Inefficiency in doctors offices

I am appalled. I have just returned from a significantly irritating visit to a doctor and a physical therapist. I usually don't have any reason to go to a doctor other than to get a release signed for working out in a gym. This time I had an appointment because I was having issues with my new desk at work. For some reason or another I ended up having to wait 45 mins.

Grrrrr..
Its just amazing that any service provider would treat you so callously as making you wait without any explanation. But most people seemed to accept this as a fact of life that doctor's offices will run late. I think this is because they assume that the doctors are providing the best possible service to other patients and since they would expect similar levels of treatment, this is OK. But what this really does is completely mask the inefficiency in the system.

On time service
Let us look at other services that we receive and the expectations we hold . Let me start with servicing my car. Lets say I have an appointment for 9:00 to have my oil changed. Once I arrive there and sign the paperwork, my car is assigned to a bay and typically work begins on it within 5 mins of my signing the paperwork. Some service stations even allow you to drive up to a bay and get all this service done without even getting out of the car. Customers usually begin to get annoyed if the wait is greater than 15mins before some attention is paid to you. I can think of other services like the bank, legal help etc. where you are seen by appointment and people are served reasonably promptly. So what so special about the doctor's office?

The culprit
Well, some may argue that looking after your body is much more complicated than servicing your car; plus what happens if they find problems with your car which causes it to take more time. What happens to other customers who may have to wait because of this? Typically when this happens, things get juggled around and/or another appointment is made before significantly inconveniencing other customers.

So I would claim that there is nothing special about the doctor's office and I think we should have a similar expectation of prompt treatment. But I'll go further and point who IMHO is the culprit: the front office. The job of the front office is to manage people who come in, arrange for their records to be available and then assign a doctor or guide you to the appropriate doctor if you already have a relationship with one.

Most doctor's front offices seem completely dis-organized. They still seem to be making scheduling appointments using pencil and a date book. A lot of time seems to be spent in looking things up or identifying the right data needed to get the patient's record. Then there is the wait to access the patient's record which is still stored in paper form in some sub-basement somewhere. Only after all the paperwork is assembled, you are added to the queue to see a doctor. If at any of these various steps there is a delay or a mistake then you face significant waits.

Trillions to be saved
I wonder whether we could save trillions if we had somebody like Wal-Mart, FedEx or Xerox look at these processes and streamline them. Here are a few quick suggestions:

1. Understand the workflow for a given patient and enter them into the queue as soon as they enter.
2. Provide mechanisms for patient to help you by giving them the ability to checkin by themselves and verify important data either online or at a kiosk at the office.
3. Provide the patient with constant feedback as to where they are in the process and give them options if there are unforeseen delays. Offer some form of compensation.
4. Train the front office staff to be effecient and evaluate them based on the average wait times at the office.
5. Use technology to significantly speed up the transfer of information from one station to another within the office.

I hope someone is working on these issues and considering suggestions similar to mine. If not, I guess I will have to bite the bullet and look into doing this myself!