01/18/2012 04:07 pm ET Updated Mar 19, 2012

Waiting For The Doctor: Medical Professionals and Customer Service

When you think of customer service, the image that comes to mind is a long line at a cash register, right? Yet some of the worst customer service being delivered comes from the medical community.

Let's just start off with that perennial patient gripe: How long did you last wait to see your doctor when you had a scheduled appointment?

Of course we know that doctors are important people who save lives, and no one is suggesting that medical emergencies don't occur that make the doctor fall behind. That's not what I'm talking about. I'm talking about endemic lateness caused by the family internist who routinely books appointments 10 minutes apart knowing that she spends 20 minutes with each patient. Sure, it's nice when you finally get your 20 minutes of fame and attention, but if she wants to know why your blood pressure is so high, maybe she ought to look no further than her own waiting room.

I once suggested to a doctor who I had been waiting nearly two hours to see that his apologies were unnecessary -- my staff would be sending him a bill for my time. He seemed confused by the idea that I might actually have a life that I took time away from while I was waiting for him.

For those who like statistics, the average wait to see a doctor was 23 minutes last year. Clearly, none of my doctors are average.

Today's doctors, to a large extent, are held captive by the insurance companies that pay them. This generally results in growing the patient roster until it bursts at the seams. It manifests itself in an overbooked appointment calendar and -- I hate to even raise this -- a certain degree of inattentiveness to followup.

How can the doctor possibly remember who you are or what chronic conditions ail you between visits? At best, they scan your chart for 20 seconds before the exam begins. A friend asked his doctor about diabetes management and literally needed to remind the doctor that he had suffered a major heart attack seven years ago. The doctor had visited him in the hospital and played a role in his followup care.

Then there is the office staff, my personal favorite in the lax customer service department. The office staff is your front line of defense against illness. These are the men and women -- mostly women -- who will decide who gets seen by the doctor and when. They are the ones responsible for letting you know your test results, for phoning the pharmacy when your prescription refill runs out, and for sending reports in a timely fashion to specialists you need to consult. They are also the ones who lose your test results and then call you officiously like it is somehow yourfault they don't have it and inform you that you will need to be jabbed with a needle a second time because "The Doctor" needs those results. Yes, by all means, I love rearranging my schedule, missing work and or/getting home late, and paying for parking and a baby sitter to pick up the kids because of your error.

I finally switched away from a medical practice with an office staff that, for years, would only notify patients whose pap smears were problematic. It became an annual telephone arm-wrestle where the office manager would argue that if my results were bad, I would have gotten a letter in the mail. In the time she wasted being obstinate, she could have just looked up my results in my chart. Given the office's poor track record and my own health history, I wanted to know that the absence of a letter meant good news, not just that they forgot to send it. No, I do not believe that letters never get lost or misdelivered.

(And even if they did mail the results, can you imagine opening a snail mail letter that read: "Dear Ann, We are sorry to report that you probably have a life-threatening disease. Please call the office and wait on hold for 40 minutes to make an appointment at our, we mean your earliest convenience.")

Working in a medical front office is a job that requires patience, strong organizational skills, the ability to multi-task and, some would add, a strong command of the English language if the patients you are dealing with speak English. I fully laud those doctors with Spanish-speaking patient populations staffing their offices with Spanish speakers, ditto for Mandarin, Farsi and any other tongue that reflects their patient population. Everyone, including English speakers, deserves to understand and be understood by the staff in a doctor's office. Misunderstanding or miscommunication leads to too many serious errors that can impact health.

Those are the biggies for me, although I've heard great irritation from patients about nurses barging into the exam room without knocking first and continuing a conversation with someone down the hall, all the while holding the door wide open for the world to see what the paper gown won't cover. Me? I'm usually so agitated by the long wait that I don't care anymore.