Should Physicians Pay Patients for Waiting?

Meet Elaine.


We lost touch for a while, but caught up with each other recently.


Like most girlfriends, we shared adventures of love, travel, and work. I told Elaine that I left assembly-line medicine. Now I  host town hall meetings–inspiring citizens nationwide to design ideal clinics and hospitals.


Elaine shared: “If I’m kept waiting, I bill the doctor. At the twenty minute mark, I politely tell the receptionist that the doctor has missed my appointment and, at the thirty minute mark, I will start billing at $47/hour.”


Wow! I had to hear more.

Elaine scheduled her physical as the first appointment slot of the day.  She waited thirty-five minutes in a paper gown before getting dressed, retrieving her copay, and informing the receptionist to expect a bill. The doctor pulled up just as Elaine was leaving.


Prior to her initial visit, Elaine signed the standard agreement outlining no-show and late fees. On follow up, Elaine knocked on the door and discovered her therapist with another client. He apologized for his scheduling error. Elaine sent a bill; check arrived the following week.


Elaine values herself and her time.


When the Comcast guy told her to wait at home between 3:00-6:00 pm, she said, “Expect a $141.00 bill. Is that okay with your boss?” A compromise: The driver agreed to call fifteen minutes ahead of arrival.


I was intrigued. Who pays for waiting?


Cab drivers charge hourly for waiting.  Restaurants may provide a discounted meal for the inconvenience.  Airlines cover hotel rooms for undue delays. Some physicians apologize. I offer a gift.


Central to medicine is a sacred covenant built on mutual trust, respect, and integrity. What happens when physicians fall into self-interest or self-pity?  Or when physicians are so emotionally, physically or financially distraught by their profession?


Patients suffer. And their wait times increase.


So what’s a doc to do?


1)  Remember: Respect is reciprocal. If physicians are on time, patients will be on time. If physicians don’t cancel appointments with little notice, patients won’t either. Doctors should stop charging fees they are unwilling to pay themselves.


2) Functional clinics attract functional patients. Patients fall to the level of dysfuntion within a clinic. A chaotic, disorganized clinic attracts chaotic, disorganized patients. Take care of yourself; uphold high standards and healthy boundaries.

3) Don’t wait. Doctors should apologize for delays. And if presented with an invoice for excessive waiting, doctors should gladly pay the fee. Fortunately, most patients don’t bill at the doctor’s hourly rate.


My opinion. Share yours:



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43 comments on “Should Physicians Pay Patients for Waiting?
  1. Don Peterson says:

    I think your friend has it right. Patients deserve the same respect doctors have enjoyed for years. Today’s healthcare requires a partnership built on trust and respect between equals.

  2. Rajat Bhatt says:

    I dont know why a physician would want to see a patient like above. Insurance pays a measly 60$ or so for outpatient visits, so her physician actually loses money by seeing her . Patients have to accept that waiting is a fact of life: Dont we wait forever in lines to get onto that cruise ship or at the airport or say even at the bank teller ,why dont we bill other services that make us wait, and why doctors ? In fact this will lead to further degradation of medicine since the doc will try to wrap things up in 15 mins so he can get to the next patient and not provide the extra time needed if its a sick patient because some angry blonde outside cannot wait and will start billing the physician. Medicine is not like other services since we cannot adopt a factory line approach , some patients will always take longer than others so we cannot predict when we will get to a particular patient. Picture this scenario : a surgeon starts operating on the patient and then the surgery takes longer and he has to abandon it just so as to not keep the next patient on the table waiting ! How absurd !

    Also how about reciprocity. If the patient makes the doctor wait and fails to keep his appointment , this implies we should also go ahead and bill him , correct ?

