How to make sure you’re worth the wait

Spending the past two months in and out of countless medical appointments with an ill relative has given me an entirely new perspective about what waiting for doctors feels like. I wish I had better news for you, but the experience hasn’t always been great. And I’m not even the patient.


Physicians are busy people, so staying on top of things can be challenging. No matter how skilled you are at time management, realistic scheduling, and organizational protocols within your practice, it’s pretty much expected that patients are still going to have to wait to see you.

And that wait is getting longer. For a variety of reasons, including a shortage of doctors, fluctuations in the availability of health care insurance, and an aging population, wait times are on the uptick.

According to a September 2017 survey from Merritt Hawkins, the wait time for a new patient appointment with a physician for a non-urgent visit has increased by 30 percent since 2014 in the 15 major metropolitan areas studied.

Increasing wait times add to the pressure of doctors who are already delayed. There are two orbs to every hourglass, though, and the sands of time weigh just as heavily on patients as they do on overwhelmed physicians. Patients, too, are busy people. And the inconvenience of waiting to see a medical practitioner can add more than frustration to their hectic lives. It can also add severity to their illness or injury.

The fact is, most doctors these days are in a Catch-22 situation. They simultaneously face a steady stream of patients and a seriously stressed system. And, like the sand grains in an hourglass, sooner or later something’s going to get clogged. In the case of a medical practice, that something is efficiency.

Knowing that people are lining up to see you is a given. The question is, are you worth the wait?

Here are six things you can do to enhance the experience patients have when they arrive to see you.

1. Create a pleasant waiting area. The initial thing your patients feel when they enter your door is your practice’s ambience. Tattered furniture, faded paint, and outdated reading material leave a less than stellar first impression. Sprucing up your waiting room needn’t cost a lot of time or money, and the investment will be appreciated. Replace scruffy chairs, freshen up the walls, stream some music or video, and subscribe to a variety of contemporary publications that are of interest to all populations. The family member I accompanied to myriad appointments, a male, said at more than one medical office, “I wish they had something to read other than old cooking, decorating, and gossip magazines!”

2. Provide realistic updates. Ask your receptionist to keep patients and/or their advocates updated about delays and schedule changes. Provide as much lead-time as possible to notify them about unforeseen cancellations or appointment changes. If you’re running more than 30-minutes behind, consider having a staff member call or text patients with an update so they can amend their plans. Yes, it sounds labor intensive, but it’s also respectful. And for those who are already in your waiting room, make sure someone updates them with accurate wait times. This will allow them to take care of details like changing their pick-up time if they’ve been dropped off, alerting others they’ll be late for their next meeting, or adding time to their parking in a paid lot.

3. Review the chart before you enter the examination room. Take a moment to familiarize yourself with the patients’ complaint, referral note, or history before you walk in the door. Naturally, you’ll determine both subjective and objective perspectives of their presenting condition during your assessment and examination. But having them sit there watching you read can cause an uncomfortable gap in the relationship. Briefly reviewing their chart in advance of entering the room enables you to start the conversation at a more informed level. It also ensures that when you greet your patients you’ll be making solid eye contact with them rather than with the paper or device in your hand.

4. Be patient. Most of us feel harried when we’re hurried. That sensation is contagious. When you’re feeling rushed, so will your patients. One of the ways hurrying rears its head is through impatience, often manifested by interrupting, finishing people’s sentences, sighing, or ceasing to listen. Avoid these pitfalls by taking a deep breath and imagining the person in front of you is one of your own loved ones. How would you want them to be treated and spoken to? Keeping that image in the back of your mind will help you find the patience to hear people out.

5. Confirm their comprehension. A lot of patients will smile and nod during medical conversations, even when they don’t have a clue about what you’re saying. And if they do understand what you’ve told them, they can easily forget the details when they leave. Clarify that they have a firm grasp of all diagnoses, test results, and next steps. If you have any written materials or website recommendations as a backup, share them or write a quick note in lay terms that they can refer to. Increasingly, patients are recording medical conversations.Think about setting policies regarding this growing trend so you’re not caught off guard when it happens in your practice.

