Survey: El Pasoans have longest doctor’s office wait times in US [El Paso Times, Texas]

Jan. 08--El Paso has the longest doctor's office waiting times in the country, a new study shows.

The average patient wait time at an El Paso doctor's office was just over 29 minutes -- well above the national average of 21 minutes, shows a new study done by Vitals.com, an online service which provides data about doctors for consumers.

Four other Texas cities -- Fort Worth, San Antonio, Arlington and Houston -- were among the top 10 cities with the longest waiting times.

Some doctor's offices in other parts of the country and many hospitals, including some in El Paso, are using wait tracking systems to broadcast wait times to patients, so patients can spend less time in waiting rooms.

"Patient satisfaction is a key part of the success of any medical practice. If wait times cause patients to become dissatisfied with their doctors and (they) look for another medical provider, I would assume more doctors will be concerned and focus on it," Jeff Cutler, executive vice president of New Jersey-based Vitals.com, said in an e-mail.

Vitals sifted through 314,000 wait time reports from patients, including 519 in El Paso, to come up with averages by city. Some of the doctor profiles on Vitals contain the doctor's average office wait time.

Minneapolis had the shortest average wait time at just over 16 minutes.

Waiting times are a big complaint among patients. The thousands of doctor reviews on Vitals "show that long wait times are a common concern among patients," Cutler said.

Consumer Reports Magazine in March reported that its latest survey of the magazine's readers about doctors found long waits at doctor's offices continue to be a sore point in patient-doctor relationships.

The Internet and the proliferation of wireless devices are beginning to be used to make patients more aware of wait times at medical facilities.

A Chicago company last year launched an online-based wait alert system, MedWaitTime, for doctor's offices and other medical facilities to buy, and late last year launched a free wait alert system available to patients nationwide, WaitCatcher.

Sierra Providence Health Network began posting average emergency room wait times on its Web sites last year and in the summer started an emergency room patient reservation service. Las Palmas Del Sol Health Network reported its average emergency room wait times online and on electronic billboards last year, but recently stopped.

Waiting times in emergency rooms were not part of the Vitals study. ER wait times averaged just under an hour nationwide in a 2006 federal survey, but waits often are much longer than that average.

"In many ways, it is not surprising that patient wait times in El Paso are among the nation's highest. El Paso is under-served for health care across the spectrum of ages and specialties," Dr. Michael Romano, associate dean for clinical affairs at the Texas Tech University medical school in El Paso, said in an e-mail. "In addition, our community struggles with a disproportionate burden of chronic disease, such as obesity, diabetes and hypertension that require recurrent health provider visits."

Texas Tech measures patient volumes at its El Paso clinics and adjusts doctors' schedules to balance appointments across a week to better use resources and reduce waiting times, Romano said.

Texas Tech is looking at working with New Mexico State University "to develop computer scheduling algorithms that can optimize the appointment process specifically to reduce patient waiting times," he said.

Dr. Andres Enriquez, a family practitioner in West El Paso, said a shortage of El Paso doctors, many doctors no longer accepting Medicaid and Medicare insurance patients, increasing government-required paperwork and insurance red tape are reasons for longer wait times.

"A lot of (private) clinics are not taking Medicare and Medicaid anymore. That means the ones that do take it get overwhelmed, like myself," Enriquez said. "My wait times probably average 45 to 60 minutes." (Vitals lists the average wait at Enriquez's office as 60 minutes-plus.)

"Wait times are a concern. I try to make sure people don't wait. But a lot of paperwork is holding things up," he said.

Dr. Raj Marwah, an El Paso rheumatologist and spokesman for the El Paso County Medical Society, a local doctors group, said El Paso's unique patient population has a lot to do with increased wait times. El Paso has a lot of Spanish-speaking patients who often have to fill out English medical forms at doctors' offices, which can take longer, he said. Doctors who don't speak Spanish may need to use a translator, which also can slow the patient flow, he said.

A doctor's office is "not an assembly line," Marwah said. "You can't process patients every 20 minutes. People have different medical problems that takes different levels of care and time," he said.

"Scheduling is key to reducing wait times, and reminding patients to bring in all (necessary) documents," Marwah said. "In my practice, we have a 30-minute time slot for follow-ups, and 60 minutes for new patients. We try to work in that time frame." (Vitals has the average wait time at Marwah's office listed as 15 minutes).

Dr. Vishal Mehta, a Chicago area orthopedic surgeon, said it's not unusual for his patients and patients of other surgeons to wait more than an hour for an appointment because surgeries often wreak havoc with appointment schedules. That's why he had many patients asking for a way to find out if he's running behind on appointments so they could come in later than their scheduled time, he said.

That's the impetus for MedWaitTime, a wait-tracking service started in May by Mehta and two partners. The service alerts patients via a health-care provider's Web site whether wait times at a subscribing doctor's office or other medical facility are running low, moderate or high. It also sends wait times to patients' mobile devices.

