“Aren’t You Ashamed?”

Across the U.S. Waiting 15, 30 or even 45 minutes for a physician appointment is not uncommon. Let me clarify, waiting 45 minutes for a scheduled appointment is not uncommon.  It doesn’t have to be this way.

The PBS  Newshour describes Virginia Mason Medical Center‘s re-design of its medical clinics, in which waiting rooms are being eliminated and 45-minute wait times to see a physician a thing of the past.

What was the inspiration for this change? The answer is a trip Dr. Robert Mecklenburg and other Virgina Mason executives made to a Toyota production plant in Japan to meet with various manufacturing Sensei‘s. Take a look at Dr. Mecklenburg’s retelling of the interaction.

The Sensei asked, “How long is the patient waiting?” Mecklenburg replied, “Oh, 45 minutes or so.”

Then the Sensei wanted to know if this was a scheduled appointment. “By this time I was starting to feel bad,” Mecklenburg recalls.

Then the Sensei asked “You have waiting rooms where patients wait for scheduled appointments for 45 minutes to see the doctor. These measure 25 by 30 feet and you have least 40 of these?”

Mecklenburg nodded his head to say yes.

Then the interpreter turned back to him and said “Sensei wishes to know aren’t you ashamed?”

“This is a moment I’ll never forget,” Mecklenburg says today. “I was ashamed.”

What did they do about it? In many clinics, Virgina Mason eliminated the waiting room. They were able to do this using radio frequency identification (RFID) technology to track where patients and staff members are located. According to the RFID Journal:

Rather than sitting in a waiting room until an employee escorts them to an exam room, patients at Virginia Mason Kirkland go through a registration process similar to that used when checking into a hotel, and are then assigned an examination room, given directions on where to find it, and instructed to proceed immediately to that location.

To allow this process to work, the clinic is using a hybrid RFID-IR system [enabling] the clinic’s staff to track the locations of patients and workers…

After registering at the desk, a patient is assigned a room and given a card indicating that room’s number, as well as the section of the clinic…in which it can be found. Clipped to the card is a Versus battery-powered hybrid RF-IR tag. Every three seconds, the tag transmits RF and infrared signals simultaneously, both encoded with the same unique ID number.


  1. wonderful good intentions

    what is the resulting improvement in patient waiting time for scheduled appointments?

  2. It does sound like they just end up waiting in the exam room instead.

  3. Ginger, it’s likely true that patients wait in their room. But I see at least two positive outcomes of this change: (1) patients get through some of the initial “administrative” steps earlier and get a sense of moving somewhere instead of sitting in a waiting room; and (2) the provider no longer needs to use all that space for waiting rooms.

    Like jamzo, I wonder what the resulting change in actual patient wait times was.

  4. My GF was scheduled to see her doctor at 1:30. Once there, the doctor’s office staff said the doctor was out and probably wouldn’t arrive until 3:00. Oh, and one other patient was ahead in the queue.

    These things happen. But why couldn’t the office staff have called my GF’s office to reschedule; or called to advise her to arrive two hours later? I already know the answer: because doctors are part of a professional cartel that wields an exclusive right to practice medicine. And because third-party payment creates a perverse incentive that discourages doctors from competing on price, quality or customer service. I doubt if other professions would dare treated a client this way. But it’s not uncommon in medicine.

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