This article is inspired by the age old question that I believe any patient waiting in their physician’s waiting room has asked before. “What the heck is taking so long? If I can show up on time, why can’t my doctor?” I hear you. It is very frustrating. You took time off of work, you drove to the doctor, you arranged child care for your little ones, you brought your insurance card, and you just want the invasive pap smear to be done. One of my priorities at work is that above all else (and I mean ALL else- eating, going to the bathroom, drinking water, changing my scrubs when I get blood, lube, acetic acid, etc on them….I mean you get the point), above all else, I want patients in and out as close to their appointment time as possible. I promise, most of us do really value your time and respect that you also have a life. Although I’m sure some docs have a weird power trip probably because their moms didn’t hug them enough, and they want to revel in the fact that their waiting room is always full, most of us don’t feel like that at all. So, I’m sharing a recent day in the life of your (mostly) friendly, neighborhood OB- GYN. Hopefully this helps shed some light on why you end up waiting for your appointment, and also why my handwriting is so messy and I can’t take the time to make my 2nd grade teacher proud with my cursive.
It’s Thursday morning. This is the day I am on call for my group. This means any phone calls that come to the clinic have to be screened with me. This means any emergency surgeries, all deliveries, any add on patients with problems, all of this falls on my shoulders. I get a call in the morning from my partner. We have a critically ill pregnant patient in the ICU. I also have an induction scheduled for a high risk pregnant patient. So before 9am, I’ve been in the hospital for an hour reviewing charts, consulting with the ICU doctor, answering my scared labor patient’s questions. The ICU patient is getting an MRI so I can’t see her before clinic hours. I head to the office at 9am. Once I get to the office, my first few patients require a little extra attention than the usual 15 minute allotted slot. One had a devastating loss that we discuss (read: talk, cry, analyze, grieve) together. In between this, I page the high risk doctor to discuss this ICU patient. When he calls back, this is a 5 minute conversation. Then I have to discuss the course of action with the ICU doctor, another 5 minute conversation. Finally, I run back over to the hospital to see the patient in question and explain the plan to her. All while my waiting room is slowly filling up, my patients are getting frustrated, and my nurses are getting (understandably) overwhelmed. Finally! Only 2 patients left in the morning before I can regroup. I walk into the last patient’s room and find out she is in her first trimester and bleeding heavily. Unfortunately she is having a miscarriage and needs an urgent procedure. She gets added on to the afternoon schedule at the hospital, and 5 patients are rescheduled to the end of the afternoon.
After a 15 minute lunch, I head back to the office where the nurse hands me 3 phone calls to answer before my afternoon patients start coming in. In between all of this, I get a call from the hospital, and am on the phone with the radiology department for 20 minutes clarifying the ultrasound needed for the case scheduled in the afternoon. This delays surgery. I run over and do the procedure which thankfully is uncomplicated. Once I get back to the office, again the waiting room runeth over and I jump back into seeing patients. I’m in the middle of seeing not only the regularly scheduled patients, but also the rescheduled ones from earlier in the afternoon. I get 3 pages in a row from the hospital (never a good sign). My labor patient! Remember her? Well, she defied the normal first time mom labor curve and is ready to push this beautiful baby girl out. I tried asking the baby to wait another hour so I could finish my clinic, turns out she wasn’t interested in my schedule (I have heard most babies aren’t considerate of adult’s schedule? Rude…). This means everyone gets rescheduled if they don’t want to wait. Even the people that were already rescheduled once this afternoon and are patiently waiting. Although I touched on some of the more emergent cases your practioner may deal with (especially if they are in a surgical specialty), I did not mention registration delays (insurance problem? Name change? Wrong phone number?), women getting stuck in traffic, the front desk scheduling the wrong visit type, all the things that can add up and make your wait and our day a bit longer. I strive to give everyone time in their visit, it’s not like a salon where if you’re late, your appointment time gets cut. Jane Doe may have shown up 5 minutes late for her appointment, but she will still get 15-20 minutes of my relatively undivided attention.
Finally, around 6:45p I have seen everyone that waited. Now, I sit and type my notes from my clinic afternoon, my hospital patients and my surgery. I sign off on labs, and I answer non-urgent patient phone calls that trickled in throughout the day. When I finally tackle the stack of paper notes/ labs/ reports at 7:30pm, this is why, folks, despite having excellent penmanship in grade school, this is why my handwriting is messy.