The Long Wait for the Doctor Justified?


The Long Wait for the Doctor Justified?

One of the most frustrating things about the doctor visit is the wait time. Even after you finally gain admittance to an examining room you can end up staring at the walls for quite a while wondering if it’s really worth the wait.

My parents’ primary physician probably has one of the longest wait periods of all the doctors we visit. There have been occasions when we’ve spent up to three hours in the lobby and another hour waiting in the examination room, not leaving until long after normal office hours. On a bad day the lobby can be standing room only.

You might think this is an inefficient operation. But quite to the contrary it’s probably the most efficient doctor’s office we visit.

The doctor has three people administrating the front office including a paralegal. He has four nurse practitioners: One acts as a triage nurse, one stays by his side during examinations reviewing triage notes, taking notes and watching for inconsistencies such as adverse drug interactions, the other two see patients with minor ailments and consult with the doctor before discharging the patients. He also has a discharge nurse who sees every patient before they leave. She makes sure all instructions are understood, prescriptions are received and ordered and future appointments are scheduled.

Because of the efficient operation the doctor has developed a large private practice. Still, it’s difficult to anticipate the extent of medical care each patient will need. Everyone receives a thorough examination appropriate to their needs regardless of insurance status and whether they are seeing a nurse practitioner or the doctor.

When people make appointments with a doctor neither they nor the doctor’s office can always know how extensive the examination will need to be for an accurate diagnosis and treatment. There are too many variables to contend with to approximate an accurate examination time. Patient’s vital symptoms may not be recognized by the patient and circumstances change. Patients aren’t always forthcoming and sometimes lie, most often at the time of scheduling but sometimes even when seeing the doctor. A good doctor will work through this in order to provide the best care possible and that can require more time with the patient.

The parents’ doctor specializes in Geriatrics but he also treats a large number of Medicaid patients of all ages. There aren’t a lot of highly experienced doctors who do accept Medicaid patients in our area. I suspect the reason he is able to is because senior citizens are likely to have excellent health insurance, which offsets the expense of caring for the less fortunate. A medical practice that accepts Medicaid attracts more patients; combined with a high quality of care it’s not unusual for it to also attract a large number of private patients.

People with good healthcare coverage have a lot more choices in their providers then those on Medicaid. The government is constantly reviewing the amount it is willing to pay Doctors for their Medicaid services and looks for ways to cut doctor’s reimbursement. If doctors refuse to show preference to patients with full coverage eventually those patients will find another doctor who will. The doctor will not be able to offset the cost of treating Medicaid patients and the quality of care he can provide will suffer.

My parents’ doctor has found a successful balance. Though many of his patients don’t understand that and think it’s unfair, they keep going back.

The triage nurse interviews every patient. She goes over medications, reviews medical history, determines if there are new complications or treatments the doctor might not be aware of since the last visit. She also prioritizes appointments and, yes, patients with full healthcare coverage can receive priority over a Medicaid patient with a similar condition. However insurance preference is not prioritized over a Medicaid patient with special needs such as an insulin dependent diabetic who could be at risk during a long wait time. Insurance status is not a top priority in triage, but unless the doctor is willing to sacrifice quality of care it is a necessary consideration. With out that privately insured patient it’s unlikely he would have the resources to provide quality care to all patients.

One of things I find most frustrating is waiting to see a doctor. But in all honesty when it comes to my parent’s healthcare, I’d wait all day without complaining when I know they’re going to receive the best care available.

It’s up to the individual to decide if the wait is worth it. My parents have experienced plenty of times they could’ve resented the way they’ve been treated by other patients waiting to see the Doctor. They’ve never resented other patients or the doctor and his staff for long waits. They could afford to see a highly qualified primary physician with short wait times who didn’t accept Medicaid. I’m sure the lobby would be much more comfortable, less crowded and less unruly. But Dad appreciated his primary physician’s philosophy and believed being treated by this Doctor supported excellent healthcare for people less fortunate.

It took me a long time to understand the philosophy and many times I tried to get the parents to find a different doctor. But they’ve never wavered in their loyalty to their primary physician. Now that I understand, I still get frustrated waiting, but then I just thank God for Kindle and the doctor’s Wi-Fi service. The only resentment I hold is against those damned chick television shows constantly playing on the TV in the lobby.