    • Jack Spillan says:

      Doctors overbook because they are trying to maximize revenue. It is a business and since it is a business there are operation management principles that have to be applied. Unfortunately, Drs. are not trained in operations management and thus they let underlings do the dirty work of moving patients through the office. I see a lot of inefficiencies in Drs. offices and very, very poor customer service. Mr. Bhatt says that Drs. are different than Cruise ships or other places. That is correct Drs. are different but most of the time they do not show it. For example: a doctor comes into an office and spends 10-17 minutes and charges $350.00 with other additional office charges. Then when the patient wants to talk to the Dr. by phone the Dr. is busy. The staff says that the Dr. will call back later. So the person has to sit by the phone and wait for the Dr. What a double standard. Drs. want it their way or no way. The power relationship is so intense that patients are intimidated by the Dr. The Dr. has to move so many people through his/her office per day, per hour that they do not have time to do a thorough exam or a thorough interaction with the patient. The name of the game is billable hours. Again it is a business and if the patient does not like the long wait the they can go somewhere else only to experience the same nonsense. Some of the people that the Drs. employ are not really trained well because that would cost more and the Drs. do not want to train them in customer service because that would impact the bottom line of profits. I know of a dentist that comes in at 10:00 a.m. and walks around chats with staff and other nonsense and when he wants comes in to the room to deal with the patient. Meanwhile the patient has been sitting in the chair for 45 minutes to an hour. What an insult to the patient.

      How about the time waiting in the treatment room. The nurse says come to the treatment room. The patient sits there staring at the wall for 45 minutes to one hour. No Dr. would tolerate that abuse.

      Clearly there is a major double standard that exists and most patients are so intimidated by the dr’s power relationship that they act like little children each time the Dr. comes into the room.

      • Pamela Wible MD says:

        Exactly! This is what I am trying to get across to my colleagues. In the end what liberates patients will liberate physicians. Let us all raise the bar on our behavior and treat each other with respect.

        • Jack Spillan says:

          Dr. Wible: I sincerely respect your efforts and sincerity but unfortunately you have a very, very long uphill battle with doctors. The elitism and arrogance that is embedded in the profession is like granite. It will take an enormous amount of uproar for them to change. Our society is so socialized to worship doctors and to do anything they say or pay any amount they want to satisfy them. The job is not really converting the drs, the job is getting the customer to say NO, I have had enough of your nonsense. Once the drs realize the customers are not going to tolerate it then things might change. Why will a doctor change when he/she has all the power? That is crazy. Drs are in the driver seat. They have all the chips. The patient comes to them like beggars because of the Drs monopoly on information and knowledge. The average person is so, so intimidated by a physician that they can hardly talk to them let along confront them. I strongly believe until the customer begins to confront them like I do, the environment will remain the same.
          I learned several years ago that the patient doctor relationship should be a two way street. Unfortunately, we as a society have allowed it to become a one way street strongly in favor of the Physician. No one would tolerate anything of the same treatment from a plumber, carpenter, mechanic etc. But we do tolerate it with a Dr. for one and only one sole reason: power, dominance and because the physician know they always have the upper hand. Unfortunately, I learned later in life that the physician is no better than I. He/she is like any other technician. They are (supposedly ???) experts in one narrow area of medicine. Yet, because of this expertise we worship them. A computer technician has a very narrow area of knowledge about computers but we do not worship him or her.

          I would like to vigorously move forward with this battle but it will take enormous amount of energy and dedication. Again it will be like chipping away at granite. Count me in to help out in the long haul.

          • Pamela Wible MD says:

            I don’t look at this as a battle. It feels more like “surfing the wave of universal truth.” If patients were empowered to stand up for themselves we would have health care reform tomorrow – no legislation needed. Thanks for your support!

    • Lola says:

      Overbooking is mostly the culprit. Poor time management is unacceptable as an excuse for poor quality care. If medical practitioners would book patients in 20 minute intervals, instead of ten minute parcels of time, the doctor maybe better able to handle an unexpected delay.

    • EglEyez says:

      Hmm… you must a doctor. Nothing in your comment was respectful, so that goes to show doctors (not all ) have no respect. As far as your measly statement that insurance only pays you $60.00, what does that add up to per person, per day, per week and how much did make in a month?

    • Noelle says:

      Hear, hear, Rajat! I work in a medical office, and while I completely agree, physicians need to be timely, sometimes things happen. I have been in an office where we had a patient have a heart attack, right in the office. Should we have told the patient he’d have to die, because the doctor had other patients to see?

      The patient above, would have received a very chilly, “I am sorry you feel that way, ma’am, but how the doctor runs his or her schedule, is NOT up to me. Please discuss your concerns with the physician.”

      Listen, my Mom is an end-stage cancer patient, and she waits for her doctor, graciously, and appropriately, meanwhile dealing with a LOT of pain. So if she can do it, you bet others can, too. I am not advocating physicians being tardy, but a bit of compassion, understanding, and a lot less selfishness from patients, would be really nice.

