Honorable Mention in our 2001 writing contest

Running late

Doctors aren't the only ones who get behind schedule, as the author learned when he made time for a tardy patient.

By William T. Sheahan, MD
Family Physician/Winter Park, FL

"The doctor is very busy; we're sorry for the wait." "The doctor was called to the hospital for an emergency. It might be hours until he gets here."

"The doctor called; he's stuck in traffic on the interstate, but will be here soon."

Although it would be nice not to have emergencies or double-booked appointment slots, things rarely go as planned—and we've become accustomed to asking patients to wait for long periods of time, or even to reschedule an appointment if we're running behind. Is it any wonder that many patients seem angry when you finally enter the exam room?

I try always to acknowledge those situations, showing my patients respect and empathy. If someone has been in the waiting room for a while, I'll say, "Sorry you've had such a long wait. I'm glad you're here, and I hope I can help." Often, I learn that their day has been more stressful than mine.

One such patient was Michael, a middle-aged crack addict who had lost everything—job, money, and family. He had been "clean" for almost a year and was living in a treatment facility outside the city. One morning, he called our clinic at 7 am to report that he would be "a little late" for his 8:40 appointment.

A little late, indeed. At 5:30 pm, I was waiting for the elevator when a harried-looking Michael stepped out. He asked me if I was about to leave. I said Yes, then joked that by arriving almost nine hours behind schedule he had redefined "a little late." Michael looked at the floor, said he was sorry, promised to make another appointment, then turned to get back on the elevator.

"Before you leave," I said, "tell me how everything is going."

He responded by relating the saga of his 30-mile trip to our office. He had gotten up at 5 am, intending to ride his bike a mile or so from the treatment facility to the bus stop. But his bicycle tire was flat, so he missed the 5:30 bus, and the next bus didn't leave until 1 pm. That bus developed mechanical problems, and the passengers had to wait in 100-degree heat while another bus was put in service. He hadn't eaten all day.

I was glad I had asked. Although my staff had left for the day, I took Michael into an exam room. He gratefully accepted some crackers and juice, and he cried when we talked about the children he hadn't seen for months. I told him he was doing well medically and encouraged him to remain optimistic and drug-free. He replied that he would.

Yes, we often have bad days, but so do our patients. And though we might strive for perfection in scheduling, we—and our staff—need to go with the flow. It should be policy to welcome a patient and thank him for coming to your office before chiding him for being late. Remind him of his appointment time, but acknowledge that sometimes tardiness is unavoidable. After all, patients get stuck in traffic on the interstate, too.

Repeat offenders might need some counseling, but never berate patients for being late. That way, they're more likely to treat you with the same courtesy when you're the one who's playing catchup.

Remember, there's always a Michael. The night I stayed to see him, I got home a little later than usual. Michael got back to his "house" at about the same time I went to sleep that night.

 

William Sheahan. Running late. Medical Economics 2002;11:94.