The Waiting Game

One day you are going to squint your eyes and cock your head to one side and say to your child, in a high-pitched voice, “Did you ever notice?” and they are going to stare at you blankly, having no idea who Andy Rooney was. But did you ever notice that the front area of your doctor’s office is not called a lobby, or a reception area, it is called a waiting room. It is in the name; you know when you go to the doctor, you will have to wait.

And that is after you negotiate with the scheduler to get the appointment, like the guy on Pawn Stars buying a signed letter from Lenny Bruce… "The best I can do is 4:30, a week from Tuesday." This is not the way it started out, but I know why the problem remains: the system cannot scale. They have no way to predict when you will need to see them, but they know that when you do, everyone else will need to see them too (any of you get Omicron over the holidays? Heyooo).

Even when you are paying through the nose to go to the ER, you will likely wait. I can’t tell you how many times, as a 911 paramedic, I stood in someone’s living room after they called EMS with a minor complaint. They wanted to go by ambulance because they thought they would get in faster. One patient became visibly angry as we wheeled them from the back of the ambulance, through the ER and out the doors to the waiting room. The ER was already full, and they just paid $2k for Uber Flashing Red.

My mother would have never taken us to the ER. I got hit by a car in the 6th grade, and she took me to the pediatrician. And yet, the way the market has responded to patients’ desire for better access is by building more Urgent Care clinics and Emergency Rooms. Texas and a handful of states allow freestanding emergency rooms (fully functional ERs that are not connected to a hospital). These are super convenient, but they charge full ER prices.

According to one study, 60% of ER visits are for low acuity complaints that could be handled with a lower cost option.?I worked at a freestanding clinic that was a combination ER/Urgent Care, which was a great option. But show up after 9pm, and it was ER prices. Just ask the patient that paid a $500 deductible one night because they had the “worst sore throat of their life”.?

Change is coming, but it is likely not coming in the way of brick and mortar. The market will innovate to deliver healthcare that meets people when, where and how they need it, and do it more cost effectively. If you are frustrated because you are stuck waiting to access care, remember: Just like Crash Davis telegraphing the next fastball to an opposing batter in the Carolina league – They told you there would be a wait, that is why the status quo delivery system calls them waiting rooms. It’s in the name.

Obligatory disclaimer: This post is solely my opinion and does not necessarily reflect the views of my employer.