    • RALPH says:

      If you are more than 15 min late to an appointment,you are not seen and the Dr. still biils your insurance and you (if copay) for the appointment. Also many Dr. Charge and additionall $25 charge to the patient as well. My wife and son have continuously had to wait an 1hr and a 1/2 or more to see a Dr. Beyond thier appointment time on numerous occasions. My son is a nine yr old with the emotional level of a 2 yr old with numerous birth defects he has 26 Dr. Most are very good with him some are not. But also on the Dr. Defense a few of the problems were the nurses and not the Dr. Fault. So after waiting 15 min always politly ask about the delay. If the nurse or receptionist is rude wait for another person to show and politly ask them to check for you.

    • Nancy Reid says:

      An excellent idea. In the past 40 years I have waited and waited for doctors who are ridiculously late. I have tried making the first appointment of the day. They show up 45 minutes late. I have tried making the first appointment after lunch. Same thing. I have waited 3 and 4 hours for unsuccessful appointments that accomplish nothing. I have sat in a hospital emergency department for 7 hours with severe gall bladder disease. The result of that wait? An appointment for an ultrasound in 3 weeks’ time. And I’m no different than 1000’s of others.

  3. Pamela Wible MD says:

    Rajat ~ Elaine’s story simply share the frustration that patients have with the double standard that allows physicians to charge missed/cancellations fees on patients, however physicians are not held to the same standards when they are clearly in the wrong. In both examples above the physician’s miss her appointments through negligence. The Ob/gyn arrives to work 40 minutes late because she had to drop her child off at daycare and the therapist schedules Elaine’s one-hou visit with another patient.

    Patients just want equal respect from physicians. Just and apology and an explanation is fine for 99.9% of patients, but many are not even given that courtesy.

  4. Pamela Wible MD says:

    Here’s a perfect example taken from KevinMD comments. JOSE says:

    First of all, I am a physician, but the common denominator here is respect. Recently a family member of mine went to the doctors office and on the way was stopped by a Police Officer on the way from the Airport to the doctors office, making her and her husband literally 5 mins late to his appointment. The administrator told my uncle that it was too late and that it did not matter why they were late, but to expect a bill for not showing up on time or canceling with a 24 hour notice. He was in a hurry and needed a physical ASAP, he made an appointment for the very next day and to his surprise waited 2 hrs in the exam room before the doctor “got to him” no apologies were made and was just told that the doctor was running a LITTLE late. When he asked to speak to the administrator and told her that he had been waiting for 2 hours and without any explanation she said that he was just running a LITTLE behind, that he needed to be patient. This is what kind of sent him over the edge, being that he had not received that patience or understanding just the day before. When he said that he was going to bill the physicians office for his time and lack of medical attention, the administrator dismissed his comment and told him that he was free to go to another doctors office to be taken care of if he was not happy with the attention he was receiving (which is just what he did). This lack of respect is what gives many of us a bad name, making patients feel like we think we are superior to them and think that our time is more valuable than theirs, alienating us from our patients.

  5. Geoff Koerner says:

    (I copy-and-pasted this from the post I did on article: “Patients who bill their doctor for being late.” at the time I write this now, there are 210 comments on that article. – gk)
    My goodness! I’m glad folks from both sides of the stethoscope are entering into this discussion. I’m seeing a couple “big-picture” threads happening here. First, is “responsibility.” – The MDs take responsibility for caring for themselves properly as people and for keeping their promises as much as humanly possible. The patients take responsibility to care for themselves as much as they can and not expect the MDs to be their personal slaves, (e.g., the 6-month med supply with no call-in refills) The second thread is “empathy”. We’re all humans here and metaphorical bedpans flip from time to time and it doesn’t matter whose former lunch it was. We all win when we pitch-in to try to clean up the messes, communicate with each other, and learn from the experiences to take steps toward dealing with the uglinesses and smellinesses. Dr. Wible’s solutions may not be the best fit in every context for everybody everywhere, but having been one of her patients from before she left Big Box Medicine until the present, I can say she’s become a far better doctor and I’ve become a far better patient and person because of what she’s doing. I think her process of rethinking the Med-biz is just what we all need to do to discover solutions in our respective realms.

