If a patient can charge for her time, why can’t the doctor charge for his?

By Brandon Betancourt

Today I came across an article on CNN Health that talked about a woman that billed her doctor for the time he made her wait.

“It’s ludicrous — why would I wait for free?” said the woman that billed her physician. She billed the doctor $100.

I work at a doctor’s office and I think billing the doctor for the time she makes a patient wait is a great idea. But why should we stop with doctors?

Why not bill everybody that wastes our time?

For example, I could bill the IL Tollways for the hours I sit in traffic thanks to their tollbooths. They are huge funnels, thus creating unnecessary traffic jams. Pay for tolls and wait too? Ludicrous.

We could also bill restaurants that tell us it will be 5 to 10 minutes for a table when in fact, it is really 20 minutes before me and my family gets to sit down. You know? Who they think they are? Our time is valuable too.

How about if we bill the movie theaters? Movies don’t start when they say, but rather roll advertising and previews for 20 minutes. I paid to see a movie on time, damn it! By the time the movie begins, I’ve already eaten all my popcorn. That ain’t right!

Oh, and let’s not forget amusement and parks like Disney. Waiting for “It’s a Small World” for over an hour… “pay up Mickey!” My kids’ time is valuable too.

Doctors should be able to get in the game too. How about if doctors charged patients when patients wasted the doctors time with unnecessary questions or for questions that already have been answered, phone calls, filling out forms, sending out pre-authorizations, calling the pharmacy, billing the insurance on the patient’s behalf or waking up in the middle of the night because the patient is not feeling well and can’t wait a couple of hours to be seen in the morning?

How about we do this…

If the patient takes up more than 15 minutes (the patient’s insurance company doesn’t pay for more) we bill by the minute which is paid at the time of service.

One last thing, when doctors run late, it usually isn’t because the doctor was doing something for themselves, but rather because they were doing something for another patient.

Perhaps an even better idea is to have patients like Elaine Farstad (the woman in the CNN story) that want to bill their doctor for the “wasted” time, bill all the other patients the doctor saw before her. Because in fact, they are the reason the doctor was running late for her appointment.

Brandon Betancourt is a practice administrator and blogs regularly at PediatricInc.com

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20 thoughts on “If a patient can charge for her time, why can’t the doctor charge for his?

  1. Doctors are not allowed to bill for telephone calls. So why not just wait until after hours and then call the doctor and get free care over the telephone?

    • Nothing forbids doctors from billing for telephone calls, it’s just that most insurance companies won’t pay for them. Many doctors DO charge for after hours calls. Calls after hours are for emergencies only. If a patient starts to abuse that but calling with routine questions they may be asked to find a new physician.

  2. Very accurate. The primary reason doctors run late is because of patients: patients who show up late, patients with more serious problems, patients who want the doc to take care of “one more thing…”, patients with emergencies, etc., etc. Would the fool who wrote the CNN article like her appointment cut off the moment a buzzer rings indicating her time is up? So what if she’s still bleeding? So what if she’s still describing her symptoms? So what if her questions haven’t been answered? No patient wants to wait and yet most patients want to spend unrestricted time with the doc.

  3. As the doctor featured in story I’ll share my video that CNN picked up:

    Excluding emergencies, here are reasons why doçtors are late
    for scheduled appointments:

    PATIENT-CAUSED:
    Not advising receptionist of real reason for appointment
    (wrong time allotted)
    Add-on complaints & “oh by the ways”
    Add-on family members “mom brings sick siblings to one child’s visit”
    Being late
    Not having insurance card/appropriate ID/copay ready etc. . .
    On cell phone

    PHYSICIAN-CAUSED:
    Unrealistic schedule
    Overbooking
    Socializing with staff
    Personal phone calls
    Drug rep conversations
    Arrive late for work (poor time management)

    SYSTEM-CAUSED:
    Third party B.S. (prior auths, etc. . ) **
    EMR Issues/IT breakdown

    ** Since PHYSICIAN signed contract with abusive third party
    and PATIENT pays monthly premiums then this
    is a PHYSICIAN & PATIENT-CAUSED delay.

    My take: http://www.idealmedicalcare.org/blog/should-physicians-pay-patients-for-waiting/

    Pamela Wible MD

  4. Brandon, that was absolute perfection to the point. THANK YOU for representing many offices……… YOU make us proud. You were to the point and precise. Met you at the OP conference and know that you are for real and not a nit picker in any way. Business is business… let physicians pratice their craft without all the unnecessary ridiculousness……..THANKS again…

    • Thank you for your kind words Nellie. I appreciate the feedback. Make sure to stop and say hi next time we are at the same conference. I’d love to chat about other ridiculous things that plague our healthcare world.