6. Honor your commitments. Patients will take you at your word. If you say you’ll follow up in two weeks, do it. If you promise to send a referral letter that day, send it. And if you ask a patient to book an appointment the following week, make sure you’re going to be in town. While time flies by for you, it can stand still for your patients. That’s why it’s so critical that you do what you say, when you say you’ll do it.

So many giant leaps have been made in modern medicine, but decreased wait times isn’t among them…yet. You can make a difference, though. By following these guidelines, rather than testing your patients’ patience, you’ll honor them by making the wait worthwhile.

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A model for positive connections

When you interact with others (staff, patients, colleagues, and family), how do you make people feel? Do they feel you have their best interest at heart?


While your medical knowledge and expertise are necessary ingredients to your success as a physician, how you interact with others is a critical but often overlooked factor. That’s because how we make people feel directly impacts the outcome of those interactions. It’s important to focus on mitigating threat that can cause people to distance themselves physically or emotionally and maximizing reward.

Many of my past articles have focused on the importance of understanding some basic brain dynamics and translating that into practical behaviors and communication strategies. Now let’s turn that into practice.

CONNECT© is a brain-based model I developed to help my clients incorporate brain friendly strategies into everyday interactions. The CONNECT model shows how to communicate in a way that creates a reward state through the release of chemicals such as dopamine, serotonin, oxytocin, and endorphins. When people feel threatened, their amygdala—the part of the brain responsible for the fight or flight response—is activated. The more threatened people feel, the less they are able to leverage their pre-frontal cortex, and the more avoidant they become.

Here are seven ways to improve interactions with others.

C = Consistency. Predictability is something the brain craves. When the brain encounters something it is has expected, it is very rewarding. Change is inherently threatening to the brain, so be mindful of providing people with adequate information and lead time so they can be better prepared. Be clear on expectations so people know what you want and/or are asking of them.

O = Ownership. Being told what to do triggers a negative response. But if people feel they have a choice and that they are given some autonomy, they can be motivated to act. Find opportunities to let others feel a sense of control. For example, let them decide how to do something or make a decision. Tell people more of the what than the how.

N = Novelty. While change is inherently threatening and boredom shuts down creativity and motivation, a state of curiosity is rewarding. Novelty and challenge create a reward state in the brain that causes people to feel intrinsically motivated, making it more likely that they will want to achieve their goals. Interestingly, our brains like to fill in gaps. We can help create a state of curiosity if we provide partial positive information, such as: “Did you know there are steps you can take to improve your blood pressure?” Asking open-ended questions is another way to encourage others to consider possibilities.

N = Need to Know. When people understand the meaning, purpose, and/or significance of their actions, they become more rewarding. The brain searches for meaning every time we encounter something new. If you ask patients or staff to do something but they don’t understand the “why,” that can trigger a threat state. Helping them establish challenging and meaningful goals they can see themselves making progress towards is highly motivating. It is a critical factor affecting job satisfaction and positive affect at work.

E = Equity. Not everything is equal, but perceptions of inequity trigger the disgust center of the brain and make it difficult to focus. People want to feel that things are fair—providing explanations about how you arrive at decisions and holding everyone to the same expectations goes a long towards creating perceptions of equity. Additionally, when people feel that their social “status” is less than that of others (we frequently, and often unconsciously, compare ourselves to others), it can trigger a threat response. Be careful to avoid making comparisons between people, such as staff.

C = Confidence. Feeling a sense of competency and capability enhances self-esteem, which creates a reward state in the brain. Situations that lower our self-esteem and confidence trigger a threat response. Help boost self-confidence by providing adequate training and instruction, by acknowledging what people are doing right (rather than focusing more on what they do wrong), and asking what they need to be successful.

