Tired of waiting for the doctor? You're not alone

For Santa Clarita, Calif., college professor David Stevenson, 46, the Wait from Hell involved a procedure he was a little anxious about, a vasectomy. He and his wife took time off work, hired a baby sitter for their three children, checked in at the doctor’s office, and then sat. After 15 minutes in a crowded waiting room, they were told he was next. The waiting room emptied, filled, and emptied again “and then it was just me,” Stevenson said.

After an hour and a half, the doctor said he had to leave for an emergency. Fuming, Stevenson said he’d just wait some more, but the doctor replied curtly that he wouldn’t be returning that day.

“He just said, 'Sorry buddy, you’re going to have to reschedule,”’ Stevenson said.

For 30-year-old Ihor Andruch of Elmwood Park, N.J., the unbearable waits were just for routine exams. Until he recently switched doctors, Andruch had to take a partial sick day for doctors’ visits that would last 10 minutes but required waiting two to three hours.

One time, after checking in, he took a “brunch break” at a nearby bagel shop, returning with plenty of time before he was called.

“I was as patient as I could be, but it was very frustrating,” Andruch said.

Overbooked doctors' offices
Such waits often are due to overbooking. That happens partly because under many health insurance reimbursement systems, doctors are paid by volume.

Doctors “are responsive to the same economic pressures that everybody else is,” said Dr. Michael Barr of the American College of Physicians.

The group, which represents about 120,000 internists and other doctors, issued a policy statement earlier this year advocating changes that Barr said could help address the waiting problem.

Recommendations include insurance reimbursement for less traditional patient visits, such as telephone and e-mail consultations to give patients speedier access to doctors.

The group also supports “open-access” scheduling, which some doctors already use, reserving up to 70 percent of their daily schedules for patients who call early for same-day appointments.

Patient-friendly scheduling is also a feature in so-called “boutique” medical practices, which offer virtually no waiting but often aren’t covered by insurance.

Playing phone-tag for test results
Most patients have experienced playing phone-tag to get test results. That’s at least partly because of the traditional paper-based method of relaying information. Test results are transcribed onto paper, then given to the doctor, who then phones or snail-mails them to patients.

At Boston’s Beth Israel Deaconess Medical Center, patients can get test results electronically the same time as the doctor through a private online account called PatientSite.

“There is no waiting for paper printouts to arrive by mail,” said Dr. John Halamka.

All test results show up on the site, except those involving diagnosing cancer or HIV, “assuming that this news should be delivered in person,” he said.

The waiting that goes along with diagnosing and even ruling out cancer can be particularly nerve-racking.

Dr. Marisa Weiss, a Philadelphia-area breast cancer specialist, hears from patients upset about long waits for routine mammograms, then more waiting for the results.

“This is part of the job description” of being a woman today, said Weiss, founder of an online resource center for breast cancer patients.

Weiss, 47, said she dreads her own annual mammogram — especially that windowless waiting room full of women in ill-fitting hospital gowns who are nervously waiting, too.

'Thank God it's only once a year'
“Meanwhile, I have a full practice, three kids, I’m text-messaging back and forth — thank God it’s only once a year,” she said.

In conventional busy mammogram centers, technicians perform dozens of routine screenings daily, piling up X-ray images that a radiologist reads later in bulk. Patients get the results days or weeks later.

Many physicians consider that process the most efficient, although research has shown that having a radiologist read mammograms immediately and give results during the appointment makes women feel much less anxious.

Malpractice concerns and low insurance reimbursements for mammograms have led to radiologist shortages in some places, and not all centers are equipped to offer same-day results for routine exams.

But Faulkner Hospital’s breast center in Boston is, with three radiologists reading mammograms full-time and a computer-assisted system that helps identify X-ray abnormalities.

Dr. Norman Sadowsky, a radiologist who helped create the program more than 30 years ago, said he’s given talks around the country promoting the same-day service but few centers have followed suit.

“This is the most anxiety-producing routine exam,” Sadowsky said. “You come in and you worry, and you worry until you get an answer.

“If we can get the patient an answer before she leaves, that’s the way to do it. You get a lot of kisses” instead of complaints, he said.

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