I have adult children. It's sometimes difficult staying out of their lives and decisions, especially in matters of health. So instead I ask a lot of questions. The last several weeks I've been asking quite a few of one child who is struggling, as so many patients do, with getting through the referral process into specialty care. She first saw her primary care doc for an unusual acute illness. He was easy enough to get in to see. He evaluated her, took blood for labs and said the office would call with results. After a week of no response I encouraged her to call and get the results. They were then promptly provided along with a scheduled next appointment for the following week. During the appointment, the doc said he would refer her to a specialist to follow up with the lab findings. She waited another week with no contact from the specialist so I prodded her to call the primary care again. They said they sent the referral and to wait for contact from the specialist. She did get the number of the specialist, but waited another week with no call from them. With more urging from me, she then called the specialist office who said yes, she was on the list to be called and would hear in a couple of days. Ten days later with no call, I urged her to call back...
Are you tired of reading this yet? Imagine being the patient, fearful with abnormal labs and wondering what's wrong and whether or not the delay in care will impact her long term health.
How often does this happen in the US? We have surprisingly little data to address. Merritt Hawkins conducted a survey by calling physician offices in 15 metropolitan areas to schedule an appointment with several specialties for non-emergent conditions. https://www.merritthawkins.com/2014-survey/patientwaittime.aspx They found average wait to schedule a cardiology appointment in DC was 32 days ranging from as short as 4 to as long as 186 days! Average wait to see an ob-gyn in Boston was 46 days ranging from 5 to 103.
How long do patients wait to get to your care or the care of your specialty colleagues? Do you know? We cannot improve what we haven't measured.
- Do you know how long your patients wait to get an appointment to see you?
- Do you know how long your patients wait to get an appointment when you refer them for specialty care?
- Do you know how smooth the process is for patients to navigate?
- Do you provide your patients with information they can use while waiting for their next appointment?
- Have you ever thought about what it's like for patients trying to get access to your care?
I know we were trained to provide the best care to our patients when we interact with them. But the patient interaction begins long before you see them in your office.
How can you improve scheduling for your patients? You can start by asking your patients about their wait experience (gather data). Then you can read this free resource from the National Academies of Science, Engineering and Medicine for some ideas on what to do about it. https://www.nap.edu/catalog/20220/transforming-health-care-scheduling-and-access-getting-to-now
Make sure your patients don't compare their wait to see you to Waiting for Godot.