    • Elaine F. says:


      I’m really glad you wrote this, and where you wrote it. It’s a valuable contribution to a discussion that maybe is making headway. Obviously the issue has struck a raw nerve in America.

  6. Sharon says:

    I thought maybe I should post on here again and gently goad some folks into action or at least thought.

    If youre gonna try billing your doctor for making you wait your chances to be a radical rabble rouser will soon pass. We, the United States are headed for a rude awakening when the system overloads because people can’t afford to PAY. We therefore are headed to a single payer national healthcare system of some kind. In that system you can’t bill your doctor for making you wait so this idea is really a short term solution to a much larger problem.

    My case is a perfect example. Short and sweet, my care comes the V.A. healthcare system. Do not however conclude that we have to wait and we have no choice. There are signs posted at nearly every medical module that clearly state, “If you have been waiting longer than…….please let us know.” Im not quoting that exactly but only in general to indicate in the American model of single payer health care this topic has been covered.

    • Pamela Wible MD says:

      Thanks for posting Sharon. Appreciate your thoughts. I’m not particularly attached to any one “system” as I feel the most important thing we can do is be human with each other. Mutual respect is a big piece of restoring our humanity. It can only help in the long run to remove double standards. Honesty in communication and scheduling go a long way to prevent frustration on both sides.

      • Lola says:

        @Pamaela Wible, M.D.: I heard the recent interview conducted by the hosts of the Peoples Pharmacy with Elaine and you on NPR.

        I was interested to hear a patient who is doing what I did about thirty years ago. I was totally thrilled to hear from a physician who believes, and likely practices, the mutual respect component of the doctor patient relationship. At least you recognize its importance, a truth which puts you head and shoulders above the usual medical practitioners…especially those who’ve been around for more than 20 years. That fact alone made me excited to seek your web site, voice my opinion as a patient, and share a modicum of my experience of the American health care system.

        I wish you continued success in your endeavors.

        • Pamela Wible MD says:

          So happy to have inspired you. I amazed that this story has attracted so much attention even 6 weeks after I first uploaded the video.
          Made it to ABC World News with Diane Sawyer as lead story to their Patients’ Bill of Rights:
          Thanks so much Lola! Spread the joy . . . Pamela

  7. Frederick J Sauerburger, MD says:

    I have been practicing ophthalmic surgery for 34 years and have yet to charge patients for missed appointments or short-term cancellations. I have only reimbursed one patient for a 45 minute delay. He was a typical yuppie-entitlement-30-something who made a big fuss in the reception area, and then seemed very put out when I sent him a check for $30.00 along with a letter discharging him from my practice.

    The Grateful Fred

    • Pamela Wible MD says:

      The Grateful Fred (LOVE your name!) Thanks for the comment. It’s about mutual respect and since you do not charge missed appointment fees there is no double standard in your office. 😉 Pamela

    • Lola says:

      @The Grateful Fred: I like your name. I like how you handled the situation with the patient. It’s one thing to make a complaint to the doctor in the privacy of the examining room; it is quite another to be disruptive in the wiating area in the presence of other patients. After all isn’t a doctor’s office a place of healing? I believe there are only certain extreme circumstances which warrant such outraged behavior.

  8. David Kaiser says:

    Billing the doctor is not new. It was happening as far back as 1980 in El Paso, Texas. It was popular particulaly among my Jewish accountant freinds.

    • Pamela Wible MD says:

      Hey David ~ Yep. I think this has been going on for ages. Most patients feel disempowered and frustrated and continue to sit in waiting rooms. Some sit for 8-9 hours to see in-network doctors.

  9. Lola says:

    It was about thirty years ago, before we turned over, in its entirety, responsibility for our personal health to the experts, when I had my first encounter with a medical practice assigned to me by the then new HMO program offered by my employer. (HMOs had existed for seven or eight years and were touted as “the greatest new thing” in modern medical care.)

    When I arrived at my first appointment I looked around the waiting room to see patients who appeared to have been there for several hours; many of the patients I saw were about the age I am now or older. I’m 62. I may have been the youngest person in the waiting area.

    When I asked how soon I’d be seen by the doctor I was told I may have to wait up to forty minutes. I had purposely scheduled my appointment prior to going into my work as a broadcast technician at a Philadelphia radio station owned at the time by a major broadcasting company. I needed to be at work by 3PM. I had arranged appointment for 1230PM and presumed I would have enough time to get to my next activity.

