Why do doctor's appointments always start so late?

I have consistently failed to understand the scheduling of an appointment at X time, only to be in the waiting room for at least an hour, sometimes 2, sometimes longer, before the actual appointment. I am hoping someone in the know can shed some light!

I do understand that visits are rarely set to a certain time frame, and that it’s easy to be with a patient longer than expected. BUT…it is SUCH an over-reaching phenomenon that it’s apparantly considered rude to cancel your appointment after an hour and a half of waiting (which I just tried to do). I’ve worked places where one had to take the whole day off for an appointment because there was just no way to tell just when it’d be done.
Is there a problem with patient ‘stacking’? Do offices schedule for every 15 minutes, knowing full well no visit is going to take only that long?

That’s the only thing I can come up with. I sure hope one day I find an office that can at least attempt to schedule enough time between patients that it’s less than a half hour wait after the scheduling before getting in, I really do. 'cause I’d go to them for everything!

Or is that just a pipe dream? I’m always tempted to just come in two hours late, but I just know my spot will be given away to someone else if I’m even one minute late. :smack:

Doubt there is a factual answer, as it doesn’t always happen. My current GP is almost always on time. The longest I have had to wait beyond my appointment time is about 10 minutes.

Many doctors get behind regularly. I highly recommend that you make your appointments early in the morning so you are one of the physicians first appointments before he/she has a chance to get behind.

Emergencies would be one reason things might run late. My oncology surgeon is almost never late. In fact I’ve actually had short appointments in which I was finished before my scheduled start time. The one time he was 10-15 minutes late, he apologized profusely. But then I suspect Oncology surgeons rarely have emergencies.

I understand a 1:00 appointment works for that as well. I think it’s just double/triple booking and getting behind plus emergency appointments that pop up during the day, phone calls that have to be made/returned, unexpected things that happen etc. But two hours late is excessive. After 45 minutes or so, you should go back up the the counter and ‘re-register’.

I have an ENT that I love. If I make the appointment for 2:00 I can show up at 1:40 and be walking out the door at 2:00.

I don’t have any experience, but I always thought that when it came to cancer, it was pretty normal to get started really soon, like that day. I wonder how often someone comes back with an X-ray that that doesn’t look quite right and a GP sends the patient over for a consultation the same day.

I used to have that problem with my doctors. But a few years ago I switched to a new medical group that is much more efficient, and now I rarely have to wait more than fifteen minutes for any appointment. I don’t know how they do it exactly, but they sure use a lot of technology – there’s a computer terminal in every exam room, and every doctor enters everything into your computer medical record right on the spot while he’s still talking to you. He can order tests, or look up the results of past tests, in seconds. I’m sure that saves time.

I have had this experience with three medical practices. I stopped going there.

My family doctor rarely keeps me waiting more than maybe 10 minutes. None of the specialists I see have ever kept me waiting. Nor does my dentist.

Back when I was dealing with such things, the OB/GYN I went to very often had waits despite it being a group practice. However, this was because on occasion more than one woman was in labor or some emergency occurred and the doctors were busy at the hospital. In those cases the office staff would tell those waiting what the situation was and give us the choice of waiting or coming back another time.

One set of doctors I stopped going to because the office staff outright lied. I had to take of work early for the appointment and I called ahead to see if things were on schedule, and was told I would be seen on time. I waited an hour and then told them sorry, I have to go pick up my kids from after school care now. They tried to say oh, please wait, it will only be a few more minutes. Sorry, you told me that 15 minutes ago and a half hour ago. I never went back.

Emergencies can happen, but if you are always waiting that long, it is simply poor scheduling practices. Getting the first appointment in the morning should help. Unless you have a specific reason for needing this particular doctor, find another doctor.

Several of my docs use that, but the one the thing that impressed me most was when one of them said “Which Walgreens do you use [waits for my response] Okay, they have the prescription, it’ll probably be ready in an hour or two”.

Agreed, none of the doctors I go to currently leave me waiting much longer than 10-15 minutes at most, and frequently I’m in the room promptly and seen quickly.

Having worked in a few doctors’ offices, it depends on a lot of things:

  • Emergencies / needing to do treatment procedures (vs making a patient return another day for treatment)
  • No-show rate for the office - if they don’t overbook at least a little, then there can be days when half the patients don’t show and you’re doing nothing for long stretches
  • Weather (good or bad) leading to cancellations/postponements or more people coming in than usual
  • Day of the week/month - lots of appointments right before/after school starts, right around the holidays, lots of emergencies on Fridays/Mondays
  • Being the consulting doctor on service for residents/other doctors to refer their in-clinic patients to, so they have to break their “rhythm” to see someone else
  • The doctor’s speed of working with patients. Some doctors are very slow and deliberate in how they move during an exam, some are quick. I know one doctor who can probably examine three “normal” patients in the same time that another particular doctor can examine one, just because the first doctor is nearly hyperactive in movements, speaking speed, etc. - but he is also very affable and kind, and doesn’t really leave patients feeling unattended to.
  • Doctor attending to other things during clinic (meetings, answering e-mail, having lunch)
  • The popularity of the doctor (new/less popular doctors will have fewer patients than popular/respected ones)

I’ve also seen things like doctors giving certain patients (well-to-do, friends, etc.) priority treatment and tons of time, leaving other patients fuming in the waiting room and wondering when they’re going to be seen. Some doctors regularly show up late for their clinics but insist that their staff book patients to come in fairly early so that when they finally do arrive, there will be lots of patients ready to be seen and so they can just whip through seeing a bunch of patients one after another.

