Consumer Reports surveyed its readers last year regarding their satisfaction with their medical care and found that the “overwhelming majority … were highly satisfied with their doctors.” Of course, they did have some complaints.

As you might expect, their top complaint about doctors was the time spent waiting to see them: Twenty-four percent said they frequently waited 30 minutes or longer.

I've written about punctuality before, but this is such a ubiquitous problem that it bears repeating.

Here are some suggestions that can help to keep you on track:

Start on time. That seems obvious, but I'm always amazed at the number of doctors who admit to running late who also admit that they start late. If you're in the hole before you even start, you can seldom dig yourself out. Sometimes an on-time start is the solution to the entire problem. If you doubt me, try it.

Book realistically. Everyone works at a different pace. Determine the number of patients you can comfortably see in an hour, and book only that number. If you want to see more patients, the solution is working longer hours or hiring physicians or physician extenders (or both), not overloading your schedule.

Time-stamp each chart. Every office should have a time clock, not only for employees, but for patients as well. As each patient arrives, have your receptionist time-stamp the “encounter form” that goes to the back with the chart. As you take each chart off the door and enter the exam room, one glance at the time stamp will tell you exactly how long that patient has been waiting for you.

Schedule all surgeries. If you haven't scheduled the time necessary for a surgical procedure, don't do it. It's tempting to “squeeze in” an excision because you feel guilty that the patient has already had to wait for you, but every unscheduled surgery puts you that much further behind. And hurrying through a procedure increases the risk of mistakes.

Explain to the patient that surgery requires extra time and it cannot be rushed, so you will have to schedule another appointment.

Work-ins come last, not first. Patients with urgent problems should be seen after scheduled patients.

This may seem counterintuitive. Receptionists often assume it's better to squeeze them in early, while you're still running on time, but doing that guarantees you will run late, and it isn't fair to patients who have appointments and expect to be seen promptly.

Work-ins, on the other hand, expect a wait because they have no appointment. We tell these patients, “Our schedule is full today, but if you come at the end of hours, the doctor will see you. But you may have a wait.” Far from complaining, they invariably thank us for seeing them.

Seize the list. You know which list I mean: “No. 16: My right big toe itches. No. 17: I think I feel something on my back. No. 18: This weird chartreuse thing on my arm. …” One long list can leave an entire half-day schedule in shambles.

When a list is produced, the best option is to take it and read it yourself. Identify the most important two or three problems and address them.

For the rest of the items on the list, I will say, “This group of problems deserves a visit of its own, and we will schedule that visit.”

Then I will ask if I can place the list (or a photocopy) in the patient's chart. It is, after all, important clinical information.

All of the problems on the list are important to the patient and should be addressed—but on your schedule, not on the patient's.

Avoid interruptions. Especially phone calls. Unless it's an emergency or an immediate family member, my receptionists say, “I'm sorry, the doctor is with patients. May I take a message?” Everyone—even other physicians—understands. Just be sure to return those calls promptly.

Pharmaceutical reps should not be allowed to interrupt you, either. Have them make an appointment, just like everybody else.

Don't stop to open the mail, to do paperwork, or to perform any other task that can be delegated.

There will be times, of course, when you run late, but they should be the exception rather than the rule. By streamlining your procedures and avoiding the pitfalls mentioned, you can give almost every patient all the time he or she deserves without keeping the next patient waiting.

Incidentally, the other leading patient complaints in the Consumer Reports survey were: couldn't schedule an appointment within a week (19%), spent too little time with me (9%), didn't provide test results promptly (7%), and didn't respond to my phone calls promptly (6%).

Now would be an excellent opportunity to identify and address any of those problems as well.

To respond to this column, e-mail Dr. Eastern at sknews@elsevier.com

Don't Keep Your Patients Waiting