Dr. Roach writes: In a recent column, I gave my opinion that doctors who are habitually late are disrespectful to their patients, and advised readers to try to get the first appointment of the day or to consider switching doctors. This generated some letters, including these two:
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Dear Dr. Roach: When I read this morning鈥檚 item about the wait time in doctors鈥� offices, I had to set the record straight.
There is no way to avoid a wait in a doctor鈥檚 office. In fact, the 20 to30 minutes that the reader complained about is mild. Most waits can be 鈥� and usually are 鈥� 45 minutes to an hour. In my area, I know that two-hour waits are very common and, believe it or not, patients put up with it to go to that doctor.
You must wake up out of this idealized la la land that you practise in. It just doesn鈥檛 work like that in today鈥檚 world. You are building your readers up for disastrous expectations when you advise these things.
M.W.
Dear Dr. Roach: As a physician for more than 40 years, I occasionally was 15 or more minutes late for a patient appointment. On these occasions, I had my staff advise those patients in the waiting room and call those who had not yet arrived to ask if they wanted to reschedule.
Medicine is not 100 per cent predictable. We need to take care of patients as their needs arise, not on a fixed 鈥�15-minute appointment鈥� schedule. Sometimes it takes a little extra time to provide good medical care.
Unfortunately, the last patient of the day often winds up having all the 鈥渆xtra five minutes鈥� the other patients needed tacked on to their waiting time. Medical needs trump scheduling. Do you think your doctor 鈥渟cheduled鈥� your 2 a.m. emergency-room visit or your newly diagnosed cancer or your son鈥檚 drug problems that delayed his entire day? It鈥檚 not a business, it鈥檚 a medical practice.
That being said, a doctor who routinely runs behind needs to revise his or her scheduling. Of course, that might mean prolonged delays getting appointments. It鈥檚 a no-win scenario.
J.L.S.
I looked up the reported wait times for a primary-care doctor around the United States, and they vary from 15 to 23 minutes. I think Dr. J.L.S. does at least one very important thing 鈥� when he is late, he lets his patients know.
I feel very badly for M.W., but find it hard to believe that there are no doctors in the area who are not habitually late.
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Dear Dr. Roach: I have read the questions and answers in your column regarding the application of testosterone gel. Is it acceptable to apply it to the upper legs, above the knees, on the inside of the thighs?
D.P.
There are four different testosterone gel preparations, and all have specific instructions, which should be followed for consistent results.
For example, AndroGel is absorbed 30 per cent better when applied to the arms and shoulders than to the abdomen.
Fortesta is recommended to be applied to the front and inner thighs, and Axiron is supposed to be applied to the underarms. I recommend following the manufacturer鈥檚 directions, as absorption can be variable.