I’ve been kept waiting by my GP on many an occasion over the years, sometimes to the point where I would have “pitted” him, if I had been a SDMB member at the time. However, this same physician also treats both of my elderly parents, for whom my sister and I have medical POA for, and during several incidents over the past few years when each has been hospitalized this doctor has always taken the time to patiently and compassionately answer any questions and address any concerns that she and I have had about our parents (which have recently included difficult topics such as long term care, as well as one potential DNR situation) without ever making us feel rushed in any way. Knowing this, I am now more than willing to give him the benefit of the doubt whenever he keeps me waiting for one of my own appointments, and assume that he is showing one of his less fortunate patients and/or their family the same patience, compassion, and dedication that he has always shown me during such difficult times.

I’m pretty sure what OldGuy means is that by the time you are diagnosed with cancer, you’ve probably had it for months, or even years for slow-growing tumors, so waiting a bit longer isn’t going to make any difference (unlike say, massive trauma, heart attacks, strokes, infections, etc).

Doctors usually start out on time with their first few appointments, but get further and further behind as the day goes on. So your best bet is to get as early (in the day) an appointment as possible.

I got to a very large clinic, and they are seldom late. When I get my INR checked I often walk out just at my appointment time. But I don’t mind being a bit late if the doctor is in a serious discussion with another patient. But 2 hours late as common practice is showing the patient how important the doctor is. My father in law just went to a hand specialist who usually runs 3 hours late - but at least they don’t make you sit in the office the whole time. They need beepers like restaurants use.

Still, I felt much better about waiting when my wife’s retina detached and she went to a retina specialist without an appointment (but calling ahead.) They got her in eventually, but someone who went after must have had to wait.

Scheduling software and greed.

From the MD side, and a practice that prides itself on running on time the vast majority of the time.

  1. There is no good reason to routinely run an hour behind. The bad reasons include docs who take a lot of time but who insist on being scheduled as if they worked more efficiently, and the desire to never have the doctor waiting on a patient and being nonproductive - maximizing his/her facetime with patients is efficient utilization, waiting for a late patient or having no one to see because of a no show is an inefficiency best avoided when possible and having others waiting avoids that.

  2. The other side of it is of course that it is extremely difficult to run completely on time. Patients come early, patients come late, patients seem to all take the bus together. Patients schedule something reporting a simple issue but then unveil the complex issue that they are really concerned about once your close the door. Or they think it is something simple but you discover by history or exam something else. Or they don’t realize that their asthma is not really under good control, and suddenly something scheduled as a straightforward room is a “weigh anchor” one. The scheduled as stomach flu turns out to be an appendicitis that needs to be admitted. The kid with vomiting turns out to be a new diabetic with diabetic ketoacidosis. The well care turns out to also be about possible ADD and a host of social issues. The quick phone call made while waiting for the next patient to get set up turns into a major complex event. Patients are not predictable homogenous widgets. You can only schedule for so much of the unexpected, so when more than the expected unexpected occurs you get backed up.

Thing is those should not be the norm. The norm should be within 15 to 20 minutes of appointment time. Much beyond that and you should both be getting updates from staff as to how long it is going to be and a brief apology. IMHO.

I’m usually able to get the first appointment which my endocrinologist has during his Friday office hours (which is 4pm). He’s late about 50% of the time, though rarely more than 15-20 minutes late. On Fridays, he’s coming to his office from his hours at a local hospital, and that’s what causes the unpredictability – if he has a case which requires more time than usual at the hospital, he’ll be late arriving at his office.

Anecdote: I had an appointment with our base’s optometry clinic, which I ended up 5 minutes late for due to a series of time-consuming delays (mandatory formation that ran long, holdup in traffic trying to get across base, and finally a big semi truck blocking the entrance to the parking lot while they unloaded something at the hospital itself).

I got one of the most epic ass-chewings I have ever received as an NCO from a Lt. Colonel (the optometrist) for not arriving 15 minutes early for my appointment like I had been instructed to, and how as a result, I may very likely cause the retirees in the waiting room to be delayed for THEIR appointment even though they were early.

Afterwards, he told me not to take it personally, as a Major General’s wife had received the same lecture the day before, and he fully expected to receive a phone call from her husband about it. His “Like I give a crap” attitude was a refreshing wonder to behold. The joys of being the only optometrist on base. :smiley:

The only way a few people cannot be busy or ‘queue’ people is to severely under-schedule their day.

It’s the nature of in/out in an environment with just a doctor or two accepting patients (traffic).

The process of appointments/scheduling gets efficient for all when the the number of doctors increases significantly.

One patient slows things down. You can factor in that when you schedule, but then you accept less patients, and the queue gets measured in days/weeks/months instead of half hours.

It really depends on the doctor. I had a doctor once that always kept me waiting. I found out he was letting walk-ins go ahead of appointments, especially old people who would be querulous. Rather than make his secretaries argue, he would just let everyone in.

This made me see red (hey, I WORK!) so I switched doctors. Now this doctor never makes me wait.

I love our dermatologist. He takes a much time as you want to explain everything and is never rushed. Truly a pleasure to have.

Oh, and I never accept anything but the first or second appointment slot. Everything else is a crap shoot.