      Brandon

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  7. Great blog, Brandon! This is something that has plagued practices for many years and has become a stereotypical joke. Unfortunately, many people don’t understand the inner workings of health care. Just the other day, we had a patient who went ballistic in our reception area because “we were twenty minutes late” for his appointment. He could not understand that we made two attempts to room him, but he wasn’t present in the reception area. On the second attempt, the medical assistant even looked outside to see if she could find him (which is not usually done). He was on his cellphone for ten minutes….yet, it was our fault!

    I blogged about this last year and here is my article:

    https://charleneburgett.wordpress.com/2010/07/20/why-is-my-doctor-always-late/

  8. I think if waiting for an appointment was a rarity, fair enough. However, when you know as a general rule that a 2pm appointment means 2:30pm than I think your profession has poor management/greed. Why aren’t you putting in ‘buffer’ time periods during the day to account for the ‘patient caused’ delays? Why aren’t you making appointments for 15 minute blocks with a max 10 contact minutes? If your ‘profession’ needs help on being professional and respectful to your clients time, you should consider consulting a professional that can manage their time.

    • Chris,

      Putting ‘buffers’ is a great idea… I don’t know why none of those “greedy” docs haven’t thought of that.

      Maybe because it is hard to anticipate how sick a kid is going to be when they walk in the door (15minutes; 20minutes and hour?). Or maybe because it is hard to anticipate how many questions a new mom and dad are going to have about their newborn child. Or maybe because it is hard to determine how many phone calls the doc has to return because parents (trying to save a buck and not come in) would prefer to be treated over the phone. Or maybe because we don’t know if health insurance plans are not going to cover the Rx we just gave the patient, so we’ll have to call back the pharmacy to change the medication (which requires further documentation).

      Or maybe, just maybe, it is because your health insurance company doesn’t pay for the doctor to put in “buffers” thus requiring docs to schedule patients every 15minutes instead of every hour in order to pay for keeping him or her in business so the doc can continue providing health care.

      A professional that can help us manage our time? That is another great idea (boy, you are full of them today, aren’t ya?) I’d love to have a “professional” come and try to help us manage our time… between family, work, health insurance companies request for pre-auth, insurance forms, referrals, phone calls to parents, treating patients, making hospital rounds, documenting every single word that is said in an office visit, submitting claims to insurance, dealing with parents that don’t want to pay for their bills, paying the bills, training staff, supervising mid-level staff, preparing and administering vaccines, sending our specimens to the lab and making sure we are right 100% of the time diagnosing an illness, all before noon, we can get a little delayed.

      Thank you for your comments. It is always nice to come across someone that “values” the work pediatricians do and recognize that just like everybody else, money is an important part of making a living.

      Brandon

  9. You are missing the whole point. Doctor always over book. They must cram as many patients in. When we go to the doctors the majority of the time we have to leave work to do it. We have to take leave time or sick time. So yes the doctor is wasting our time. You can’t compare restaurants, movie theaters to doctor’s visits. That likes comparing apples to oranges. If at the last minute at work you find you must miss your appointment and the doctor can charge you a no show fee, then anything over a fifteen minute wait, the doctor should be charged. This does work both ways

  10. I think charging doctors for being excessively late for their patients is a great idea, I’ll be warning my doctors office at my appointment once I am waiting for 20 minutes. I agree, patient time with the physician is very important and I completely agree that physicians will run behind at times, completely acceptable. I make my appointments first thing in the morning, usually the first or second appointment. The last two appointments I was at least 1 hour after my scheduled appointment. The REASON, the receptionist advised me that the doctor is still on the road. OK, but that’s not my fault. I actually wasted 2 and 1/2 hours of my time at the doctors office and was extremely late for work. I will send the doctor a bill the next time.

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  12. ” How about if doctors charged patients when patients wasted the doctors time with unnecessary questions or for questions that already have been answered, phone calls, filling our forms, sending out pre-authorizations, calling the pharmacy…..”

    We do charge for all these things. That is all in the cost of business. Let’s not act as if we aren’t getting paid for the work we do.

    If you don’t like these aspects, charge more, in cash, and deal with less patients. We have the option to do so….. for now. If not, you probably shouldn’t have gotten into the single most deeply rooted personal contact practice known to man.

  13. It’s not the 30 to 45 minute waits that should be billed for its the waits that are excessive 1.5 or more I’ve been stuck at the doctors exam room for up to 3 hours that’s not including the waiting rooms or waiting on results. To me that’s horribly wrong…

    • Ri,

      I agree with you. 3-hour wait time is plain wrong. At the very least the doctor’s staff should notify you of the wait so that you can decide whether to stay or reschedule. Like restaurants do.

      There are times when doctors have un-expected circumstances that cause delays. In Pediatrics all it takes is two asthmatic kids to show up and the schedule gets backed up.

      Also, if you schedule appts late in the day your chances of waiting increases.

      We try at our office to be as upfront as we can when we run behind.

      But again, chronic delays and poor communicatuon from the staff is unacceptable.

  14. If my doctor is going to charge me for missec appointments or arriving late for an appointment, you bet I’m going to charge him for leaving me waiting for him for an hour

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