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 dysfunction 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:

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor.

Image credit: Shutterstock.com