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 By Neil B. Gailmard, OD, MBA, FAAO, Editor September 10, 2008 - Tip #345 
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Patient Waiting Time

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Additional Information

As we continue our analysis of the major influence points in your practice, let's look at the typical wait time for a patient. A long wait has become the norm in health care offices today, but just because it's common doesn't mean we should accept it.

There are some medical specialties that are inherently extremely busy and have all the patient demand they could ever need but, unfortunately, eye care is usually not one of them. Most eye care practices need many more patients to reach high success levels. Rather than worry and wonder how things got this way, I'm far more interested in changing it. The way to build patient demand for private practice eye care is excellent customer service. Making people wait beyond a reasonable period of time is a huge step in the wrong direction.

An opportunity

Most practices need more competitive advantages: reasons why a patient should choose your office over others in the area. Developing those advantages can be difficult and expensive. Earning a reputation for generally being on time for appointments is a very strong advantage that doesn't cost anything and can be implemented immediately. Smart practice owners embrace the opportunity to be different than most doctors' offices by being on time and they generate patient loyalty and word of mouth buzz in the process.

Remedies for chronic problems

If your practice often runs more than ten minutes past appointment times, consider these strategies for changing your operations.
  • Observe and analyze why your office runs late. Ask your staff for input as well, since they may see things differently than you. Is it in the processing before the exam? Is it a bottleneck in pretesting? Does the doctor talk too long? Are there not enough exam rooms? Diagnose the problem before trying to treat it.
  • I define the beginning of a visit as the time when someone calls the patient into the clinical area to begin some aspect of testing. Usually, that is a technician. Make sure you have enough staff. Trying to keep expenses down with fewer employees is penny-wise but pound-foolish. Doing so will hold back your practice growth. Proper staffing is a wise investment that pays for itself with improved service and higher productivity.
  • Be aware of the inner waiting time as well as the reception room wait time. Calling someone into the office only to make them wait in an exam room or holding area is not being on time.
  • The doctor must be interested in an excellent record of being on time. Everyone knows that occasional emergencies or complex cases can cause any doctor to run late on occasion, but what is the track record like? Some doctors really don't mind if they make patients wait. If they don't see the benefits of a great reputation for being on time, then this tip won't help. Doctors who wish to improve their track record will work on being flexible with their exam procedures.
  • Doctors who are interested in the schedule will leap frog an easy patient who arrives early or may change the routine for dilation or other testing to suit the flow at the time. The order you do some things can be changed to accommodate the appointment status.
  • Delegate more to staff so the doctor can concentrate on the patient rather than data collection.
  • Consider using scribes in the exam room. This technique brings amazing time saving efficiencies, not the least of which is saving the doctor from walking patients around the office and explaining the treatment plan to staff.
  • Be upfront and honest about wait times with patients. If your staff knows the doctor is running behind schedule, it's best to tell patients this as they check in and even offer to reschedule them if the problem is severe.
  • I like to see doctors apologize directly to the patient if they are significantly late. It shows a respect for the patient's time and conveys that running late is not the norm. It reverses some bad feelings.
How to handle early and late arrivers

There is no question that people who don't arrive on time play havoc with your schedule. The early bird wants to be seen right away and the late person wonders why you are not calling him in since it's past his appointment time. Both would like to ignore that you have other appointments.

Train your receptionists to politely acknowledge the current time at the moment of check-in. Just say, "Hi Mr. Jones! It's so nice to see you again! I see you have a 3:00 appointment and it's now 3:20. We'll work you into the schedule just as soon as possible. It shouldn't be too long of a wait; please make yourself comfortable." This approach let's the patient know that you know he's late and that any wait is his fault. The same is true with early folks - mention the current time and tell them you'll try to work them in sooner than the appointed time if possible.

Staff members would sometimes like to be tougher on late arrivers, but my approach is very lenient and understanding. If you work with people and genuinely try to serve them and avoid inconveniencing them, it all works out.

Wait times for patients who drop in

As you examine typical wait times in your practice, don't forget to consider patients who stop in to pick up glasses or replacement contacts or to have an adjustment or repair. Since these folks don't generally have appointments (I don't recommend appointments for these kinds of visits), a small wait is understandable, but it should be brief most of the time. If there are often long waits for picking up glasses I would be concerned that you don't have enough employees.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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