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Managing the Quality of Patients' Wait

By Elizabeth Woodcock, MBA, FACMPE, CPC

October, 2019


Patients now wait 24 days to see a specialist, up 30 percent since 2014, according to a survey of specialists in the 15 largest U.S. metro areas.[1] As patients wait longer just to get open appointments to see their physicians, making them linger another 30-plus minutes in the reception area on the day of the visit could seem like an additional insult. Yet, eliminating all wait time — whether to the next open appointment or on the day of the visit — is next to impossible in many physician practices. Patients may intellectually accept the difficulty of delivering a service as complex as medical care on a time schedule — one patient might take 30 minutes, the next one just five minutes — but that knowledge does little to erase negative emotional responses to delays. Making matters worse, the longer the perceived wait, the more patients expect from you and your staff.

Assuming you have, or plan to, consider more complex approaches to improve overall access — offering express clinics, self-scheduling, group visits, and so on — let’s take a look at one portion of the waiting experience that you can quickly improve: the quality of the wait, specifically, what the patient experiences at the time of the visit. Your efforts to improve the quality of patients’ wait times not only can reduce frustration, but it could also make a positive impression on patients.

Be aware of wait times. Make tracking wait times a key function of your receptionists’ responsibilities. They can use the patient arrival function in your practice management system to keep track of the time of each patient’s entrance and (ideally) when they are escorted to the clinical area. Lacking an automatic method, use small, inexpensive timers with magnets on the back. Get a magnetized white board, recording patients’ names as they check-in. Place the timer adjacent to the name (and start it), allowing the receptionist to track the wait time of each patient. Erase each name as the patient is roomed. This white board – viewable only to staff – would be constantly changing, but it would serve the purpose of keeping you cognizant about waits.

Keep patients informed. To prevent discontent over delays from reaching a boiling point, plan to intervene at about the 20-minute mark. Once a patient has waited 20 minutes, communicate with him or her about the wait. Start with an apology for the delay. Then explain the cause in very general terms: “your doctor’s patient visits are running longer than we expected this afternoon,” or “your physician was called to an emergency offsite this morning,” and so on.

Offer to reschedule. After a certain time period – let’s say an hour of waiting – it may be helpful to offer patients the opportunity to reschedule. From a clinical perspective, this may not be an option for all patients, but it may be a viable (and appreciated) alternative for some. From a practical perspective, you’ll do no good proposing a new appointment time that is many weeks away. Even if it requires a manager’s intervention into the scheduling process, find places to quickly fit in the rescheduled patients. If rescheduling isn’t an option, when the wait time becomes significant (say, that hour mark), the physician’s nurse or medical assistant should come out to speak with patients about the delay. Meanwhile, the reception staff can telephone patients scheduled for the remainder of the day’s session to offer new arrival times or, perhaps, to reschedule their appointments. Maintain gift cards at the front office for a complimentary beverage or snack at an onsite cafe or nearby business; offer them to patients when wait times become excessive.

Convert the “waiting room” into a “reception area.” Sure, renaming the area where patients wait to be seen seems like window dressing, but it’s a start on creating a new attitude for you and your patients. Instead of giving patients the perception that you expect them to wait, your practice will be saying, “we’re ready to receive you.”

Make the “reception area” receptive. It may require a small investment, but items like natural (or natural-like) lighting; soft, soothing music; comfortable furniture; an agreeable temperature; clean, accessible restrooms; and a comforting color palette tell patients that you do care about their experience. Stocking the room with current magazines and a television also helps, but don’t stop there. Here are more ways to make waiting a little less annoying in your practice:

Refreshments. Offer water or a coffee bar. Install a machine that provides self-serve specialty coffee and hot water for tea (but not if your practice serves small children).

Wireless Internet. Nearly every patient has a device that can log onto the Internet, so why not offer the amenity of access to them, particularly if you don’t want them chatting on their cell phones while they wait (which can be disruptive to other patients). Providing wireless Internet allows waiting patients to work, communicate with friends and family, or just play. (To avoid hackers, work with a reputable technology company to set up a secure wireless network specifically for your patients’ use.)

Children’s entertainment. Provide used children’s books in good condition; shop a consignment sale at least once a year to replenish your supply. Go further by offering visual treats, such as a model train suspended from the ceiling, with a button on the wall for children to start the train. Put a carnival mirror on the wall. Turtles in a tank are another great entertainment option.

Art. Perhaps some of your staff or patients are painters, photographers, quilters, etc., who would like to display their works on your walls. Place school projects by the children of staff and physicians or hold a photography contest for staff – or patients – to enter. In addition to showcasing local talent, your reception area will be decorated for free or at a very low cost.

Faces. Photographs of the physicians, providers, and staff with some professional and personal information can help establish a “personal” relationship between patients and your practice. Ask your physicians, providers, and staff to bring in baby pictures – of themselves. A display of your baby pictures will provide significant entertainment.

Marketing. Since you’ll have your patients’ undivided attention for at least a few minutes in the reception area, use the opportunity to promote your practice’s services and provide helpful knowledge to patients. Display a PowerPoint presentation (a good one with high-quality photos and other images) on a large flat screen monitor in the reception area. Slides can discuss the benefits of your website or patient portal, practice policies, new services, and new clinicians or staff. Intersperse the marketing with displays of patient education and community resources.

In today’s web-linked world of instant answers, online shopping, and one-day deliveries, managing patients’ perspectives about your practice becomes ever-more important. Tending to the quality of your patients’ wait can give them a reason to come back and recommend your practice to friends and family. As the old saying goes, it’s the little things that count.

[1] “2017 Survey of Physician Appointment Wait Times and Medicare and Medicaid Acceptance Rates.”  Merritt-Hawkins

About The Author

Elizabeth Woodcock is the founder and principal of Woodcock & Associates. She has focused on medical group operations and revenue cycle management for more than 20 years and has led educational sessions for the Medical Group Management Association, the American Congress of Obstetricians & Gynecologists, and the American Medical Association. She has authored and co-authored many books. She is frequently published and quoted in national publications including The Wall Street Journal, Family Practice Management, MGMA Connexion, and American Medical News. Elizabeth is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a Bachelor of Arts from Duke University, she completed a Master of Business Administration in healthcare management from The Wharton School of Business of the University of Pennsylvania.

The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time.

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