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Posted on 8. December 2011

Should Physicians Pay Patients for Waiting?

By Pamela Wible, MD

Meet Elaine.
We lost touch for a while, but caught up with each other recently.
Like most girlfriends, we shared adventures of love, travel, and work. I told Elaine that I left assembly-line medicine. Now I host town hall meetings-inspiring citizens nationwide to design ideal clinics and hospitals.
Elaine shared: “If I’m kept waiting, I bill the doctor. At the twenty minute mark, I politely tell the receptionist that the doctor has missed my appointment and, at the thirty minute mark, I will start billing at $47/hour.”
Wow! I had to hear more.

Elaine scheduled her physical as the first appointment slot of the day.  She waited thirty-five minutes in a paper gown before getting dressed, retrieving her copay, and informing the receptionist to expect a bill. The doctor pulled up just as Elaine was leaving.
Prior to her initial visit, Elaine signed the standard agreement outlining no-show and late fees. On follow up, Elaine knocked on the door and discovered her therapist with another client. He apologized for his scheduling error. Elaine sent a bill; check arrived the following week.
Elaine values herself and her time.
When the Comcast guy told her to wait at home between 3:00-6:00 pm, she said, “Expect a $141.00 bill. Is that okay with your boss?” A compromise: The driver agreed to call fifteen minutes ahead of arrival.
I was intrigued. Who pays for waiting?
Cab drivers charge hourly for waiting.  Restaurants may provide a discounted meal for the inconvenience.  Airlines cover hotel rooms for undue delays. Some physicians apologize. I offer a gift.
Central to medicine is a sacred covenant built on mutual trust, respect, and integrity. What happens when physicians fall into self-interest or self-pity?  Or when physicians are so emotionally, physically or financially distraught by their profession?
Patients suffer. And their wait times increase.
So what’s a doc to do?
1)  Remember: Respect is reciprocal. If physicians are on time, patients will be on time. If physicians don’t cancel appointments with little notice, patients won’t either. Doctors should stop charging fees they are unwilling to pay themselves.
2) Functional clinics attract functional patients. Patients fall to the level of dysfunction within a clinic. A chaotic, disorganized clinic attracts chaotic, disorganized patients. Take care of yourself; uphold high standards and healthy boundaries.

3) Don’t wait. Doctors should apologize for delays. And if presented with an invoice for excessive waiting, doctors should gladly pay the fee. Fortunately, most patients don’t bill at the doctor’s hourly rate.
My opinion. Share yours.

Reposted with permission from www.idealmedicalcare.org


Comments (2) -

Medical Mom
9:37 AM on Friday, December 09, 2011

This woman is demanding of docs what they expect from clients. I am a practicing attorney and parent to 2 children who've faced long term chronic illness. I love this post!!

Interestingly, in my state, a client’s demand for payment for waiting time would be an implied enforceable contract if the doc made the woman sign an agreement that required her to pay for a visit for which she was X minutes late or missed.  Contract terms such as this, that impose obligation on one party are impliedly enforceable against the other party, particularly when the other party (doc) was responsible for the creation of the written agreement. Of course, this law of contract varies state to state.

The most important aspect of what she is doing is demanding of docs what they ask of her.  BRAVO!

IG Living reader
9:04 AM on Monday, January 09, 2012

Hello, I read this article and while I understand that waiting is an inconvenience and many people truly hate it and complain bitterly. I have been blessed with a physician who is worth waiting for. Why? Because he does not rush through your visit. If your medical issue is a simple one fine. However if your problem is complex or there is more than one problem apparent he will take the time needed to adequately care for you. He is worth waiting for; he is worth his weight in diamonds. Waiting for an incompetent physician would rankle me though.

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