Jaewon Ryu, M.D., J.D., Geisinger executive vice president and chief medical officer, and Thomas H. Lee, M.D., Press Ganey chief medical officer and a member of Geisinger's Board of Directors, have co-authored a New England Journal of Medicine article entitled, "The Waiting Game — Why Providers May Fail to Reduce Wait Times."
Waiting a long time for an appointment to see a physician causes much more than just inconvenience when it comes to patients, the pair conveys in the article.
"Waiting has emotional effects on patients. Uncertainty causes anguish, particularly in patients concerned that disease may be progressing and intervention opportunities may be lost. Other variables such as teamwork, communication, and empathy are more powerful drivers of patients' likelihood of recommending clinicians to others, but no one likes to wait. Data reveal a dose–response effect: the longer the wait, the lower patients' satisfaction with care. When patients have to wait weeks for a specialist appointment, their satisfaction falls off a cliff," they write.
Waiting months to see a patient also has potential downsides for physicians and the health care industry overall.
"The longer patients wait for their appointments, the greater the chance that they won't show up. No-shows are as problematic from a fiscal perspective as unfilled schedule slots. To reduce their impact, practices often "double-book" patients, which makes volume surge when all patients show up. The result may be chaos, with angry patients waiting an hour or more and dispirited clinicians and staff trying to both appease and care for them."
The article continues: "Beyond chaos and anger, long waits before appointments, particularly specialist appointments, often contribute to the development of avoidable complications that can lead to provision of care in less desirable (and more costly) environments such as emergency departments or hospitals, where care is often more fragmented."
One solution, the authors offer, can be attained by transforming how health care is delivered and having the right payment model in place to support such a transformation.
"The painful reality is that the fee-for-service system rewards long waits and overbooking to squeeze in sicker patients…The system does not reward providers who organize care to reduce waits for all patients, even though that might keep some patients from becoming sicker. And that may be why most providers have been slow to invest in systems that might reduce waiting time."
The article cites other health systems in addition to Geisinger that are effectively implementing scheduling solutions through teamwork, technology, and the adoption of new payment models. The focus, both authors agree, should be on reducing waste.
Most importantly, lowered wait times means a healthier population.
"Having patients seen regularly, conveniently, and expeditiously helps in addressing care gaps and managing conditions effectively."
Geisinger Health System is an integrated health services organization widely recognized for its innovative use of the electronic health record and the development of innovative care delivery models such as ProvenHealth Navigator®, ProvenCare® and ProvenExperience®. As one of the nation's largest health service organizations, Geisinger serves more than 3 million residents throughout 45 counties in central, south-central and northeast Pennsylvania, and also in southern New Jersey at AtlantiCare, a Malcolm Baldrige National Quality Award recipient. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family. The physician-led system is comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 12 hospital campuses, two research centers, and a 551,000-member health plan, all of which leverage an estimated $10.5 billion positive impact on the Pennsylvania and New Jersey economies. Geisinger has repeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.