!!!Things That REALLY Piss Me Off
(…why I always carry a razor and toothbrush around with me)  
 I’d like to begin this chapter by coming clean and admitting that I’ve never gone to medical school or business school nor do I plan on doing so any time soon or even later than soon. That means that I’ve had no special training in running a medical professional’s office, but judging from what I’ve seen and experienced in most physicians’ office, neither have they! (I’m not really sure why I thought it was important to say that, but I just felt it should be said.) Probably the best place to start would be to first establish exactly why doctors’ offices qualify for inclusion in this book. In other words, what is it about doctors’ offices that pisses me off?

But before I get into that, let me tell you a bit more about what makes me tick. You know how some people are really good tennis players while others are particularly good at math, but those same people might also be really lousy golfers or the ones who pick their nose while waiting for a red light to change. Well, in my case, I can tie shoelaces like nobody’s business and I’m really good at sarcasm too, but I’m absolutely lousy at waiting. I can’t tell you why….it’s just something I never excelled at. 

So with that out of the way, what is it about doctors’ offices that pisses me off to the point where I deemed it necessary to write this chapter? The symptom, not to be confused with the cause, is the inordinately long wait time most of us experience during scheduled visits to most of our doctors. It’s not like I’m bitching about having to wait ten or fifteen minutes beyond the time for which my appointment was scheduled. No, what I’m talking about here is wait times of forty five minutes to an hour and sometimes even more. And that’s where the above chapter subtitle originates, and that’s also why I always carry a toothbrush and razor with me….you know, in case I have to go to my doctor’s office. There’s a more than reasonable chance I might be there long enough for me to have to shave or brush my teeth (or maybe even brush your teeth!).

In today’s world of medicine patients often can expect to spend as much or more time waiting in the exam room as they actually spend with the doctor when he finally enters the exam room. (Man, talk about an expensive waiting room!) But before I build up an even bigger head of steam on the subject, I should note that this is not necessarily the case with all doctors. In fact, I can almost guarantee that the smaller the medical practice, the shorter the wait time. It’s one of the basic laws of physics discovered by Einstein shortly after he published his Theory of Special Relativity. (But this one is his Special Theory of Waiting!) For example, my family doctor is in practice by himself, and whether it’s on his orders or simply the way his office manager runs the place, only on very rare occasions have I been taken from the waiting room to an exam room after the scheduled time of my appointment, and rarely do I wait in the exam room for more a few minutes before my doctor makes his entrance. The entire visit from my arrival to my departure is rarely more than twenty or thirty minutes and often less. Unfortunately, this is much more the exception than the rule, and kudos to my doctor and his staff and boos to all of the other medical practices that show little consideration for their patients. The time most patients have to wait to see their physicians is a form of medical rudeness bordering on malpractice. It is not only unnecessary but also demonstrates the total lack of consideration and respect some physicians have for their patients many of whom are quite ill and for whom a long wait may be very stressful if not physically debilitating.

And what it all really all comes down to is simple consideration by a physician to his patients. Apparently, way too many physicians see nothing wrong with wrecking a patient’s entire day just to keep them “on call” for when the physician is ready to see them. I can understand why no physician wants to get to a point during his day where there are no patients available to be seen because they were scheduled too far apart, but when their staffs schedule appointments ten minutes apart, the doctor will already be behind the eight ball after only a few patients. This same scenario is repeated day after day after day in way to many medical offices and for years on end, yet neither the physicians nor their staffs seem to feel there’s anything wrong with making people wait well beyond the scheduled times of their appointments.   

In fact, doesn’t that sort of defeat the purpose of appointments? I mean, if you’re going to run an hour or more behind schedule, why have appointments in the first place? Why not just have people drop by whenever they feel like it? “Hey, I was on my way to have a pedicure and I had a few minutes, so I thought I’d drop by to see the doctor and have my gall bladder removed.” The reason doctors don’t want to do it that way is because they want to control their time at the expense of yours, and so the patient ends up being a victim. What seems to get lost in this instance is the definition of the word “appointment” which Merriam-Webster defines as, “an agreement to meet someone at a particular time (and place).” I had to read it twice to be sure, but it looks to me like both parties are supposed to be there and ready to meet at the same time! In other words, it’s a two way street, and not only is the patient supposed to be there and ready to be seen at the appointed time, the doctor is supposed to be there at the same time as well. If that’s not the way it goes, then it’s not really an “appointment”, is it? 

The first and most obvious sign of a long waiting time in a doctor’s office is a waiting room which is as large as one of the main waiting rooms in New York’s LaGuardia Airport. That might be appropriate for a medical practice in which five or more doctors hold concurrent office hours, but such enormous waiting rooms should be the exception rather than the rule. From my own personal and professional experience (as a healthcare architect who has designed a large number of physicians’ offices), I can tell you that when you see a waiting room that large, rest assured that you’re almost certainly in for a very long day. My suggestion….bring a lunch and take out a few magazine subscriptions. Oh, and like I already said, bring a razor and toothbrush….just in case!

So what can we do to remedy this problem? Even with my super powers, this was a tough one, but I think I may have an appropriate and innovative solution. This is how it would work. Doctors and their wives and/or families eat out at restaurants a lot….right? But let’s be realists and concede that even in the most perfect of all worlds most of us will never have the money of Bill Gates or the physical appearance of George Clooney or a Joan Collins in their prime, nor will our doctor walk into the exam room to see us at the exact moment of our scheduled appointment. So we’ll give them a little slack and say that they need to appear in our exam room no more than fifteen minutes past the scheduled time of our appointment. (See, I’m a reasonable man!) And so, as they say in ice hockey, this is where we go into the “penalty situation”, and this is where the use of restaurants comes into play. Yes, you heard me correctly….restaurants!

Since doctors eat out a lot, we’ll use that simple fact to our advantage. For every minute beyond the aforementioned fifteen minute appointment start time allowance, the offending doctor will be penalized 10%. In other words, we add up the “penalty” time for all patients seen by any given doctor each day of any given week. Let’s say that the total penalty (or “overage”) time that week is three hours (180 minutes). That time frame multiplied by ten percent equals exactly eighteen minutes. Now, be patient and you’ll see why this calculation is so important. The next time the doctor dines out at a restaurant where a reservation is required, his penalty assessment (eighteen minutes in our example) will be added to the time of his reservation (when his table actually becomes available), and the eighteen minute penalty clock won’t start running until the doctor and his party actually arrive at the restaurant. How’s that for justice? So no matter what he does, the good doctor is going to have to wait for his table a bare minimum of eighteen minutes. How’s that for poetic justice?

​Now I have to tell you that I’m not married (or even engaged) to the ten percent penalty used in my example. I mean, I’m certainly open to arguments for something higher for really bad offenders. In fact, we might even want to consider a sliding scale of sorts where perpetual, long term offenders are hit with a much higher percentage penalty. Just something to think about when you’re sitting on the john with nothing to read. 

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