2. What procedures were followed to keep the appointment system flexible enough to accommodate the emergency cases, and yet be able to keep up with the other patients' appointments? Good doctor-patient relations begin with both parties being punctual for appointments. This is particularly important in my specialty-pediatrics. Mothers whose children have only minor problems don't like them to sit in the waiting room with really sick ones, and the sick kids become fussy if they have to wait long. But lateness-no matter who's responsible for it-can cause problems in any practice. Once you've fallen more than slightly behind, it may be impossible to catch up that day. And although it's unfair to keep someone waiting who may have other appointments, the average office patient cools his heels for almost 20 minutes, according to one recent survey. Patients may tolerate this, but they don't like it. I don't tolerate that in my office, and I don't believe you have to in yours. I see patients exactly at the appointed hour more than 99 times out of 100. So there are many GPs (grateful patients) in my busy solo practice. Parents often remark to me, "We really appreciate your being on time. Why can't other doctors do that too?" My answer is "I don't know, but I'm willing to tell them how I do it." BOOKING APPOINTMENTS REALISTICALLY The key to successful scheduling is to allot the proper amount of time for each visit, depending on the services required, and then stick to it. This means that the physician must pace himself carefully, receptionists must be conected if they stray from the plan, and patients must be taught to respect their appointment times. By actually timing a number of patient visits, I found that they break down into several categories. We allow half an hour for any new patient, 15 minutes for a well-baby checkup or an important illness, and either 5 or 10 minutes for a recheck on an illness or injury, an immunization, or a minor problem like warts. You can, of course, work out your own time allocations, geared to the way you practice.