Why Your Doctor is Always Late

Unique insights from a resident physician on the front lines of the doctor’s office

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After working in dozens of doctor’s offices, I obtained a clear understanding of why some clinics run like clockwork while others consistently fall behind.

Life Happens

• We all have these days, including your doctor. You forget to set your alarm or you don’t hear your alarm go off (alternatively, you passively hit the snooze without ever actually waking up). Your child is sick or your dog threw up as you were walking out the door. The daycare attendant is running late, thereby making you late. Road construction or a car accident backs up traffic for miles. It happens, everyone understands.

“I’m Late! I’m Late! For a Very Important Date!”

• The doctor arrives to clinic on time but there is no patient to see. Instead of arriving at 8:00 AM, the first patient of the day checks in at 8:15 AM. Because the patient drove a long way, the doctor agrees to see them. Now the first patient visit ends at 8:45 AM, making the doctor 15 minutes late and it isn’t even an hour into the day.

COVID-19

• During the world pandemic of the novel coronavirus, hospitals and clinics are taking extra precautions. Patient rooms are cleaned thoroughly and all surfaces are wiped with strong disinfectant wipes. Staff is reduced in number to decrease potential exposure. Masks and face shields are often worn during encounters. Ensuring the safety of patients and staff is essential, even if the process requires additional time.

Oh, By The Way…

• Imagine this: You have a rather suspicious looking mole located in a very private area. You want to ask the doctor about it but you’re nervous and, frankly, a little embarrassed. The visit is about to end and the doctor’s hand is on the door knob. Finally, you pipe up, “Well since I’m here, could you look at this?” The doctor examines the mole, tells you it is nothing to worry about, and says goodbye once more. The extra question only took 5 minutes to resolve but this sequence of events occurs so often it adds up to an extra 30 minutes behind schedule by the end of the day.

You have a rather suspicious looking mole located in a very private area. You want to ask the doctor about it but you’re nervous and, frankly, a little embarrassed.

Learners

• When a medical student or resident physician is working with the doctor, visits may take up to twice as long as usual. The learner first sees the patient on their own then leaves the room to update the doctor. Then the learner and doctor see the patient together. This process leads to repetition of questions and additional clarification, requiring extra time for each visit.

Documentation. So Much Documentation.

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• A medical note must be generated for each patient visit to document the visit for future reference. Insurance companies also require detailed documentation with rationalizations of medications and tests ordered for payment to be made to the hospital system and doctor. Detailed documentation becomes a significant time burden. Many doctors combat this by typing their documentation during the patient visit. Others will verbally record their notes after leaving the patient’s room. Often times the doctor still will have notes to complete at home after clinic ends for the day.

The “Chatty Kathy”

• This label may be applied to the doctor or the patient. Some doctors truly enjoy visiting with each patient, getting to know them on deeper levels, and being updated on how the patient’s second cousin twice-removed used to live the same state that Elvis Presley once ate a fried peanut butter and banana sandwich in. Many patients divulge their deepest and darkest secrets, even if the doctor’s question had nothing to do with how the patient’s cat loves chasing the robot vacuum around the house. These visits quickly increase from the scheduled 30 minutes to over 45 minutes.

Many patients divulge their deepest and darkest secrets, even if the doctor’s question had nothing to do with how the patient’s cat loves chasing the robot vacuum around the house.

Well That Took Longer Than Expected

• Occasionally, procedures just take longer than expected. Simple as that. Maybe the numbing medication needs more time to take effect. Maybe it was difficult to squeeze all the puss out of the abscess. Maybe the injection was so painful the doctor had to stop in the middle to give the patient a break. There are numerous possibilities but they all add up to extra time.

“Double Booked” Appointments

• Patients occasionally need to be seen by a doctor urgently but the issue is not serious enough to require a trip to the emergency room. Your child spikes a fever in the middle of the night. A patient notices increased swelling at their surgical site. Due to the short notice, clinics may be fully booked so two appointments must be scheduled for the same time slot (a.k.a. double booked). Even if the doctor is very efficient, it is very unlikely they will be able to see two patients in the same time they are scheduled to see one.

Any combination of the above events causes the doctor to become further and further behind. As much as patients dislike waiting, the doctor hates running late even more. Please be kind and understanding. We are all in this together.