    Even though I did not like the idea of a forty minute wait, I decided to stay to meet the doctor. I could afford to wait forty minutes and still be on time to my work. As I waited I remembered reading an article published in the Reader’s Digest written by an accountant wherein he suggested billing the doctor who keeps you waiting, not because of an emergency, simply because the office has poor time management skills. I’d put the suggested strategy to the test. I’d set some ground rules if the doctor and I were compatible.

    I waited 85 minutes. I was really upset. The extra time I’d waited was just enough to put me in the danger zone of being late to my job. When I finally saw the doctor I informed him I’d be sending a bill for my time. Basically stating, just as your friend Elaine did, the facts: Our need to establish mutual respect. My time is just as valuable as yours. His reaction was surprise. He revealed he had never had a patient state an intention to bill for her time. He went into the “I’m a victim” mode to make excuses for being tardy.

    The conclusion is: I sent a bill for my time. I never returned to his office. I’ve walked out of at least one other doctor’s office when I wasn’t seen in a timely manner; (Since I typically arrive about fifteen minutes early my rule of thumb is fifteen minutes maximum wait time after the scheduled time for any appointment-medical or otherwise.) And I sent a bill for my time which includes travel time as well.

    I’ve experienced serious injury as the result of an auto crash. During that 9 month adventure in the medical system I found physicians who routinely perform the Independent Medical Examinations (IME) for insurance companies are typically notoriously disrespectful for keeping patients waiting an inordinate length of time …that is part of another discussion for another time.

    This controversial matter of doctors selfishly having patients wait has been around for a long time. I have observed over the years it has only gotten worse. I’ve heard horror stories from friends and family members alike. When I suggest they bill the doctor or complain the reaction is one of incredulity. The situation has been exacerbated by us consumers. We train people to treat us in a certain way. As patients, we have allowed ourselves to be held in disregard, to be treated poorly, by those who have some part in providing our medical care.

    I, for one, conduct myself in a respectful manner so I may demand respect from everyone, even those persons who so erroneously, and arrogantly believe they received their G.O. D. when conferred with the M.D.

    • Pamela Wible MD says:

      Lola – I totally agree with you (obviously!) and I think it’s time for all of us to raise the bar on what is acceptable behavior. I have received some hate mail from docs on this topic. Docs still seem to live in victim mode. How easy we give up our power to make the world into the beautiful place we all want to live. You may find the 388 and counting comments (from mostly doctors) a real eye opener.

      • Lola says:

        Thanks, Dr. Wible. I’ll be reading with great interest the responses from the doctors. My eyes are wide with anticipation…;=D

  10. Pamela Wible MD says:

    This comment posted by someone who wishes to remain anonymous:

    I heard the People’s Pharmacy program the other morning and I did not want the podcast but a printable copy re: late doctor’s. I am sending this to a woman who should have known better than to leave a 62 year old female in a paper tutu with the wall of the room next to a children’s clinic and screaming children for one entire hour. I was given some malarkey excuse, but the truth will never be known as to why she made me wait. There was no other name on the sign in sheet before mine that had not been crossed off. I had gone in to be tested for STD”s because my room mate of four years and quite a bit younger than myself had been in a strange situation that I did not trust and I was quite nervous. Maybe the 70 year old Dr. did not want to touch a woman who might have cooties!!!! She is being written up with the state board and this copy of your statement is being sent to the board and to her. I went to another Dr. but it took three weeks to have my fears be settled and nothing was amiss, but in the meantime, I was really upset. That unprofessional lady could have saved me a major headache and chose to make me wait. You are great!!!

  11. Brett Fink, M.D. says:

    Not all of the delay is the physician’s fault. I am an orthopedic surgeon and try to be responsible about my patient’s time. I schedule my patients at an increment that is typical for the average patient. However, the patients that complain the most are also the ones that seem to be responsible for the delays in my clinic. Most of the time, I am a head of schedule, but there are times when things run behind. Here are the most common problems:

    -Patients that come in late for appointments. The time that I allot for these patients has already past when they are late. Now, I must steal time from the other patients to see them.

    -Patients that want to discuss multiple problems. “Since I’m here, I might as well have him look at my shoulder/back/neck/rash”. In order to adequately evaluate these problems, multiple studies and treatment plans need to be developed. This takes time.

