At least once a year, my family heads out to the world-famous Butchart Gardens, about a half hour drive from our home here in Victoria. We spend a magical Saturday evening enjoying the summer gardens, a picnic supper on the lawn, live entertainment and especially the eye-popping summer fireworks extravaganza at dusk. We are joined by approximately a zillion other visitors from around the globe, and the minute those last fireworks have fizzled, the zillions stand up and shuffle en masse to the vast parking lot to exit.
A little secret that our family has learned over the years, however, has saved us a lot of late night aggravation trying to get out of that tour bus-clogged traffic jam – and it also confirms social scientists’ theory that Occupied Waiting Time feels far shorter than Unoccupied Waiting Time – a profound lesson for those of us who spend way too much time cooling our heels in doctors’ waiting rooms.
Here’s the secret: at Butchart’s, while that endless sea of humanity is shuffling s-l-o-w-l-y towards the parking lot at the end of a Saturday evening fireworks show, our family heads off cheerfully in the opposite direction. We enjoy the dramatic night lighting in the near-deserted Sunken Gardens, stroll the exquisite Japanese Garden pathways, sit down near the Ross Fountain to watch the lovely light show there and snack on our picnic leftovers. By the time we finally mosey on back to our cars, the parking lot is almost empty. We sail out the long driveway with virtually no delay, just behind those who have been slowly inching their way out of the parking lot for the past 45 minutes. The difference is that we are happy, while they are exhausted and cranky.
Dr. Richard Larson of M.I.T. is widely considered to be the world’s foremost expert on waiting in lines. He told the New York Times recently:
“Often the psychology of queuing is more important than the statistics of the wait itself.
“That’s why Occupied Time (a long walk to an airport’s baggage claim area, for example) feels far shorter than Unoccupied Time (just standing there waiting at the carousel).
“Research on queuing has shown that, on average, people overestimate how long they’ve been waiting by about 36 percent.”
Here’s an interesting story about that long wait to pick up luggage at the baggage claim carousel in the airport. Some years ago, according to the Times, passengers at a Houston airport were lodging a record number of complaints about the long waits at baggage claim. So airport executives increased the number of baggage handlers. But although the average wait fell to eight minutes, well within industry benchmarks, passenger complaints about long waits mysteriously continued.
Upon careful analysis, the puzzled execs found that it took passengers one minute to walk from their arrival gates to baggage claim and seven more minutes waiting to get their bags. So roughly 88 percent of their time was spent standing around waiting. A new approach was implemented: instead of reducing wait times, the airport execs moved the arrival gates away from the main terminal and routed bags to the outermost carousel. Passengers now had to walk six times longer to get their bags – and complaints dropped to near zero. A successful example of Occupied Waiting Time!
Researchers Ziv Carmon and Daniel Kahneman have also found that we are far more concerned with how long a line is than how fast it’s moving.* They have observed that given a choice between a slow-moving short line and a fast-moving long one, we will often opt for the former, even if the waits are identical. This is why Disney hides the lengths of its lines by wrapping them around buildings and using serpentine queues.
It’s also why our local hospital Emergency Department has created an inner and outer waiting area. Incoming patients are triaged and moved into the inner area as fast as possible; wait times there may not actually be any shorter, but patients feel like things are moving along, and new incoming patients perceive that the wait may not be too bad – because they don’t see the true number of people in the queue.
People also judge waiting times based on the concept of fairness. Just watch what happens when somebody attempts to butt into line ahead of those who have been waiting longer.
Or observe the murderous indignation of patients watching the cute blonde Big Pharma drug rep waltz through a packed waiting room into the doctor’s back office, where – to add insult to injury – they then get to wait even longer while forced to listen to the happy sounds of laughing and chatting during her sales call.
The sociological concept of Occupied vs Unoccupied Time spent waiting in line got me thinking of how doctors and hospitals could use this awareness to help patients who spend far too many hours cooling their heels in waiting rooms.
Dr. Charles Kilo of Portland, Oregon told American Medical News recently:
“Health care professionals are becoming more and more aware of waiting as a problem. The current system was really set up around physicians’ needs. It’s disrespectful. Patients are busy people, too.”
First, let’s give patients something meaningful to occupy their time while they wait. This seems like a profoundly simple solution that could not only make patients less cranky, but also help educate us at the same time.
I recently responded to a physician’s online article lamenting the fact that a standard 15-minute doctor’s appointment is just not long enough to advise his patients on important lifestyle improvements: lose weight, quit smoking, eat healthy, etc. My suggestion to him:
“Why not show Dr. Mike Evans‘ brilliant 9-minute film called ’23 and 1/2 Hours‘ on a continuous loop in the waiting room?
“It’s a must-see video for all patients and their family members – and no doubt Dr. Mike does a better job at inspiring change than you can.”
Steve Wilkins, who writes about doctor-patient communication at Mind The Gap, asks: what if physicians actually put patients to work during wait time?
“What if physicians integrated patient wait time into the office visit by:
♥ Talking to patients (via printed handouts, electronic media, patient portals, etc). Contrary to the popular press which touts the empowered patient, most of us still assume the traditional ‘sick role’ during the office visit. The sick role is characterized by patient passivity, limited information sharing, and minimal question-asking.
♥ Teaching people while waiting how (using the same media as above) to become ‘better patients’. I recall an article where physicians were asked five things they wished their patients knew. At the top of the physicians’ ‘wish list’ was a desire for patients to be better prepared and more focused during the visit – the point being that better-prepared patients would help the physician get to the correct diagnosis and treatment plan faster.”
Here are a few other options for physicians to consider for their waiting rooms:
- free Wi-Fi can help patients pass the time by getting some work done or entertaining themselves.
- a call-back service if you anticipate a long wait and there are other things to do in the nearby neighbourhood (like grab a cup of coffee, browse a bookshop, etc.), offer to call or send the patient a text message so they can leave the office and come back when you’re ready for them.
- Offer people a hot beverage when they arrive. It takes several minutes for tea to steep or to brew fresh coffee, plus another 10 or 15 minutes to drink it. This can help a patient warm up from the cold, wake up in the morning, or de-stress. All of this adds value, and for just a few dollars a day. And it’s just good hospitality.
Q: What would help make your waiting room experience less painful?
* Ziv Carmon, Daniel Kahneman. “The Experienced Utility of Queuing: Real-Time Affect and Retrospective Evaluations of Simulated Queues”. PhD dissertation, University of California at Berkeley, 1995.
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