Physicians on the Receiving End of Bills from Patients Sick of Waiting

July 19, 2011

Physicians often require patients to sign late-fee contracts prior to scheduled appointments. When the physician doesn’t hold up his end of the bargain, it leads patients to wonder, why is his time more valuable than mine?

Several recently published articles address a number of patients who bill their physicians for delayed appointments.

And why not? Restaurants compensate patrons for meals that arrive late; airlines reimburse passengers bumped from flights; plumbers, electricians, and carpet cleaners often reimburse customers for lateness.

Elaine Farstad, an engineering graduate student at North Carolina State University told CNN she charges physicians the equivalent of one hour of her salary for each hour a doctor is late.

Farstad's doctor sent her a check for $100, the full amount she requested. And other doctors told CNN they compensate patients for lateness before the patient even asks.

"It's ludicrous - why would I wait for free?" Farstad said. "Like we all learned in kindergarten, it's about respecting each other."

In a recent poll taken by MedPage Today, nearly half of 3,200 respondents said they should get a discounted bill if their appointment is delayed.

If that becomes the reality, practices are going to suffer financially. Especially if patients charge based on the amount of time they miss from work, as Farstad does.

The average time patients spent waiting to be seen by physicians in 2010 was 23 minutes, according to Press Ganey, a healthcare performance research organization. And the mean annual hourly wage for salaried Americans in 2010 was $21.35, according to the Bureau of Labor Statistics.

That translates to an average physician payout of about $10 per patient visit.

According to our 2010 physician compensation survey, 34 percent of solo practitioners, and 18 percent of physicians in practices of 10 or less, said their personal income declined last year.

That $10 revenue loss per patient is not an option for these physicians.

So what can they do to avoid it?

In reality, most fed-up patients are probably frustrated not because of the monetary loss they suffer due to waiting, but because, as Farstad said, they feel that their time is not being respected.

Physicians often require patients to sign late-fee contracts prior to scheduled appointments. When the physician doesn’t hold up his end of the bargain, it leads patients to wonder, why is his time more valuable than mine?

As you and your fellow physicians and practice administrators know, it’s not that you don’t respect your patients or their time - it’s that you do respect them.

The majority of the time you are late, it’s because you are ensuring that all your patients’ needs are met, that they are receiving the highest quality of care.

That said, explaining your reasons for lateness to frustrated patients may sound like excuses and complaints.

Perhaps, instead, physicians and practice managers merely need to explain the lateness - not the reasons.

In other words, as soon as patients arrive at their appointments, tell them exactly how much of a wait time to anticipate.

This puts the control back in the patient’s hands. They can choose to leave or stay. And they will appreciate your honesty.

What are some of the ways your practice addresses lateness?