T= Trust. As part of its focus on survival, the brain has evolved to quickly form in-groups (you are part of my tribe and therefore, you are safe) and out-groups (you represent a potential danger). These in and out-groups are formed easily and can lead to problems with collaboration and cooperation. One of the best ways to create a greater sense of in-group (trust) is to help people connect to their common goal (such as providing the best care we can for our patients).

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My first medical mission: An administrator’s perspective

Guest Post by Lisa Grabl

Earlier this year, I had the opportunity to accompany a group of healthcare providers on a medical mission to Cambodia. Though I have worked in healthcare staffing for nearly 20 years, I have never worked in any sort of clinical setting. The thought of going to another country to offer medical care was rather intimidating, but I still jumped at the opportunity to go and participate in whatever way I could.


We set up a permanent base of operations on one of the Cambodian islands in the Thailand Gulf and made daily trips to other nearby isolated islands.

Each day, the entire group would form a line and pass the supplies onto shore and then load everything up on carts to transport them to wherever we were offering care. We usually would take over an empty schoolhouse or other public gathering space to set up the clinic for the day. At the end of the day, we would for a line and pack everything back up

The importance of health education

People on these islands were given advanced notice of our visit and were lined up waiting for us to open each day. My role was to teach community education classes to patients while they waited for treatment. We taught simple ways to manage your health, such as how to brush your teeth, wash your hands, clean your drinking water, and avoid mosquito bites.

It was eye-opening to realize there are people who don’t know basic hygiene techniques that most healthcare providers in the United States likely wouldn’t even consider “healthcare.” However, the people we visited were often living in conditions where something as simple as handwashing was difficult to do.

When you can’t fix things (even though you want to)

The medical mission was hosted by International Medical Relief (IMR), an organization that provides mobile medical clinics and sustainable health education to underserved communities in 57 countries around the world.

Because the residents of some of these islands only see healthcare professionals once a year, IMR focuses on health education rather than ongoing treatment. When providers see a patient with diabetes, for example, they prescribe changes to diet and activity rather than medication. This method of treatment may take longer for the patient to start seeing health improvements, but it is better for their long-term health since taking regular medication is not realistically possible.

This method of practicing medicine was tough for some of the physicians at first —they really wanted to immediately solve these peoples’ health problems. However, in most cases, they didn’t have the resources to set up long-term care plans with follow-up visits and medications. Instead, they had to focus on disease management and educating the patients on lifestyle changes that would help them feel better and lead healthier lives.

By the end of the week, we were all physically and mentally spent. One of physicians remarked that while he didn’t save any lives or perform dramatic procedures, he did get to provide care and education to people who really needed it—and that made it all worth it.

A new perspective

For me, the trip changed my perspective in two ways. First, seeing patient care in its rawest form really showed me how important healthcare is in all our lives. Amid the many heated debates about Medicare coverage, the Affordable Care Act, prescription drug costs and so forth, it can be easy to take our healthcare system for granted. I feel fortunate to have a clinic located at my office considering there are people who are lucky to see a doctor for a few minutes once a year.

Second, healthcare takes a village. These types of trips take a huge amount of work behind the scenes—identifying areas of need, coordinating with governments and nonprofits, obtaining supplies, and recruiting healthcare providers. Knowing what went into planning this trip helped reinforce to me the importance of all of us who work behind the scenes.

Whether you are a physician managing a practice, a facility administrator, or one of the countless other workers who support the healthcare system. You are important. We all have our role to fill. We all make an impact on patient care, even if we are not the ones directly providing it.

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Lisa Grabl is president of CompHealth, the nation’s largest provider of locum tenens physicians and founder of the traveling physician industry. Lisa joined CompHealth in 2001 as a sales consultant and excelled in a variety of management roles prior to being named president in 2017. Lisa is passionate about building lasting relationships and helping her team members reach their highest potential.
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