Recently, a social media post bewailed the long waits in doctors’ offices, which in turn elicited more of the same complaints. These posts explicitly slammed doctors in general for their misery and anguish in lining up for doctors’ consultations while claiming they are entitled to better treatment.

Unfortunately for us, we have one of the lowest doctor-patient ratios in Southeast Asia. The national average is 3.7-5 doctors per 10,000 people, which is far from the ideal 10 doctors per 10,000 population, no thanks to brain drain. That in itself will translate into long queues for medical care, no matter how you juggle it.

In the Metro Manila area, the ratio is far better at 10.9 doctors per 10,000 population. But obviously, this doesn’t automatically translate to shorter waits or easier access. Other factors are operating in this situation.

Unlike other countries with socialized medical care, where patients often see generalist physicians who evaluate their conditions before being referred to specialists or subspecialists, our situation is much more complicated. Even then, I’ve heard many friends from these countries also lamenting long waits for primary care, with one who had to wait years before being scheduled for much needed surgery.

Here, patients often go straight to specialists rather than see a general practitioner, now known as family medicine specialists. I’m often asked by friends and family about which doctor to see with their particular symptoms, and I try to direct them to the specialty I think they need to consult. It’s not really an inefficient manner of getting medical attention. But let’s find out more about how medical practice is done, at least in the Metro Manila area.

Of the many doctors practicing in the metropolis, the number one issue I often hear is the amount of time they spend in traffic when moving form one clinic to another. Doctors usually practice in multiple settings (hospitals, private clinics, online etc.), which increases the number of times they have to travel from one to another. That alone is a confounding factor that eats up many hours of the day unproductively. So, if your doctor is late for his/her clinic schedule, that is most probably the reason.

People should realize that doctors also have to make rounds on their admitted patients. The more admitted patients they have, the more time they have to spend to care for these patients who are more seriously affected by their health issues. Surgeons, OB-GYNs, eye and ENT specialists also have to devote time to their scheduled surgeries, which are often in the morning but may extend into the afternoon or evening if the OR schedule is very full.

Surgeries are never routine, as there may be findings during the procedure that will require intraoperative consultations with pathologists for rapid diagnosis (frozen sections) of the disease/tumor. In other cases, the surgery may be more complicated than anticipated and more time is spent taking care of these issues.

Definitely, a doctor’s working day is far from a walk in the park. He/she may also have family/home issues that need their attention during the day, or they may need to attend to their own persons, as well as other more mundane stuff that ordinary people do.

Many physicians also chose to work in government hospitals as a way of paying back for their education. Others also devote time to medical missions where they treat patients in underserved areas.

But let’s tackle another issue. Many patients will often ask family and friends for doctor referrals. Usually, these patients will be referred to the most popular doctor for the specialty that he/she needs to see. In that case, there are usually long waiting lines for these highly in-demand doctors, who are often more senior, have heavy caseloads, more surgeries and more admitted patients. If you’re seeing of these popular doctors, be prepared for long waits.

Do not, in any case, be surprised if your consultation will be short and the doctor will already prescribe medications, procedures or laboratory tests. Due to their extensive experience, they may not have to do extensive physical examinations to know what you need. Some patients come away from such consultations disappointed that they didn’t get their money’s worth for the time they spent waiting for their doctor, but rest assured that your doctor has your best interests at heart, and so for other patients as well.

There are many excellent younger doctors who may have fewer patients, especially those who have just started their practice and can devote more time to their patients. Our medical training institutions do a great job and many young doctors are as adept as their older peers. In some cases, especially with surgical conditions, they may have steadier hands and sharper vision. Go see them instead, rather than spending hours waiting for your doctor.