I would have been better suited and more comfortable had I been a product of the era of Mad Men. I see much of life as though I am living it through a black and white television program. The world seemed to make more sense at a time when we thought we knew how to handle everything. There were simple answers to even our greatest perceived fears—if the Soviets try to bomb us off of the planet all we had to do was duck and cover under our desks, and once the nuclear fallout had ceased we could head over to the vacant lot and play baseball.
Have you ever wondered how many waiting rooms are in the average hospital? Those types of questions keep me awake. There ought to be a plaque in each waiting room that reads, “This is where nothing happens. Whatever you were doing ended, and whatever you need to do next has not started. Wait.”
One episode of Mad Men depicted a hospital’s waiting room. The men and women in the room were dressed like they had just come from church. I think waiting rooms led to the invention of magazines. The sole purpose of magazines was to improve the experiences of the people doing the waiting. Magazines were meant to distract patients from the fact they were waiting; you are not waiting, you are reading. Dog-eared copies of Boy’s Life, Popular Mechanics, and Highlights were stacked neatly on the vinyl, avocado-colored chair next to the percolator. After a while the nurse comes to get you, and there are times when you want to say, “May I have a few more minutes? I haven’t finished reading Goofus and Gallant in this eight year-old copy of Highlights.
Over the last fifty years we have seen dramatic changes in every aspect of healthcare except the aspect having to do with us as people. People who have things to do other than wait. Other than talk to you on the phone. Waiting rooms have not been eliminated, but they have been upgraded. And the upgrade makes for a much better distraction; it helps us forget that we are waiting.
Whether you are at the hospital for surgery, an outpatient procedure, or lab work, the very first thing you must do—before you pass GO and collect two hundred dollars—is wait.
So, after you pay for concierge parking you are directed to the waiting room, a room that now looks like a hotel lobby. Today’s waiting rooms come with their own espresso bars and they provide free Wi-Fi. A flat-screen television will be hard-wired to some financial news channel. You sit transfixed to some reporter speaking from the floor of the Stock Exchange, and you are mesmerized by how busy everyone looks as they scurry from one place to the next. And you think, I bet the Stock Exchange doesn’t have a waiting room. Everyone there looks so busy. I wish I were busy.
As you drink your espresso you look around the lobby at all of the other waiters. Your life is on hold. You thumb through the pile of magazines; The Latin American Economist, Smithsonian, WebMD, and you think, I wish I were busy.
Out comes your laptop. By now your espresso is cold. You gratefully log in to the free Wi-Fi. You pay all of your bills online. To keep yourself from constantly checking your watch you begin to read the eight hundred emails in your spam folder. Why am I waiting? You ask yourself. They knew I was coming. They were the ones who told me what time to be here. There are twenty of us and only two of them. The process reminds you of being at the DMV to renew your license, and you try to comfort yourself in the knowledge that the DMV does not have an espresso bar.
The matron in the tiny cubicle invites Mr. Jones to have a seat in her cube. But I was here before he was you tell her. “Did you sign in?” She asks. I tell her I did not know I had to sign in. She scribbles my name to the bottom of her list, and she motions me back to my chair.
Thinking I am smarter than the average bear I call the hospital while I am at the hospital to reschedule my appointment because I want to be busy. There are no magazines left to read. My spam folder is empty and my bills have all been paid and my espresso is cold. The voice on the phone tells me the average wait time until someone speaks with me is fifteen minutes. My call is placed on hold.
I am done. I hand the concierge my parking ticket and he tells me I have to pay him ten dollars to get my car back. But I have not done anything, I tell him. All I did was wait.
Five dollars for the espresso. Ten dollars for parking. I could have stayed home for free.
The Japanese solved the waiting room problem a long time ago.
I had a joint-venture with s private hospital in Osaka for a short time (problems of communication eventually caused it to shut down) but the first time I visited and walked through the waiting room I remarked to the owner of the hospital that the software would reduce wait times.
The response was ‘Why would anyone want to do that?” – he pointed out that the usual problem at this hospital was getting patients to leave the waiting room for their appointments.
Reason: the waiting room had an entire wall of large TVs tuned to game shows. If the time to go to an appointment came at a critical moment in the show, patients would typically respond “I will be there in just a few minutes”
Why mystifies me is if you ask around any waiting room, you will find that 10 other people have a 10 AM appointment, same as you.
What kind of resource allocation algorithm functions this way?
Why not have things such that on arrival you get a beeper that will alert you 15 mins before your appointment, giving you time to return from the mall?
Restaurants reduce wait time stress by handing out beepers, why can’t hospitals do the same?
Now that almost everyone has smart phones, very little infrastructure would be required to send out alerts.