Late Arrival Policy – There’s Good Reason For It

March 7, 2011
Melissa Young, MD

Most of my patients appreciate that I run on time. Many of them plan other things around their visits with me because they know approximately what time they will be done. I’d rather lose the late-comer than have patients complain that they had to wait too long.

According to several surveys, one of the most common complaints patients have is that they have to wait too long in a doctor’s office to be seen. The waiting room is exactly that - a room in which to wait. And wait. And wait. And then, after they are moved to an exam room, they wait some more. 

I, on the other hand, am very particular about running on time. I have said this before in previous posts. I do my best to schedule people for a length of time that I think is appropriate. I have patients who I know need extra time because they ask a million questions, or are just slower due to age or arthritis. I do not like to make patients wait for more than a few minutes. Of course, there are bad days, and things happen and I get behind schedule, but at most, I have been half an hour behind. And I always apologize for my tardiness.

In order to maintain this schedule, our practice, like many others, has a “late arrival” policy. If a patient is more than 10 minutes late, then he/she may be rescheduled. If there is an opening in the schedule, that patient may be asked if they would like to hang out and wait for that spot. And if there are extenuating circumstances, or if they are particularly frail, or if they come from a facility and they are late because of their transport, we make accommodations.

As I mentioned last week, a patient arrived 30 minutes late for her 15-minute appointment. She was told that she could not be squeezed in right then, but that later in that morning, there was an opening. She was irate. She couldn’t wait until the open spot. And she couldn’t understand why I couldn’t spare five minutes of my time to see her. She carried on for a while, according to my staff, but finally did arrange another appointment.

This same patient came in the other day. She was brought in promptly, and I was in the exam room with her within a minute of the MA leaving the room. I conducted my history and exam, went over her labs and other tests, and went over the plan. During all of which, it did not escape my attention that she periodically looked at her watch. Is she in a hurry? Is she timing me?

Turns out it was the latter. I know this because at the conclusion of her visit, she brought up the fact that she had been there the week before, was late, was told she couldn’t be seen, and that is “ridiculous.” She said there was no one in the waiting room. I said that just because there is no one in the waiting room, it doesn’t mean that I am not in a room with a patient, and that another patient isn’t ready to be seen in another room. She said that what occurred during her visit could have been done in five minutes (even though it took 15) if I had just squeezed her in. And that there was nothing that was done during her visit, except for her vitals (which she could get at her primary’s) that couldn’t have been done over the phone. Besides, she said, all I did was read her results of tests, which she already knew.

I tried to get her to see it from the point of view of the patients who arrived on time. It would not be fair for them to wait because I accommodated her, when she was the one who was late. Not by a little, but by a half hour. She would hear none of it. I told her that we have a policy, and I am sticking by it and if she is late again, she will not be seen. And if she feels that all I do is read her the results of her tests, then she can follow up with her primary. Then she started to complain that it was pouring rain that day, and I just said that I have no control over the weather and walked away. For reasons, I don’t believe she scheduled a follow-up appointment.

Most of my patients appreciate that I run on time. Many of them plan other things around their visits with me because they know approximately what time they will be done. I want to keep it that way. I figure I’d rather lose the late-comer than have patients complain that they had to wait too long.