    -Problem that takes extra time. The serious infection, wound, or procedure that was unanticipated or unscheduled. An armload of radiographs and records that need to be reviewed.

    -Patients that take extra time. The patient with brain difficulties, dementia, mental illness, or medical comorbidities that complicate treatment. The patient that cannot answer a question without beginning in the 1960’s or repeating the same information three or four times. Those that need other doctors contacted before a new medication or treatment can be started. Those that do not bring in their records because they assumed that we made sure that we obtained that MRI from a hospital 40 miles away that was done 3 yrs ago before their appointment.

    -Families that require extra time. After explaining treatment to an elderly couple, I had to reexplain treatment to their daughter whom they contacted on a cell phone.

    I love my patients and I respect them. I understand that they do not like to be inconvenienced by the problems of the other people that I see, but the same doctor that listens to their problems and helps them get their medical information together patiently, is often trying to keep all the other patients on his schedule happy and give them the time that they need even when he doesn’t have that extra time to give. With 60% of my fees going towards my practice’s overhead, I cannot see people at 30 to 60 minute intervals. If I did, I would be out of business.

    • Pamela Wible MD says:

      Thanks Brett ~ Totally understand where you are coming from. Much can be solved by communication and empathy on both sides. I am authoring a journal article which will present more of the story from all angles. Appreciate your opinions.

    • Noelle says:

      Thank you for that comment, Doctor. I too, work in a really busy orthopaedic office and we get very complicated patients who come in, sometimes we have to admit them (we are an outpatient clinic associated with a hospital). This can put the doctors behind, and while I truly understand that it is hard to wait, we staff always get the brunt of it. I’m always being yelled at by very nasty patients, cursed out, you name it, I’ve gotten it. I’ve gently advised them to speak to the physician about the schedule, I’ve had my supervisor get involved, I’ve even walked away from screaming or cursing patients, to prevent them from getting my temper up.

      I sometimes wish patients could work a day in their doctor’s office, to understand what we staff go through, and hopefully the patients might be a little bit more respectful towards staff and physicians.

      • Pamela Wible MD says:

        We would all do well to walk in another person’s shoes for a day. And give that you are in orthopedics, you are helping people learn to walk again anyway!

  12. SengHee Tan says:

    I love the Ideal Clinic concept. I’m not done work in physician practice management but in the last 20 years, I have done substantial work with retail operation management internationally.

    In the last few months, I have been doing research via the web on the tussle between physicians and patients on the issue of the long waits at the doctors’ office. Both sides have strong and valid arguments. There are as many doctors supporting patients and patients supporting doctors, as the other way around.

    Everyone’s time is precious and delays do happen. Mutual respect and good communications are probably the strongest solution. If there is a delay from either sides, let’s be respectful and communicate.

    Apologies, changing doctors and billing each other are band aid solutions and not always practical, aren’t they?

    Many assembly line physician practices delay their customers often with unreasonably tight appointment slots. They are resigned to the fact that there are no solutions if they wish to remain profitable. They have to ignore the basic respect of the customer’s time.

    There are good doctors who are genuinely delayed by complicated cases and they face the wrath of the other patients. If I’m the patient, I will definitely not want my doctor to tell me that he has found a serious condition but I will have to make another appointment another day to have that investigated further.

    Could these doctors tell their customers that the term and condition of a visit to their clinic could be a long wait? Would they tell their customers not to come if they cannot accept those terms. Doctor’s don’t do that today nor tomorrow.

    On the patient side, sometimes delays are genuine. Often they are not. Would telling a patient that their appointment will be kept for them for only 10 minutes, as they do in many restaurants? Of course, the gravity of having a meal and seeing a doctor is different but the concept holds.

    The waits continue.

    One the bright side, there are too many case studies on thriving businesses with great customer service that have happy customers and referred friends of these happy customers. These customers are happy to pay for the right level of customer experience. These businesses and their customers are in a mutual positive partnership. I hope your Ideal Clinic model spreads.

    Disclosure: While I try to ensure a balanced view, I do work with a software solution company producing the Qender Mobile Queue app that let practices offer their patients the option of waiting in comfort nearby and also let them see the movement of the queue from their app. If their office is nearby, they can wait in their office. And in today’s world of iPhone and iPad, they can find a quiet nook and be productive. For others, going shopping in the meantime ain’t a bad idea!

