Should a doctor’s waiting room be managed like a gate at O’Hare?
That’s roughly the plan of Chicago start up, MedWaitTime (Using Web to Curb Waiting-Room Times, May 25, Wall Street Journal). Here’s how it is supposed to work:
A new Web-based tool seeks to help patients spend less time in the waiting room before seeing their doctor. The application, called MedWaitTime, allows patients to check before their appointment whether their doctor is running late, akin to getting a flight-status update before going to the airport.
Patients can access the site, medwaittime.com, up to two hours ahead of their appointment. If the doctor is running late, patients can be instructed to arrive later than their scheduled appointment. Patients can also enter their cellphone number into the system for alerts through text messaging.
The system is currently in place at ten doctors’ offices and aims to address patient concerns that they rush to get to their appointment only to find that the doctor is running an hour late. On that basis, this has the potential to improve customer service. And at a pretty reasonable price. MedWaitTime charges $50 per doctor using the system and $300 for a hospital department.
I have to admit that I am not sold on this. First, the system can only be as good as the data available. The article notes that time updates have to be entered manually. This seems to be the least of the MedWaitTime’s problems. It can be addressed easily in a system with electronic medical records. In my experience, once an office has adopted electronic records, the first thing a physician does after greeting the patient is to log in. Bingo! It is easy to know that it’s 3:15 and Dr. Jones has yet to log in for her 2:30 patient. She must be running 45 minutes late.
The bigger problems I see are that it is going to create a public record of just how bad waits are at a clinic and it is going to induce bad patient behavior. In the airline industry, it is easy to find out that a flight is on time only 70% of the time. If this system is used regularly, won’t patients learn that doctor is running late every afternoon? How is that a good thing? An airline can take a variety of actions to improve on-time performance. A physician’s choices would seem to be spend less time with each patient (which may not endanger quality of care but will likely not be viewed positively by patients) or see fewer patients (which will stretch out times to see the doctor). Neither of those will benefit patients in the long run.
Now put yourself in the shoes of a patient who has just learned that the his doctor is running late. If it were a plane that was delayed, a passenger might postpone leaving for the airport but not by a whole lot. Most of us know that we are not that important to United and if the weather clears or the maintenance problem is resolved, the plane is leaving whether we are there or not. But what about a patient? He is not being served in a batch. What incentive does he have to hedge and not be too late? If he is told that the doctor is running an hour late, is it wrong to conclude that he is more likely to be seen and hour and a half late as opposed to 45 minutes late? This just seems an invitation to game the system and drive greater delays and inefficiencies in the system.