My third year of medical school began with a family medicine outpatient clinic clerkship, which is quite a different setting than my last 6 years practicing as a Registered Nurse in the inpatient dialysis unit. This was my first practical patient care experience in the ambulatory setting. One thing struck me about the family medicine clinic that I had not experienced at any point prior to this. The patients were waiting.
Every morning, I arrived to the clinic at 0715. The first patients were scheduled at 0800, so this gave me time to review charts, contemplate possible diagnosis, and research anything confusing or medications with which I was unfamiliar.
Patients were scheduled every 20 minutes. However, as is often the case, appointments begin to run off schedule — a patient runs late because she relies on public transportation, rooming takes an abnormally long time, insurance changes at the front desk, etc. The reasons are many and varied but leave me with 15 minutes or less for each patient.
Despite best efforts, there is, more often than not, an important delay early in my schedule. Believe it or not, patients will arrive for an annual physical and upon reviewing their symptoms I discover they have had a couple of weeks of crushing chest pains. Well, we can’t ignore that one! By the second or third patient scheduled for the day, there begins… the wait.
As soon as I finished with a patient, I would immediately move to the next patient’s room. Before my hand would knock on the closed, thick oak door, I knew they were in there. Waiting.
The waiting is profound to me because there is an incredible amount of character in the way people wait.
A 22 year-‐old new mom was playing with her 5 month old.
A 75 year-old female newly diagnosed with cancer was reading a self-‐help book on coping.
A 55 year-‐old male for an upper respiratory infection was working on a crossword puzzle.
A 47 year-‐old female following up on prediabetes labs was knitting.
A 35 year-old male for a general check-‐up was screaming profanities.
A 67 year-old female to discuss back pain was listening to NPR via ear buds on her phone.
There is so much one can learn about people from their waiting styles. But, it also made me realize there is a short list of professions or circumstances where customers will wait over 20 minutes for their services. If I went to a restaurant, was seated at a table, and no one came to wait on me within 15 minutes, I would likely get up and leave.
What an honor it is to serve people. To gain their trust enough to learn of their vulnerabilities, the things that are ailing them, it takes time. It takes more than 15 minutes to discuss your anxieties. It takes more than 15 minutes to explain your medications and lab results. It takes more than 15 minutes to comfort you in a time of need.
Some of this has to do with the doctor shortage. Some of this has to do with the system. Some of this has to do with patient acuity in outpatient settings. But, maybe, someday the wait will change.
Until then, I promise I will do my best to serve you when I see you. I promise I will give you as much attention as you need. Because of this, I cannot guarantee I will knock on that door exactly at your scheduled time.
But when I knock, just know, I know— you have been waiting.
About Christina Hughey
Christina Hughey is a third year medical student at the University of Kansas School of Medicine. She is a Kansas native and earned her bachelor’s degree in nursing with a minor in applied behavior science in 2010 from the University of Kansas. She continues to work as a Registered Nurse in Inpatient Dialysis, where her patient care experiences inform her everyday practice of medicine. In her spare time, she serves as the Chair of the Student Government Association where she guides the university in policy decisions from a student perspective. She has gone on multiple international medical missions to Kenya, Belize, and Panama and volunteers at local underserved free health clinics for high risk youth and immigrant populations. She hopes to incorporate academic research into everyday practice as she was the recipient of an NIH T32 grant, which gave her the funding to complete an internship in the Alzheimer’s lab of Dr. Russell Swerdlow, MD. She ultimately aspires to serve Kansans as a critical care/pulmonary physician after completing an internal medicine residency and critical care/pulmonary fellowship.