If you're reading this story in a doctor's office, there's a good chance that you're waiting. And waiting. And waiting. It's Monday, the day your doctor's waiting room is likely to be backed up worse than the Cross Bronx Expressway at rush hour.

In addition to scheduled patients, there will be folks who got sick over the weekend. There will be voice mails that came in on Saturday and Sunday from patients, hospitals and other physicians that need to be answered.

It was a recent Monday afternoon when an irritated Record reader called after waiting three hours to see a specialist. She wanted to understand why physicians don't seem to value patients' time.

"I have a life, too," she said in exasperation. "I have a job. I have to pick up my kids at school."

After all, time is money. A recent study by the National Cancer Institute, focused only on new cancer patients, found that $2.3 billion in wages are lost annually in waiting rooms at doctors' offices and hospitals.

And there is no prospect for improvement. Because medical insurance carriers keep lowering reimbursements while piling on paperwork and rules, a doctor's practice can't stay afloat unless it schedules as many patients as possible -- even if that means chronically running late.

Local physicians say they share their patients' frustration.

"When patients are waiting, I'm not playing video games or making personal calls," said Wayne internist Laurie Nahum, president of the Passaic County Medical Society and chief of medicine at Chilton Memorial Hospital.

"I'm busy with patients and phone calls, charting and lab results. If you spent a day in my office, you'd understand why I swear I need roller skates."

Some additional factors responsible for long waits:

Scheduling mess-ups

Medical staffers allot, say, 10 minutes for a blood-pressure check and 45 for a full physical. However, things don't always work out as planned.

For instance, a parent makes an appointment for one child but brings along siblings to see the doctor as well. "If you have five of those, you're behind an hour," said Dr. Scott Zucker, a pediatrician and president of the Bergen County Medical Society.

Or a patient schedules a short visit for something minor, only to reveal additional concerns toward the end of the exam that need attention.

Also, many specialists often need longer times with each patient.

"Endocrine management is quite complex, and six minutes per patient doesn't work," said Dr. Jack Tohme, head of endocrinology at The Valley Hospital and past president of its medical staff.

Personal style

Doctors with the best bedside manners usually have the worst waiting-room backlogs.

A recent Wake Forest University survey revealed that most people are willing to make that trade-off, tolerating a longer wait to see an unhurried physician.

"If a patient is upset because her husband just left her and she's crying, I can't say, 'Your time is up, goodbye,' " said Nahum.

Emergencies

"I understand that patients get annoyed when they have an appointment and you're squeezing in people who are not feeling well," said Nahum. "But they have to understand that you can't predict or limit emergency visits."

Zucker said that's doubly true for pediatricians. "We can't put off children if the parents want to bring them in," he said.

Interruptions

"When a hospital or pharmacy calls with a question about a patient, I can't call them back later," said Nahum. "Other doctors call for consults, family members call with concerns. Sometimes I have to spend an hour on the phone with a patient's health-insurance carrier. You have no control over all these interruptions."

Personnel issues

When a group medical practice loses an associate -- a common situation -- the remaining physicians are left with a larger patient load until a new doctor is hired.

Population explosion

"Twenty years ago, people went to doctors when they were ill," said Tohme. "Today you go to doctors, especially specialists, because [a practitioner] found something in a general checkup. Preventive medicine is great, but it's moved everybody to the doctor's office."

On the not-so-positive side, he added, "The pharmaceutical industry is turning everyone into patients. People want to know about the drug they saw in an ad."

Zucker cited co-pays as another reason for increased volume.

"In the old days, patients had to pay the whole bill at the end of the visit," he said. "Now they pay $10 or $20, so they're more likely to come in even if an office visit isn't really necessary. Our facilities are being overutilized, but we're not in a position to tell people they can't come in."

Some physicians throughout the country are starting to give beepers to scheduled patients, so that instead of waiting in the office, they can be beeped several minutes ahead of the time they actually will be seen. Others are trying to ease the crunch with improved office-management techniques.

But given the unpredictability of a physician's daily schedule, the situation isn't likely to improve anytime soon.

"I'm stressed out over long waiting times as much as my patients are, but the solution is not so easy," said Tohme. "Most of the time it is not about money, or lack of respect, but about trying to cope with realities of a modern health-care system that has become very demanding and trying for patient and doctor alike."

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By Abigail Leichman Staff Writer