Want in on a secret? The reason doctors are ALWAYS running late?

It’s because we try to do too much in too little time. 

Let me explain with a common example: 

A patient schedules her appointment for an annual exam. It takes 3 months to get an appointment (I’m sorry!) and, in the meantime, her periods get a bit weird. She misses one and then has 2 heavy ones back to back. She knows she has a gynecology office visit coming up so plans on asking about this then. Perfect timing, right? Hmmmm …. Let’s see. 

Routine health maintenance:

This is an important part of health care. It helps you reconnect with your doctor and talk about staying healthy. This is about well being. Taking time for yourself. Giving you and your doctor time to discuss tips to keep you healthy. For gynecologic exams, we use this time to discuss preventing pregnancy or trying to get pregnant, or common symptoms of transitioning to menopause. We make sure periods are doing what they’re supposed to be doing. Order or do routine testing and imaging – not as an after-thought but as a fore-thought. Make sure there are no red flags that need to be evaluated. So that’s what is done at an annual exam. That would take a fair bit of time, right? 

Now what if someone is having irregular and heavy periods?

This is what I would potentially want to do: talk at length – figure out exact details. Do an exam. Maybe an ultrasound. Maybe a biopsy. Order blood tests. Figure out a possible treatment plan based on current information or explain why we need results to make an optimal treatment plan. Make sure you understand what to do, how to take any medications, and get your questions answered. Do all of this while simplifying complex medical information in easy to digest pieces, answering additional questions about information found on the internet and why it does / does not apply, provide counseling and informed consent for all of these pieces. That would take a fair bit of time, right?!!

That’s not all.

I then go back to my computer and write all of this up – or at least the part I didn’t write in the room with you so I could actually listen instead of type.  That write up needs to be good so 1 – your health care team remembers the details and discussion and 2 – so your insurance will cover the tests that were ordered and 3 – so we can get paid from that same insurance company.  I also enter an order for each individual lab, referral, test, prescription and send in authorizations for what may happen next time. That would take a fair bit of time, right??!!!

An educated guess: about 90 minutes would be great to make sure all this is done and I’m ready for my next patient. Guess how much time is generally given? 15 minutes! Crazy, right? 

This is why we’re late all the time! We are trying to do right by you. We’re trying to squeeze it all in. We’re trying to avoid the “well, you’ll just have to come back for that problem”. That sucks. But it’s just not possible to do it all. 

How to fix it? 

There’s a lot of talk about how to fix this system. Know that we are trying. The layers are deep. It’s hard.

But in the end, we can only control ourselves, right?  So here are some tips that I use for myself when I see my doctors: 

• I expect my doctor to be late. I bring stuff to do – my computer for emails, or my phone with ear buds to watch a show or listen to a podcast. I schedule my appointment with this in mind too so I’m not stressed about making it somewhere on time afterwards.

• If I have a time limit, I’ll ask the front desk what the time expectation is. But because I know that doctors are always running late, I try to do it in a nice way (and remember, the front desk doesn’t have control!).

• I show up early. I fill out paperwork ahead of time. If my doctor is ready for my appointment time on time, I don’t want to be the reason she’s late starting it. If I’m running late, I call and ask if I should still come. 

• I schedule my appointments for the issues I want to address. If I have several issues, I bring them up at the time I schedule my appointment. If something new comes up, I call the office and see if I should schedule another appointment. 

• I write down my questions. I want to make sure my questions are answered before I leave so I don’t send a follow up email or request a courtesy call to address something that could have / should have been addressed in person. 

• I follow instructions. Of course I do! That’s part of my personality. I want the results from the tests I had done, or an assessment of if physical therapy is working for me, or if whatever was suggested for me last visit is actually helping me. I don’t follow these instructions blindly – I ask questions and set a health plan ahead of time. But I make sure I optimized that health plan to the extent possible so if it’s not working, I can move on to the next step. Otherwise, the follow up may be “try what I suggested to begin with because it actually works for 90% of people with your problem”.