A viral video of an explosive argument in an office waiting room prompts the question: why do you have to wait so long to see the doctor, anyway? You probably saw the doctor's waiting room video that went viral last week—the one where the doctor screamed at a patient who complained after waiting more than an hour for care. It goes without saying that that incident was the exception, not the rule: most doctors are perfectly polite to patients, and most patients will just sit quietly (if not begrudgingly) and wait until the doctor is ready to see them. But one thing about the video is undoubtedly true: long doctor's office wait times are a source of frustration for everyone. So why are clinic and office wait-times so damn long? When it comes to “acute” health issues and urgent care, a big problem is that “there’s a huge shortage of primary care doctors in this country,” says Rob Danoff, D.O., a family physician and director of the family practice and emergency medicine residency programs at Philadelphia’s Aria-Jefferson Health. Danoff says that fewer and fewer M.D.s are choosing to become primary care physicians, and more and more are going into specialty fields, where they tend to make more money. According to a report from the American Academy of Family Physicians, roughly half of all doctors in 1961 were “generalists” who could see patients with a wide range of issues. Today, however, just a third of doctors are generalists. Meanwhile, America’s population is getting older and sicker. The introduction of electronic medical record-keeping is also a drain on doctors’ time, Danoff says. So in many instances, it’s a basic supply-and-demand dilemma. “This is why we’re seeing a proliferation of urgent care centers,” a.k.a., walk-in clinics where you don’t need an appointment, Danoff says. “We don’t have enough primary care doctors to see patients.” People don’t get sick on a schedule. So if your doctor’s office—or local ER, or nearby clinic—has an influx of sick patients around your appointment time, better grab a magazine and get comfortable. You’re in for a long wait. But why is the wait for specialists still so long? Doctors in America work almost exclusively on a “fee-for-service” basis, meaning they earn more money by seeing more patients. (In Europe and elsewhere, many doctors work on fixed salaries.) Because a doctor’s pay is tied to his patient volume, “physicians dread having open slots in their schedules, bringing in no revenue while expenses mount,” say the authors of a recent New England Journal of Medicine report. These slots open when patients fail to show up—a common problem. To avoid losing money, it’s typical for clinics and doctors to over-book or even double-book their schedules, the report’s authors explain. But if every patient shows up, “the result may be chaos, with angry patients waiting an hour or more and dispirited clinicians and staff trying to both appease and care for them,” they write. “The painful reality is that the fee-for-service system rewards long waits and overbooking,” they add. “The system does not reward providers who organize care to reduce waits for all patients, even though that might keep some patients from becoming sicker.” Until the American health care system changes—and don't hold your breath for that to happen—wait times are unlikely to get shorter. What can you do to avoid long waits? Call ahead if you need urgent care to make sure the wait won’t be too long. If your doctor's office is backed up, try another clinic. If you have a scheduled visit, make sure you arrive 15 to 30 minutes early, allowing time to complete all your paperwork and get your insurance specifics and referrals sorted out before your appointed time. (If you’re late, you can bet your doc is going to bump you to the back of the line.) Finally, when you book an appointment, try to snag the earliest slot of the day. The later your appointment is, the more likely it is that your doctor will encounter patient delays due to appointments that run long or patients that arrive late, Danoff says. You’ll reduce your odds of a long delay by getting there first thing. Source
