The Waiting Room – Patient Centered Medicine

Doctor's OfficeI am sitting in the waiting room of a great eye doctor here in Austin.

Medical appointments are not always easy to schedule.  And then even having booked the appointment, it is not unusual to have to wait quite a long time in the doctor’s office to be seen.  This morning is one of those times!

But with modern technology, I can at least use the time wisely, or at least I hope you will think I am using it well by the time you have read these remarks.  Waiting is increasingly going to become a fact of life for all of us in the medical world.

Does it matter if we have to wait longer to see the doctor?

In most cases the answer is no.  But it may be an inconvenience that we are not used to.  When I first practiced as a family doctor I joined the staff of a National Health Service medical practice in Britain where the average wait time for patients in our waiting room was around 70 minutes.  It seemed crazy to me that we apparently cared so little about our patient’s time that we would keep them all waiting over an hour to have a 5-10 minute appointment with the doctor.  So with a little ingenuity, and a lot of planning, I persuaded the other doctors that we could implement an appointment plan that actually worked!  Three months later, our average wait time was down to 5 minutes.

Why do I tell you this story?  Innovation is driven by motivation.  Under Britain’s National Health Service I would not get paid more for having a better run medical practice (at least not back in the 70’s), but I would be able to have more time with my family.

America is on it’s own road toward medical socialism.  Many would argue that this is a good thing.  Everyone will have ready access to medical care.  And that is clearly a good thing!  But life is never that simple.  Everyone had and has access to good medical care in the UK, but everybody has also had to learn to wait his or her turn.  Sometimes this means waiting 12 months for non-urgent knee or hip surgery.  It may mean waiting 5 days to get in for a non-emergency visit to your family doctor.  All of this is going to become normal in this country unless we actively look for innovation in the way the medical care is delivered.

Governments do not drive innovation very effectively.  People’s personal motivations, such as the opportunity to spend more time with their family, or the chance of making more income, or the pleasure derived from providing great service are the types of things that drive innovation.  If I want to know that a package is going to be delivered on time, I am more likely to use Fed Ex than USPS.  It is much the same with medical care.  If I want the best, I am more likely to choose the doctors and medical practices that cater to my time and convenience.

We need to encourage innovation in how medicine is practiced.  This is patient centered medicine.

Tony Dale | @tonydale.flywheelsitesaustin