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Hate Waiting? How Family Caregivers Can Limit Medical Office Delays

Planning and a little assertiveness are the keys to winning the waiting game

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When she was caring for her late father, who had diabetes, Nicole Rochester says she and he “learned the hard way” to always bring snacks and drinks to avoid blood sugar crashes during long waits at doctor’s offices.

Sometimes those waits were “very, very, frustrating,” and “I probably got more annoyed than my dad did,” says Rochester, a physician who left clinical practice after her caregiving experience to become an independent health advocate, based in Gambrills, Maryland.  

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Any family caregiver who has ever spent a long stretch in an outer waiting room, followed by another long wait in an exam room while a vulnerable loved one shivers in a paper gown, knows that frustration and annoyance. Long in-person waits can be particularly trying when someone is very frail or ill or has a condition such as dementia or incontinence. Long waits on the phone, with providers and insurers, can be their own special purgatory.

Why do doctors run late?

As a physician now working as a health advocate, Rochester has extra insight into why doctors so often keep patients waiting. Among the prime reasons, she says, are:

  • Overscheduling. Doctors often are “under a lot of pressure” to see a certain number of patients each day to meet revenue targets. So their staffs may schedule more patients than can comfortably be seen, betting that some won’t show up. 
  • Emergencies and other unexpected issues. Doctors sometimes must handle patient emergencies in the office. Even more commonly, patients who come in for one thing raise additional issues that take more time to address. 
  • Late patients. Sometimes your wait is the result of the cumulative delay caused by other patients who show up past their appointment times or too late to fill out pre-visit paperwork. 

But there are ways to limit those waits and deal with them when they happen, say Rochester and other advocates.

Some extra planning and a little polite assertiveness can go a long way toward easing tensions and minimizing delays, they say. The key, Rochester says, is communication among caregivers, patients and staff. “If you work with them,” she says, “they typically will work with you.”

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Among the pros’ tips for avoiding long waits:

  • Time calls to avoid the busiest hours. Don’t call late in the day, when staffs are dealing with accumulated demands, Rochester says. Try calling as soon as the line goes off voicemail, first thing in the morning or right after lunch, she says — except on Mondays, when offices are often overwhelmed with calls about weekend problems. If you are calling an insurer, all bets on timing may be off. Your call often goes to a call center in a different time zone or even a different country, says Beth Morgan, a medical billing consultant based in Tolland, Connecticut.
  • Make use of patient portals and email. The best way to avoid endless automated phone prompts and holds is to avoid the phone altogether, says Barbara Abruzzo, a registered nurse and patient advocate based in New York City. After making an initial appointment by phone, she says, she always asks if there’s a way to communicate by email. And she makes heavy use of online patient portals. They often are the fastest way to get a basic question answered directly by a physician, she says. 
  • Get a midweek appointment. Mondays and Fridays are often the busiest days in doctor’s offices, Rochester says. So if you have the flexibility, avoid those days.  
  • Get the first appointment of the day. The later in the day you arrive, the more likely you are to wait, because doctors are “playing catch-up” due to delays created by overscheduling, emergencies and other factors (see below), Rochester says.
  • Ask for advice. If you or someone you care for has particular trouble waiting, speak up when you call for the appointment, Rochester says. “You really want to be clear.” For example, she says, you might say, “I’m making this appointment for my dad. My dad has dementia. You know, he gets really agitated when he’s waiting, so please give us an appointment where it’s least likely that he’s going to be waiting.”  
  • Consider calling ahead. If you know a certain doctor often runs late, call to see if they are on schedule before you leave for the appointment, Abruzzo suggests. “They are not going to call and notify you,” she says, but they might not mind you showing up later when the doctor is delayed.
  • Consider different doctors or locations. Abruzzo says she once had an ophthalmologist she loved, but “if you went there at any time of day, you were there for three hours.” She says she implored the doctor to fix the situation, but eventually gave up and found a new eye doctor. She says she advises clients to do the same and to seek out better-run offices. If you don’t want to switch doctors, you might ask if they work at any less busy locations, Rochester suggests. 

Despite your best efforts, you will end up waiting longer than you like at times. To deal with long waits when they happen:

  • Ask questions. After a wait of 15 to 20 minutes in the outer waiting room or exam room, it’s perfectly appropriate, Rochester and Abruzzo say, to ask staff for an update. “I myself have walked out with that paper gown on,” Abruzzo says. Don’t worry that you will “bother the doctor or bother the staff,” says Rochester. Ideally, she says, “you can make an informed decision about whether you want to continue to wait or not.” While you might not want to walk away from a long-awaited specialist visit, rescheduling sometimes makes sense, she says.  
  • Come prepared. Bring snacks, water and any medications or other medical supplies that might be needed during a long wait, Rochester suggests. “Prepare for the worst,” she says.
  • Bring your patience and some distractions. Of course, you should always bring reading material or some other distraction to an in-person appointment. Morgan, the billing consultant, has a go-to pastime for long waits on the phone with insurers and health systems: “I play solitaire.”

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