How Covid Has Changed the Doctor's Office Waiting Room

Perceptions of risk and technology have changed perceptions about the necessity, let alone the advisability, of even having a waiting room. 

As a result, its form and function is in the process of changing, probably forever. JL 

Chris Cornelis reports in the Wall Street Journal:

Few people have ever wanted to wait for their doctor in uncomfortable chairs staring at a display case of old toys and years-old magazines. It is a holding pen for patients to wait until the doctor is ready to see them. But the pandemic has pushed patients and healthcare providers to a new appreciation of the risk. Healthcare providers are using technology and redesigning their facilities to change the experience and bring much of it out of the waiting room. “There should be no waiting room.”

In the name of efficiency, profits, public health and a better customer experience, healthcare providers around the country are looking at changing every aspect of the waiting-room experience, from the furniture to the fish tank.

Few people have ever wanted to wait for their doctor in uncomfortable chairs staring at a display case of old toys and years-old magazines. But the pandemic has pushed both patients and healthcare providers to a new appreciation of the risk in continuing to corral sick and healthy together in close quarters.

Historically, the waiting room has served several functions. It is where doctors collect all of the necessary information (and then some) from patients via the dreaded clipboard. It is where patients settle their bills, often through a pane of glass or plastic with a receptionist behind it. And, of course, it is a holding pen for patients to wait until the doctor is ready to see them.

Now healthcare providers are using technology and redesigning their facilities to change the experience and bring much of it out of the waiting room.

“There should be no waiting room,” says Dr. Rahul Khare, chief executive of Innovative Care clinics in the Chicago area. “We should do what we can to eliminate that.”

Even before the pandemic, San Antonio’s TSAOG Orthopaedics was rethinking the old waiting-room experience. Chris Kean, the practice’s chief operating officer, says she wants patients to feel more like they are checking in to a hotel than arriving at a clinic. The group’s new location, which Ms. Kean says will be its model going forward, includes a lobby with high ceilings, lounge chairs, an endless counter and the oversize feel of a hotel lobby. There is no glass wall shielding the receptionists, and seating behind the counter has been elevated so staff can see patients at eye level.

“I wanted our staff to have this position of feeling like they were a concierge to the patient,” says Ms. Kean, “not a receptionist.”

Returning patients no longer need to arrive early, she says, thanks, in part, to a software program called Clinic Q, one of several on the market that digitize many traditional waiting-room and administrative tasks. Patients can use it to book appointments and answer pre-appointment questionnaires from home that are tailored to their circumstances and cases. Clinic Q, created by Health Here, also links with the patient’s insurance company to provide an estimate of the cost of service. It knows a patient’s copay, deductible, and how much they have paid so far that year.

The software has enabled TSAOG to add patients and providers without adding receptionists, Ms. Kean says.

Brian Chong, who leads Mayo Clinic’s campus expansion in Phoenix, says Mayo is developing a feature for its app that gives patients an option to be tracked when their cars arrive on campus. The feature will direct patients to the parking spot closest to their appointment and tell them if their doctor is running late. If that is the case, the app will also suggest things a patient can do—perhaps visit a coffee shop on campus or attend a seminar in progress—rather than sit in a crowded waiting room.

Mayo’s new clinic design in Phoenix does include waiting areas. But instead of a large seating area, Dr. Chong says, the clinic is building long, linear waiting spaces with large windows looking out on the desert, and a variety of isolated areas for seating. Dr. Chong says the linear design is better for social distancing, while providing some space for groups to sit together and enjoy the view. It is a concept similar to one in use at a clinic in the University of Texas at Austin system.

Stacey Chang, executive director of the university’s Design Institute for Health, helped design a new clinic in the UT system. He compares its linear waiting area to an airport concourse. There are a variety of different ways to wait, including nooks for families that want to sit together and tall chairs with tables for people who want to use their laptops.

“In a system that’s not perfectly coordinated—and healthcare is not—there will be unaccounted-for time,” says Mr. Chang. “It’s not necessarily about eliminating the waiting room. It’s about gifting control over that time back to the individuals themselves.”

Increasingly, Americans have the opportunity to use time spent waiting for the doctor doing something productive: shopping. Retail businesses that feature health clinics are adding locations and expanding their offerings. CVS, for example, is expanding its HealthHUB clinics and plans to have 1,000 locations in stores by the end of the year. The company recently started including behavioral health service at its clinics. These locations often have modest waiting rooms, but they give patients the option to check items off their shopping lists while waiting to see their healthcare providers.

Tine Hansen-Turton, executive director of the Convenient Care Association, which represents retail-based healthcare providers, says that historically patrons of her group’s members were younger moms and other people with hectic schedules. Now, she says, there are more baby boomers and people with chronic conditions using such clinics out of convenience, in addition to the care they receive from primary-care doctors. Rather than wait in a large traditional waiting room, Ms. Hansen-Turton says, these patients are often shopping until a doctor or nurse practitioner can see them.

“The whole premise of the retail clinic model is that you don’t have long waits,” she says. “If you do have to wait, you sort of peruse the store. You get your errands done.”