. As I too remained humble and supportive, a strong bond was forged which eventually led to a patient who actually reduced her risk factors and was a great pleaslure to see on an ongoing basis.
As I mature the physicians have been transformed to providers and medicine is evolving into discoverable and undiscoverable EMR entries, demand for specific verbiage use and now clocking of patient throughput; all tightly knit to less income and more liability. Soon physicians will exhibit malicious intent with visits over 31 min. Retirement and pro bono care is what I am looking forward to