It’s Not Just the Wait. It’s the Empty Wait

Imagine a patient sitting in your exam room while you take an orthosis to the lab for an adjustment. You know exactly what is happening. You are relieving a pressure point, checking the finish, and making sure you get it right. The patient knows you walked out ten minutes ago. 

From your side of the door, care is moving forward. But what is happening from their perspective? They know you left, but they may not know what you are doing, how long it will take, or whether someone will check on them. 

When someone complains about waiting, our first instinct is to figure out how to work faster. Sometimes that is exactly what we need to do. But how much of that wait leaves the patient with nothing useful to do and no clear sense of what happens next? 

Lessons from an airport 

In a widely retold account published in The New York Times, a Houston airport responded to baggage-claim complaints by adding handlers and bringing the average time to collect luggage down to eight minutes, but complaints continued because passengers spent about one minute walking and seven minutes standing there (New York Times). 

The airport then moved arrival gates farther away and used the outermost carousel, making the walk about six minutes; according to the account, complaints dropped to nearly zero (New York Times). It is an anecdote, not a controlled experiment, but it illustrates the difference between moving toward something and standing around waiting for it. 

Management writer David Maister described the underlying idea simply. “Occupied Time Feels Shorter Than Unoccupied Time,” he wrote in The Psychology of Waiting Lines (David Maister). 

For us, the question is whether time alone in the exam room or waiting room could offer something better than watching the door. We do not need a longer walk to find a useful answer. 

Give the time a purpose 

Start with that exam-room example. Before leaving, try, “I’m going to adjust the area we marked. I expect it to take about ten minutes. While I’m working, would you like to look over this care guide and mark anything you want us to discuss?” 

Now the patient has an explanation, a reasonable estimate, and an optional activity connected to the visit. When you return, actually discuss what they marked. 

If you work with a care extender or another trained team member, could part of the visit happen during that pause? Within their training and assigned role, they might reinforce instructions you have already given, gather questions, or perform a Promis-29 or other outcome measure (that does not require use of the affected limb). 

Before an appointment, instead of handing someone another form that repeats information you already have, offer a prompt about their goals. “What is one activity you want us to make easier for you?” or “What has been most frustrating since your last visit?” Let them write, think, or save the answer for the clinician. Or assign a staff member to engage the patient by or taking their height, weight, scans, if applicable, and a TUG, ABC or other relevant measure. Move useful work into the wait rather than adding tasks just to fill it. 

A parent waiting during a child’s orthotic adjustment might appreciate a brief, clinician-approved video about cleaning the device. A caregiver could review the follow-up plan. None of this requires a new entertainment system, just something that serves the patient. 

Look at the room from the patient’s position. Are there useful, easy-to-read posters or illustrations? Refresh the material periodically, and consider pointing out something relevant before you leave. 

Keep activities optional and accessible. Offer paper or conversation rather than assuming everyone wants to use a phone. Someone who is tired, uncomfortable, or overwhelmed may prefer quiet, and that is a reasonable choice. 

An explanation is not the same as an activity 

Giving someone something to do does not remove our responsibility to keep them informed. A care video will not answer the question, “Did they forget about me?” 

Make updates part of the handoff. Decide who will check back if an adjustment takes longer than expected. Say what you know, acknowledge what changed, and avoid promising another “two minutes” without a sound reason. 

Consider the patient waiting at home for authorization or fabrication, too. We cannot occupy every day, but we can offer useful preparation and a clear next contact. “Here is what to bring to your fitting. We will call Friday with an update, even if we are still waiting for a response.” 

Follow your practice’s privacy procedures, and distinguish a promised update from a promised approval or delivery date. These are service recommendations, not substitutes for payer requirements or clinical judgment. 

Find one empty wait this week 

At your next staff huddle, identify where patients wait without anything useful to do or a clear sense of what comes next. Include pauses inside the appointment. Ask a few patients where the time dragged rather than assuming you know. 

Choose one wait and first ask whether it can be eliminated or shortened. For the part that remains, agree on an explanation, one optional activity, and who owns the next update. Try it for a week. 

Then ask patients whether it helped and ask staff whether it created extra work or delayed care. Track the actual minutes as well as the feedback. Fewer complaints should not become permission to let the underlying process get slower. 

The goal is not to become better at making people tolerate a poorly run office. It is to respect their time even when we cannot eliminate every pause. Where in your practice could a few empty minutes become something useful?