In November, Mehta and his partners also launched WaitChecker, a free service that allows patients nationwide to find waiting times at doctor's offices and other medical facilities through e-mails or text messages. WaitChecker's call center contacts doctor's offices and medical facilities on behalf of patients to get wait times and determine if a patient can show up late for an appointment, Mehta said. The service is being used as a marketing tool to get more subscribers to MedWaitTime, he said.

Doctors have been slower to see the need for wait alert systems than have hospitals, Mehta said.

"Hospitals pay a lot of attention to customer service," Mehta said. "Doctors are just too busy right now and are feeling pinched from all angles" to see a need for such service, which costs $50 per month per doctor, he said.

"No question the desire is there from the patient side," Mehta said. "So far, MedWaitTime is self-sustaining. It's essentially break even, and we're putting money into development of WaitChecker."

Sierra Providence last year began posting average wait times for emergency rooms at Sierra Medical Center, Providence Memorial Hospital, and Sierra Providence East Medical Center to let people with non-emergency problems know which hospitals had the shortest waiting times in hopes of alleviating wait times, said Gregory Deitch, marketing director for Sierra and Providence hospitals.

In August, it began an emergency room reservation system set up by Nashville-based InQuicker.com. Hospitals around the country are using the system. It allows patients with non-emergency medical problems to get an appointment online and be seen at one of Sierra Providence's emergency rooms within 15 minutes.

"We still post wait times for people who don't want to reserve (a time), and can see which hospital has the shortest wait," Deitch said.

"The (reservation) system was created because almost 50 percent or more of people coming to our ERs are non-emergency situations," and it makes it easier for true emergencies to get in, Deitch said.

Sally Hurt-Steffen, CEO of Sierra Providence East, said one reason emergency rooms in El Paso have high usage by people without emergencies is because of a shortage of doctors.

"If people can't get appointments, then they go to the ER," Hurt-Steffen said. "Some doctors have long waits -- two to three months -- for appointments." People also use ERs when doctors' offices are closed, she said.

The reservation system doesn't lower overall wait times for people going to ERs without a reservation, Hurt-Steffen said.

Staffing and other factors influence ER wait times, she said. The average wait time at Sierra Providence East's emergency room, for example, went from 47 minutes in the first nine months of 2011 to 27 minutes in the last three months of the year because of changes implemented by a new emergency room director, not because of the new reservation system, Hurt-Steffen said.

Las Palmas Del Sol Healthcare disbanded its emergency room wait-time postings for its two hospitals because "we changed our consumer messaging as part of our routine advertising rotation," Carla Sierra, a spokeswoman for Las Palmas Del Sol, said in an e-mail.

It has no ER reservation system because "we're concerned that it might result in the inappropriate use of the ER for conditions that might be better taken care of in a primary care setting," she said.

Las Palmas Del Sol operates an East Side after-hours clinic open until 10 p.m. daily to treat non-emergencies, she said.

Sierra Providence operates two urgent care centers for non-emergencies. It plans to open another emergency room this month in the Sierra Providence Eastside Center near Trawood and Lee Trevino, and another urgent care center later this year.

Vic Kolenc may be reached at [email protected]; 546-6421.

Longest waits

Cities with longest average wait times, in minutes, for doctor office visits:

1. El Paso: 29.3 minutes

2. Memphis: 27.1

3. Miami: 25.2

4. Las Vegas: 24.6

5. Fort Worth: 23.6

6. Arlington, Texas: 23.1

7. Louisville, Ky.: 23.0

8. Fresno, Calif.: 22.9

9. Houston: 22.5

10. Philadelphia: 22.3 minutes

Source: Vitals.com.

Shortest waits

Cities with shortest average wait times, in minutes, for doctor office visits:

1. Minneapolis: 16.3 minutes

2. Seattle: 16.4

3. Milwaukee: 16.6

4. Omaha: 16.9

5. Portland: 17.3

6. Denver: 17.4

7. San Diego: 17.6

8. Austin: 17.9

9. Colorado Springs, Colo.: 18.0

10. San Francisco: 18.3

Source: Vitals.com

Wait tracking

-- MedWaitTime.com: Wait tracking system sold to doctors for $50 per doctor. Also sold to hospitals and other medical facilities.

-- WaitChecker.com: Sends e-mails or text messages to patients with wait times for doctor's offices and other medical facilities.

-- Vitals.com: Shows average wait times for doctor's offices in some of its online doctors' profiles.

-- InQuicker.com: Used by Sierra Providence Health Network and other hospitals around the nation to reserve times at emergency rooms and send patients with appointments e-mail or text message alerts about appointment delays.

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(c)2012 the El Paso Times (El Paso, Texas)

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