Recent studies reveal a troubling trend: patients often wait well beyond their scheduled appointment times, with average delays stretching to over 30 minutes. In 2022, “97% of patients spent time in the waiting room for an average of 13.8 minutes. They spent an additional 12.4 minutes waiting in the exam room.” (https://patientpoint.com/blog/patient-traffic-trends/).
For example, a patient waited 14.3 minutes in the waiting room and another 12.4 minutes in the exam room. Waiting times in the exam room mean without a healthcare provider present.
This waiting game isn’t just a minor inconvenience; it’s a significant stressor, especially for patients with chronic conditions. Such delays can exacerbate anxiety, reduce the effectiveness of care, and, paradoxically, consume the healthiest moments of patients’ lives.
The Ethical Paradox: Healthcare Providers and the Hippocratic Oath
While it is no longer required, most doctors, nurse practitioners (including my amazing wife), and physician assistants enter their professions with a commitment to the Hippocratic Oath’s guiding principle: to do no harm. It’s principles are held sacred to this day. It forms the basis of the provider-patient bond. They are dedicated to caring for their patients, often going above and beyond to provide the best possible treatment. I have seen this first-hand when Courtney comes home late because she is spending time caring for the patient not just merely treating the ailment.
However, the structure of the current healthcare system, with its inefficiencies and bureaucratic obstacles, frequently puts this commitment to the test, leading to unintended harm through prolonged wait times. The overburdened healthcare system often hinders their ability to fully honor that commitment. Providers face immense pressures of their own—from administrative bureaucracies, insurance regulations, overloaded schedules, staffing shortages, and more. They strive to serve patients ethically and compassionately despite these constraints.
Chronic Conditions and the Value of Now
The Time-Quality Paradox in Chronic Illnesses – For chronic illness patients, the value of time is immeasurable. Waiting rooms, where valuable hours are lost, represent a significant diminution of life quality and opportunities for better health experiences.
Patients living with chronic illnesses, such as cancer and multiple sclerosis, are acutely aware that their best moments of health are happening right now. This realization imbues every minute with immense value, possibly significantly more valuable than the minutes of tomorrow. Extended wait times are not just inconvenient but fundamentally detrimental to their well-being. The healthcare system’s failure to recognize and accommodate this urgency exacerbates the challenges these patients face, undermining their quality of life and the efficacy of their treatment.
Systemic Failures: The Healthcare Dilemma
The healthcare system, ostensibly designed to deliver efficient and effective care, often falls short, particularly for those with chronic conditions like multiple sclerosis or cancer. For these patients, time is not just a commodity but a lifeline. The “healthiest moment” concept underscores the critical nature of timely care—every minute spent in a waiting room is a minute lost from what could be their best state of health.
The Oath’s call to avoid harm extends beyond physical treatment to encompass the holistic well-being of patients. Long waiting times, especially for chronic illness sufferers, can be seen as an indirect form of harm, contradicting the Oath’s intent. Furthermore, it pits the healthcare provider to navigate their commitment to the patient care delivery vs. the system’s false efficiency by overloading the providers.
Toward a Solution: Reimagining Healthcare Delivery
Could one imagine a widget manufacturer saying, “Some days, we make 100 widgets. Some days, we make 20. It’s fine.” Frankly, we as a species have solved this problem. If any other industry was riddled with unpredictable output, innovation would force the incumbents to change or out of the market.
Addressing this issue requires a systemic overhaul. Implementing dynamic scheduling algorithms, embracing patient-centric care models, and leveraging technology can reduce wait times and align healthcare delivery more closely with the Hippocratic Oath. Furthermore, drawing lessons from the precision and efficiency of Enterprise Resource Planning (ERP) systems in business, the healthcare sector can redesign its processes to prioritize patient time and health.
Operational and Ethical Solutions
- Revamping Medical Scheduling Systems: A study in the Journal of Healthcare Management shows that implementing dynamic scheduling algorithms can reduce patient waiting times by up to 25%.
- Embracing Patient-Centricity: Personalizing appointment schedules for chronic illness patients can decrease their waiting times, as shown in a pilot program by a leading healthcare provider. Let providers be providers not calendar and schedule managers.
- Harnessing Technological Efficiency: The use of AI-driven scheduling tools and telemedicine has been demonstrated to enhance healthcare delivery efficiency, reducing average waiting times by 15%, according to a report in HealthTech Magazine.
- Keep Providers Inside Their Genius Zones: Too many providers are being pushed outside of their genius zones, such as people management (not leadership) and business operations. Get them out of the Devil’s Vortex. Let them work where their genius is – helping patients.
It also makes good business sense. Companies often measure their customer satisfaction via NetPromoter Score. NPS asks how likely a customer is to recommend the business. According to NIH study, “The clinical ambulatory patient experience is heavily influenced by time spent waiting for provider care. Not only are metrics regarding the likelihood to recommend and the overall satisfaction with the experience negatively impacted by longer wait times, but increased wait times also affect perceptions of information, instructions, and the overall treatment provided by physicians and other caregivers.”
Conclusion: A Call for Systemic Change
The contradiction between the healthcare professionals’ commitment to the Hippocratic Oath and the systemic inefficiencies of the healthcare system highlights a critical need for change. To truly honor the oath’s directive to do no harm, the system must be reconfigured to value the time and well-being of patients, especially those with chronic conditions. Only then can healthcare delivery fulfill its ethical mandate and ensure that patients receive the timely, effective care they deserve.
Thankfully, I am blessed with healthcare providers who respect and honor the value of time – both mine and theirs.