The Pandemic May Have Killed Waiting Rooms

Chairs taped off in a waiting area.
A waiting area at Lenox Hill Hospital, New York City. Photo: Education Images/Getty Images

Since the onset of Covid-19, patients seeking any number of health care services have found an annoying, often frustrating hurdle inconspicuously absent: the waiting room. This dreaded area of contagion, paperwork, insurance verification, and awkward looks has been eradicated for the moment — becoming yet another possible relic of a pre-Covid past.

Before a few recent in-person visits to a medical and dental clinic, I received all relevant paperwork via email days before my appointment, was asked to submit my insurance information ahead of time, and was instructed to call or text the clinic shortly before arrival and wait outside or in my car for a text notifying me it was time to enter the office. Upon entry, I was escorted to a treatment room and seen by the doctor. I then paid for the visit on my way out. The entire process, seamless and efficient, made me question why it took a global pandemic to make this normal.

Despite efforts to rename or rebrand the waiting room a “reception room” or “greeting area” over the years, patients have not been fooled. Waiting for medical treatment is not the same as checking into a hotel or attending a wedding. At a medical office, you sign in, receive a clipboard asking for updated health or insurance information, and then, you wait.

Despite efforts to rename or rebrand the waiting room a “reception room” or “greeting area” over the years, patients have not been fooled.

I own a chiropractic clinic myself. Prior to the pandemic, we implemented some of the above procedures — emailing prospective patients their necessary paperwork, verifying insurance and payment preference beforehand in an effort to minimize wait times or delays.

In eliminating the waiting room experience, providers not only minimize interaction between possibly infectious individuals and place much needed value on patient/practitioner time, they also decrease anxiety levels associated with an already stressful process.

What brings you in today?

When you are seen by a doctor or nurse, they are likely to ask some version of the question: What brings you in today?

Consider how this might unfold if a provider was briefed on your situation hours, or possibly days, before your visit. Imagine the difference in not only the questions you might be asked, but more importantly, their increased understanding of your presentation. Imagine if your provider already knew why you sought medical care and had an opportunity to review and ponder your case, consider a possible diagnosis, and perhaps even determine which treatment would likely be best.

Would this not be more reassuring than the usual scenario, where a clinician is forced to conclude, within minutes or even seconds, possible ailments based on a form you completed moments ago?

Is it covered?

For those in countries with socialized medicine, health insurance isn’t much of a concern. For Americans, however, coverage often dictates treatment. Verifying or pre-authorizing insurance benefits prior to an initial visit clears yet another hurdle in the sometimes cumbersome process.

Clinics are often required to pre-authorize or establish medical necessity for a variety of lab work, treatment, and diagnostic testing. Due to the wide array of insurance plans, uncertainty around what those plans cover, whether providers are “in-network” or “out of network,” insurance verification can be time intensive. Upon reviewing a patient’s history and chief complaint in advance of a visit, a trained clinician could likely deduce whether and what type of diagnostic testing might be required. The certifications and preauthorizations could then be completed prior to the patient’s visit — and the necessary testing could be discussed during the visit.

Hospital-acquired infections

It is estimated that nearly 1.7 million patients will acquire, and 100,000 will die yearly, from what are termed nosocomial or health care–acquired infections. Time spent in nursing homes, clinics, and hospitals all contribute to these figures.

If anything, Covid-19 has created an awareness and urgency around the nature of infection like nothing before. In nearly every health care facility, cleanliness, ventilation, and air quality are being assessed and improved — creating an environment less suitable to pathogens and ideally minimizing contagion levels.

Pandemic relief

Though the virus has proved to be uniquely unending and challenging for the United States, it may be that the ensuing pandemic improves our health care system in a variety of short, intermediate, and long-term ways.

Almost instantly, we have become increasingly diligent regarding patient safety, implementing much-needed changes to outdated systems including sanitation and waiting rooms. Midway through, we have come to realize that clearing hurdles to diagnosis, testing, and all manner of treatment will likely improve patient outcomes.

In a perfect world, all necessary testing and treatment, especially in cases where such intervention reduces risk to others, would be publicly funded — leaving no patient untreated. We’re a long way off from that scenario, but living through a deadly pandemic sure underscores the value of such an approach.

By emphasizing patient care, eliminating waiting rooms, improving provider/patient interactions, creating awareness and understanding around insurance coverage, and minimizing nosocomial infections, it could be that Covid-19 teaches — and requires — us to finally improve America’s health care delivery system.

Restoring Health — Enhancing Life * Beirut →Detroit

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