Hey Mrs Jones, I know Johnny came in with a broken arm that is actually quite complicated and will require surgery and a lengthy rehab process, but our time is up. So maybe we can set up another time to talk?

I do my best to have patients limit their concerns to one or two issues, but they inevitably bring up three or four, appeal to your sensitive side, tell you how much pain they are in, beg for your help, ask for forms to be completed or for notes to be written for school or work or for calls to be made to their providers. They also might be terrible historians or require a translator or their issue is suddenly life threatening or more severe.

Every appointment in medicine is a crapshoot. You just never know what is coming through that door with “shoulder pain”. It’s nothing like a normal business where you schedule a set time. It takes as long as it takes to take care of the patient. And sometimes that puts you behind.

And again, I am not defending docs who are always an hour late or they start at 8 but don’t want in to see you until 830. Those are different issues.