The length of the waiting period is inversely proportional to the patients’ perception of the quality of healthcare delivered, and the patient’s satisfaction. The longer your patients wait to see the doctor, the less satisfied they will be. It is really that simple.
No one likes to wait for long periods for a service, and healthcare is no different in that regard. Healthcare is quite different in other regards though in the sense that the people who come to the hospital are generally not too eager to be there in the first place. Most people would usually not go to the hospital or clinic unless they absolutely had to. Queuing up at Disneyworld is not the same as queuing up in a hospital OPD. The former has the promise of certain fun. The latter generally holds no promise of any kind of fun for the patient. Prolonging their waiting times for longer than necessary just complicates matters.
Patients have been known to get angry and walk off after waiting for great lengths of time. Others have lost their calm and assaulted health personnel. The loss in revenue and reputation to health facilities cannot be overemphasized. This is one area many hospitals have not paid attention to. They used to get by with the nonchalance because patients did not have too many options to choose from. One particular study of the waiting times at a major health facility in Nigeria showed that the patients waited anytime between 60 to 180 minutes just to see the doctor. They spent on average about 5 minutes with the doctor. As scandalous as that sounds, it is quite representative of what pertains in many health facilities, especially public health facilities, which are generally overwhelmed by attendants and understaffed at the same time. In order to change the status quo, there must be a strong political will to overhaul the healthcare system.
The situation in the private sector is quite varied. On one end of the spectrum are some facilities that are battling for survival, with low patronage. Those are not the subject of this post. The other end of the spectrum is made up of facilities which are just like the busy public facilities, with congested waiting areas and short consulting times. For the hospital owner who didn’t use to care about the length of the waiting period, it is time to wake up. This is because patients are becoming aware that they have options. Those that cannot afford the options would simply pray for the day they acquire enough money so they can seek better experiences elsewhere.
There are a few factors that are responsible for the long waiting times in the hospitals.
First is the inadequate staff numbers that are deployed to tackle the disproportionately high numbers of patients. It is not uncommon to see one receptionist attending to dozens of patients at a time. This scenario plays up because for some owners of health facilities, especially people without any medical training, healthcare it is simply a game of numbers, where they are interested in making the barest minimum amount of investment and yet reap high returns.
The healthcare industry can be successful, even lucrative when run properly. The vast majority of investors in the health sector, I am sure, have noble intentions of actually delivering quality service. Some owners, however, are only interested in making a profit. They sacrifice patient satisfaction for a higher return on investment. Some too can simply not help it because they do not have the funds to hire the right number of staff members. They may have jumped into the healthcare industry believing that it was lucrative, only to have the shock of their lives when they realized that it called for much more than they were able or willing to invest.
Another factor that can affect patient satisfaction is the quality of the waiting period. No matter how naturally patient someone is, it is much easier to wait in a beautifully furnished and air-conditioned waiting area than to wait in a crowded, hot and humid “waiting” area with no air – conditioning and no entertainment. The socialist approach to healthcare whereby governments indoctrinate the people to believe that they should expect “free” healthcare has created the situation whereby the government cannot provide decent health facilities for the general population. (Sometimes the government is able to build a beautiful edifice but cannot get it to run efficiently.) Unfortunately, some private health facilities have bought into the dogma of socialist healthcare. They provide the bare minimum at socialist prices. The end result is that they are not able to efficiently run their facilities. A well designed and properly furnished waiting area goes a long way to improve the patient experience. People will appreciate the value you provide, and they will recommend your facility to their family and friends.
Whereas there is no specific “right” waiting period, it is generally accepted that most patients will be happier with a health facility if they waited for no longer than thirty minutes to see their doctor.
Hiring the right number of staff in the beginning, and scaling up to meet increasing demand is the way to go. If your clinic is just starting off and not so busy yet, instead of hiring a receptionist, assign a nurse to your front desk. You can have the nurses rotate. Once your patient load begins to increase, you need to hire a full-time receptionist well trained in customer care. Or you can simply hire an extra nurse to share the workload. It is important that you have a pleasant person at the front desk. It is easier for patients to wait when the front desk person is patient and pleasant. The person at the front desk must be suited to the kind of clients you seek to attract to your facility. If your goal is to compete with the government health posts for patients, then you should hire accordingly. There is nothing inherently wrong with that. Just know that it will be very difficult for you to beat the government in a price war. The government can offer everything for “free’’ because it doesn’t need to work for the money – it can simply extract more taxes from you to pay for the freebies.
If your target is to attract middle and upper-class patients, hire appropriately. You need to respect your patients. Do not put someone at your front desk who is rude, does not communicate well, and always has gum in their mouth. That would just not cut it for your patients. Your business will soon begin to suffer, as your customers discover a facility with a nice receptionist who doesn’t chew gum or frown her face often.
Sometimes the bottleneck is in other parts of the patient flow through the hospital. For instance, you may have very smart receptionists, but your nurses may be inadequate or simply slow. Worse still you may not have the right number of doctors to take care of the patients. A lot of common sense must go into running a health facility. If you have 100 patients in your clinic you cannot have just one or two doctors on duty at the time and be “fine.” You ought to actually sit down and think it through. Does that proposition make sense to you? If you were among the 100 patients waiting would that be acceptable to you to have only one or two doctors?
Sometimes the problem is with the cashier, or the laboratory, or the imaging department if you have one. If your “laboratory” takes 4 hours to run a basic test, it might be a good idea to outsource this to a proper laboratory which would give you timely and accurate results. It is inappropriate for your patient to spend 13 minutes with the doctor and yet spend 20 minutes trying to pay their bill to the cashier. You might need to hire a few more cashiers.
The thing about fixing these issues is that you cannot correct what you don’t measure. You need to actively measure the average waiting time in your facility, and also find out how long patients spend altogether when they come. You can use a timing chit which you give to the patient at the time they enter the facility, and which will be endorsed at each station as the patient progresses through the system in the facility. When you collect about one hundred chits, you will have sufficient information to make a judgment. Some simple arithmetic will give you the average waiting time.
If you are unable to do this, however, you can find a good statistician. If you cannot afford the fees, you can get any high school Math teacher and have him help you. Just make sure you pay a fair price for the help. Paying for the help will help you take it seriously.
Once you have the data, you can begin to look at areas where the patients have been spending the most time. (I can almost bet that is unlikely to be their doctor’s consultation.) You can begin to make changes to your system that will greatly impact on the perception of the quality of care your patients get from your facility.