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For all of you that would walk out, write a bad review and disparage doctors who run behind - may you never have a mid-day emergency, may your surgery never have complications requiring your doctor to spend extra time caring for you, may you never have an unexpected miscarriage or stillbirth on a day you were scheduled for a routine appointment, may your pathology never return mid-day with the diagnosis of cancer, may you never miss your bus to make it to the appointment on the one day off of work that you have had in 3 months....I find that the people who are generous with their kindness and time are the people who have been on the receiving end of this at some point in their lives. Those who are smug, angry, indignant that 'anyone would keep them waiting' are likely someone who has absolutely no understanding of how one single emergency/one patient's needs can up-end an entire day and make 20 people wait. A personal physician who is always available to you at your scheduled time is a privilege reserved for a few.

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Sep 26, 2023Liked by Adam Cifu, MD

When I lived in Florida I paid $1500 a year to see a Concierge Physician. It was worth every penny! No wait time ever. At least 45-minutes to an hour with my doctor. I had my doctor’s cellphone number for emergencies. Excellent preventive health care, with concern for physical health, mental health, fitness and diet. It was simply wonderful.

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Sep 24, 2023Liked by Adam Cifu, MD

I'm a patient. Anne Cifu gets us, she saw us and cared!

Thank you Dr. Adam Cifu for sharing these reflections by your mother, which must be endearing to you. Now shared to the public, her thoughts and words are also now instructive for all who labor to improve healthcare for everyone. Pat Flagg

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True, the hard part is pt. Waiting longer for care.

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Wow. So many comments here. I am a female primary care physician - so I come to this from both sides of the equation. Facts: 1)doctors do not differentiate or disregard patients by sex: we do not selectively feel more comfortable in making women wait longer than men.

2) Doctors are not taking leisurely lunches or scrolling Facebook in between patient appointments and extending anyone's wait. We are frantically trying to refill prescriptions, answer My Chart messages, review the abnormal test results and decide what needs to be done next. Many doctors don't have time to eat lunch or go to the bathroom.

3) Patients come into appointments with various expectations. When in for a preventive physical, a patient may also bring a "list" of other items they'd like to discuss, such as hot flashes, sore knee, abdominal pain. They might be in for checking on a sore knee, but then also want to discuss palpitations they've been noticing or anxiety that is getting worse.

4) The population is aging - more people are going to the doctor with more complicated problems. There are lots of patients to see in a day. If every doctor took 30-45 minutes with most patients, there would not be enough patient appointment slots to keep up with things as they are. Delays for getting in for appointments would increase.

5) There are more medications available to treat things. More complicated problems and many more options for medication and treatment. This takes time to review and evaluate.

6) The doctor is the "scribe" and stenographer who must record the details of the interaction between patient and physician. This also takes time.

I don't think either side is happy with the current state of medicine! As a patient, it is near impossible to find a new PCP and the wait times to get into specialists is increasing. Just calling an office is often an ordeal in and of itself.

All I can suggest is that patients will need to self-select their physicians. If wait times are extremely important and you refuse to put up with waiting, then find the docs who are ultra-efficient and always running on time (but they will typically not be answering any additional questions or concerns). If you want docs that spend more time with you and are open to additional questions, more than one problem at a visit, etc. you likely are more tolerant of waiting. For the most part, it can't happen both ways.

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Sep 23, 2023Liked by Adam Cifu, MD

I agree with your Mom, she seems like she was a VERY wise woman. I'd have to say it's because Doctors don't value our time like they their own time. It's not about customer service it's about putting us in our place.

As an translator in offices it's interesting that when the office is paying for my services there is no wait time. The patient and I are in and seen very quickly.

Also have ask WHY are Doctors are still only open when most people work? In this day and age why is that? Yes, you can go to a same day clinic but it's not the same but at least you wait less.

Then again I ask the same thing about car dealers service dept. Why is it that they aren't open (for the most part) at night and on weekends when you have time?

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Sep 23, 2023Liked by Adam Cifu, MD

It's been really eye opening to read all the comments on this issue and I think that the problem of waiting is multifactorial. Currently though I would say one that our practice has experienced is not enough practioners, not many lining up, complicated patients, late patients, and practioner burn out. As a patient, I don't mind waiting 15 min. But anything more than that and then going in and being rushed, makes me want to not come back. Very much a complicated problem.

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My ex is a doctor so I got the inside track on how it works. He had a partner who would call the office from the hospital where he was making rounds. He's ask the receptionist how many people were waiting. If not enough, he'd say he'd call back in a bit. That's one side. The other side is what my ex told his patients. Some days he runs late because he sees so many patients. He tells his patients he spends as much time as he needs with them and sometimes that puts him off schedule. I hope most doctors are like ex.

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Why should we wait? We make an appointment so as not to wait. I will wait 15 minutes and then leave. I might reschedule or I might just move on.

May I suggest that if the doctor is running late, maybe it would be polite for the receptionist/secretary/or whoever to notify the waiting patients/clients of the delay. Would that be asking too much?

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I've been the patient that needed an extra long appointment before, and I was so grateful to not be rushed or made to feel like a burden (even though I know I was one). I'm willing to wait, it's an indication that the doc is spending more time than the allotted 7-8 min or whatever it is. That said, my patience is finite, and if I've waited 30 min or more, I approach reception and politely reschedule. If it is a chronic problem with the office, I find a different care provider if at all possible.

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Sep 22, 2023Liked by Adam Cifu, MD

So prescient and yet how unfortunate your mother's wonderful writing is still true so many years later. I always saved a little grace for the OB/Gyn, as their practice is often run on nature's unpredictable schedule, but I forgive no one for not apologizing for delays. I have left two pediatricians for this offense (and told them so!). However, I also recently spent 12 hours hostage in an emergency room aghast at how unhelpful and avoidant most of the staff were, and unable to do anything about it. We are all people at the end of the day - whether we are doctors, corporate titans, electricians, or "just" moms - and deserving of kindness, dignity, and the occasional apology.

Lovely piece!

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Well, I’m a doc and I’m always suspicious that if my own physician is on time, they are shortchanging their patients. I was always running behind. Especially after the EMR was mandated.

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Sep 22, 2023Liked by Adam Cifu, MD

I do not wait. I’ve taken my business elsewhere - after all that’s how they treat it, as a business, and have shared that as my reason for changing with both the old doctor and new.

I will wait at the vet - that’s it.

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When I was running a practice using the term "waiting room" was a cuss jar offense. The room where you enter the practice is the reception area. No one comes to the practice to wait; they come to be welcomed. We measured wait times in all areas of the practiced fanatically as that was clearly the most important source of patient dissatisfaction. FWIW, as I did some consulting work later in my career, I remember going into practices which we very proud of the limited number of patients in the "waiting room"...only to find 4 exam rooms per physician, each full with a waiting family. We would remind the practices that all they had done was move people into smaller waiting rooms with fewer magazines

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Sep 22, 2023Liked by Adam Cifu, MD

Wow, her words are so super powerful. I love your Mother as represented by her astute observations and advocacy, and wish she could still wage her campaign. I need her myself! She also has shaped you into an amazing doctor who is both humane and intelligent, self reflective and an educator. Maybe you can publish more of her amazing work to help us all become better self advocates and wake up to what we are allowing ourselves to be subjected to. Thank you so much for sharing her incredible words!

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Sep 22, 2023Liked by Adam Cifu, MD

Awesome.

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