  13. Pascal Behr says:

    Have a question but not about billing the physician for being late. This particular physician charges the regular fee for an office visit. The visit is usually about 5 minutes and never longer than 10 minutes. However, he charges “extra” for writing a prescription. He charges $15.00 per prescription. He told me it was because he has to “count the pills.” I said the pharmacist performs that job. He said “no, I count the pills.” He writes the prescription for 3 months so that’s an extra $45.00 ($15 x 3). This is on top of my deductible, the premium, charge for the visit and him often being 2 hrs. late. I smell something rotten here. Anything you can explain here? Please!

    • Pamela Wible MD says:

      Hmmmm. . . not sure about that. The pharmacist counts the actual pills. The doctor does need to count how many pills per month and write them on the prescription though.

  14. Mary Stanley says:

    Great article! So refreshing to see a physician with such a sense of humor and optimism. Nice to see you out here in the blogosphere.

  15. NQ says:

    I’ve thought about billing for waiting SO many times. The reason I haven’t is because I have difficulty finding doctors and getting appointments. As some commenters have posted, I expect that if I tell them I’m charging for excessive waiting time, I’ll be shown the door and told that if I don’t like how the doctor conducts his business, don’t come back.

    That would be fine if I felt like I had other doctors lining up as alternatives! But between finding another doctor and getting an appointment, it could be 2 months before I see someone else. And if they ALL show me the door for trying to bill them for excess wait time, (which I expect they would) it could be a year or more before I found someone “mutually respectful.” I may not be able to wait that long to see a doctor. Better to wait the 1 – 4 hours, than a year or more. (I waited MORE than 4 several times. Had to. Insurance required.)

    If I had other doctors I could “take my business to instead” I’d leave in a heartbeat. Usually, the tardiest doctors are the “experts” or “specialists” or the only ones who take my insurance, or the only ones within an hour from me who are “experts/specialists/take my insurance.” There is often no one else I can see without going out of state. I want to be more empowered in this respect, but I always feel like I have few or no options.

    So now, I kind of have a follow up question. Let’s say I’ve been waiting over 20 minutes, and I decide to leave, and the staff knows this. They then bill me for a missed appointment. What can I legally do then, with regards to that bill? How do I protect myself from having to pay?

    • Pamela Wible MD says:

      I know other patients have won in small claims court when they have been made to wait beyond their scheduled visit. If you signed an office polcy to pay for missed visits, you may be liable for that.

  16. Emma says:

    Ok how do I bill my doctor been here for an hour and fifteen minutes and still waiting. This is unbelievable. Even if you change a doctor they are all the same you have to wait.

  17. AJ says:

    That is the most idiotic thing that I have ever heard.

    Here’s the deal: I DESPISE running behind. But it happens.

    You know why?

    Because as your PCP, I routinely manage 4-5 problems during each of your visits. Some visits are scheduled for 15 minutes and others for 30.

    You may be an ‘easy’ patient. Good for yiu if so.

    However, most of my days at least 3 patients will cry. This is often due to mental health concerns (which I treat as part of their care), or fears about the unknowns, or new diagnoses.

    The unexpected is part of my day.

    And you know what? That patient and the extra 5 minutes that I spend with each patient before you is why I may run 15 minutes late.

    I see 8-10 patients from 1-5:30 PM. In order to ‘fit in’ patients with potentially urgent problems, some patients will have to expect a domino effect if scheduled after them. Every 5 minutes count.

    And you know what will happen if I rush that crying / scared patient?

    “My doctor rushes me!”

    Do you think they may have rushed because they knew that by spending 5 extra minutes with this one, and that one, and the next one that the extremely rude patient who declared that she would charge the patient for time out of her previous schedule was scheduled at the end of the day.

    Take your head out of your ass and do what we do every day: CARE about the others around you. That’s why we dedicated our lives to it.

    Cause one day you WILL be the patient that needs an extra 10 minutes and who comes in with ‘the list.’

    And you’ll want me to take the time.

  18. Mary Kate Helms says:

    I made an appointment for my periodic cortisone injection and am being told on my appt. email reminder to arrive 45 minutes prior to appointment time. I feel that this is unethical. My time is valuable too! I can’t even imagine any reason for this.

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