One of my memories of childhood is waiting on many occasions for a very long time in the doctor’s surgery waiting room in west London. He was official doctor to Queens Park Rangers football club at the height of their 1976 glory, but that didn’t make it any less boring to wait.
Forty years later, the practice of keeping patients waiting even in the developed world seems not to have changed. My last two appointments for my excellent doctor here in France, I have waited 48 and 56 minutes respectively. By contrast, an appointment today with the bank, I waited 2 minutes longer than the appointed time. An appointment with a mortgage broker recently I had to wait 30 seconds longer. Why the difference between doctors and bankers. Is it an economic problem or something cultural? Given that I assume this practice is observed across different cultures and level of development (ie both rich and poor countries), I can only assume it is an economic issue. Here are the four economic reasons why i think doctors can afford to keep us waiting.
1. There are only so many doctors in the village, i.e. there is a limited supply. Supply does not respond easily to demand because it is restricted by the fixed number of doctors trained each year. You can not easily import doctors (like nurses) as they usually have to pass national examinations.
2. Because the market entry requirements are so high (i.e. being clever and studying for many years), incumbents in the market (our existing doctors) face little competition from new entrants to the market. Disgruntled clients are not a problem are they have nowhere else really to go, unless they want to wait in another queue.
3. Disgruntled clients also have little choice but to wait in the queue. Seeing your bank manager is important but usually of less immediate importance that addressing a life threatening conditions. There is therefore inelastic demand for waiting time. i.e. the waiting time has a relatively small effect on the demand for the service. However long you are required to wait, you are prepared to do so because your condition must be examined at any cost.
4. The price inelasticity of demand is also determined by the fact that doctor’s services can not be substituted by anything else. If there is a long queue at the surgery you can not go next door to the estate agent, chip shop or even a doctor of philosophy to help you.
So what can be done to reduce waiting times. Ranting and raving won’t help as you may find you have to wait even longer next time. I am no expert on the economics of health, but I imagine addressing each of the above, particularly supply constraints would help. I wonder though if my son in 40 years time will also be waiting in line like his Dad in 1976,