What Should You Expect When You Arrive at the Medical Office Late?

Some family practitioners report that they have heard every imaginable excuse for showing up late for an office appointment and some that aren't easily imaginable.

A sink hole opened up in front of my house. The President is in town and traffic is impossible. The Access-A-Ride van didn't pick me up and it took me an hour to find someone who would take off work to take me to your office. I thought it was fall forward and spring back. I let two Jehovah's witnesses into my apartment and they wouldn't leave. I got locked in the trunk by my son. I thought I was taking Prozac but it was Ex-Lax. I was abducted by aliens and I persuaded them to park their UFO outside. The dog ate my insurance card.

Typically, if you're late for your doctor's appointment, three things happen. First, you let the receptionist know you had a good reason. Then the receptionist informs you that you probably can't be seen today, and you reschedule. Then it's a tug of war between you and the receptionist over who will suffer more pain if the doctor doesn't see you today.

Arriving late is a sufficient problem for doctors that there have even been research studies on how to deal with the problem. These 117 studies offer some insight as to what helps patients who just can't make it to the doctor's office on time:

• If you know you are going to be late, wear a watch. Displaying a time piece sends a signal that you care about time, your time, and the doctor's time. Conversely, if your doctor is chronically late, wearing a watch is a not entirely subtle hint that your time should also be respected.
• If you have arrived late and your doctor sees you anyway, realize you may have to make clear that you will follow your doctor's instructions to get a good result. It's a natural conclusion from tardiness that you probably wouldn't take your medicine on time, either. If you are always late to your appointments, your doctor may lose confidence in treating you.
• Wearing a watch has implications beyond sending a social signal that you make an effort to punctual. In our era of smart watches, wearing a watch conveys caring about health. If you really want to send your doctor a message about how you care about your health, find a way to mention that fitness app you have on the smart watch you wear to his or her office.

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But even with all these nice social signals, there will be times that you simply can't be seen if you get to the doctor's office late. Doctors may have to see patients in hospital. They may have to do surgeries. They have required training and business meetings. If you arrive late when you have the last appointment of the day, you shouldn't expect your doctor to miss dinner with his or her family to accommodate you. The later in the day you have your appointment, the more critical it is for you to arrive on time. However, it doesn't always pay for the doctor to get tough on tardiness.

What Happens When Your Family Doctor Gets Tough on Patients Who Arrive Late?

Doctors at a regional pain clinic in suburban Baltimore, Maryland noticed that their schedules were frequently disrupted by patients who arrived late. In response to the problems patient tardiness caused, the clinic invoked a rule that any patient who arrived late for an appointment would be offered an appointment to be seen on another day. Scheduling staff kept precise records of patient arrival times before and after the intervention, involving every patient who was seen at the clinic, 1500 visits in all, by patients aged 18 to 93. Here's what they found:

• Before the punctuality rule was announced, patients arrived on average 23.2 minutes before their appointments.
• One month after the punctuality rule was announced, patients arrived on average 23.8 minutes before their appointments.
• A year after the punctuality rule was announced, patients arrived on average 25.0 minutes before their appointments.

In other words, in this case of a doctor office's getting tough on tardiness, the one sure result was that patients waited longer to be seen. However, most patients were arriving early before the new rule was announced. This rule made it easier for doctors and nurses to manage their workload, but it penalized patients who were already punctual. So how should patients deal with this issue?

• Whenever you can, be kind and considerate of your doctor's time, but insist on the same respect. It's often the doctors who are themselves chronically behind schedule who complain the most about patients who show up late.
• Whenever you can, use a "doctors offices near me" in selecting a doctor. The closer you are to the doctor, the less likely you are to be late.

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• Some doctors have a three strikes rule. The first time you are more than five minutes late for an appointment, for example, you may be reminded that you need to appear on time. The second time you are more than five minutes late, you may be sent a warning letter. The third time you are more than five minutes late, you will be told that if you are late again, your doctor will no longer see you. And the fourth time you are more than five minutes late, you will be told to see another doctor. However, it's fair to apply the same rule to your doctor. If your doctor is chronically tardy in seeing you even when you show up on time, especially if it's to take personal phone calls or go out to lunch while you are waiting to be seen, then you may simply need to see a different doctor yourself.
• Don't take no for an answer if you have an urgent medical need to be seen. It's not ethical for doctors to deny treatment on the basis that it is inconvenient. If you keel over and have a heart attack on your way out the door when you let the receptionist know you had chest pains, the doctor may be legally liable.

Do your best to work with the best doctors. Make sure they are paid for their services. Realize that doctors who care may spend more time than expected with other patients, or with you. But insist on the same level of respect you provide your doctor.