I was running behind. The clinic was overbooked, as usual. Imaging had been delayed. A post-op consult had taken longer than expected. When I finally opened the next exam room door, a patient I’d seen many times before—someone kind, patient, quietly suffering—looked up and said, “Did someone forget about me?”

It wasn’t angry. It was worse. It was a soft, honest question that landed like a gut punch. In that moment, all my surgical precision, my good intentions, my years of training—none of it mattered. She felt abandoned. And it didn’t take a catastrophic outcome to break that trust—just silence.

In healthcare, we talk about throughput, capacity, and staffing ratios. But we rarely talk about perception. That patient didn’t need me to be faster. She needed to know she hadn’t been forgotten.

The Cost of Uncertainty

Long wait times are more than an operational headache. They cost money, patients, and trust. Research consistently demonstrates that longer wait times and decreased patient satisfaction can contribute to higher no-show rates. Missed appointments cost the U.S. healthcare system an estimated $150 billion annually. Beyond the dollars, idle time in healthcare creates a psychological vacuum. When patients don’t know what’s happening, they assume nothing is—and perception becomes reality.

The Labor Illusion—What Behavioral Science Reveals

Harvard Business School professors Ryan Buell and Michael Norton describe the "labor illusion:”  customers value visible effort, even when wait times remain unchanged. When users see progress—an animation, a message, a status bar—their satisfaction rises.

Banking apps show "Verifying account details." Travel search sites declare "Searching 250+ airlines." Food delivery platforms trace your burrito from stovetop to doorstep. Games fill load screens with tutorials and storylines to engage attention.

These aren’t gimmicks. They’re UX strategies rooted in behavioral science. They turn dead time into designed time.

Healthcare’s Design Gap

Most patient portals do the opposite. After clicking "send," the interface often goes dark. No status updates. No progress bar. No communication. Just waiting…

In clinical care, these voids breed anxiety. For the patient, it's not just idle time—it's invisible care. They wonder: Did my message go through? Is anyone looking at my results? Should I follow up?

This isn't just bad UX. It's bad business. Research from Penn's Wharton School shows that improving patient experience improves retention, reduces litigation risk, and directly impacts clinical outcomes. In a marketplace increasingly defined by consumer expectations, opacity isn’t just inconvenient—it’s uncompetitive. A study of 132 Swiss acute-care hospitals revealed that better patient experience—even without operational change—was associated with increased future revenue and reduced system-wide costs. Perception matters.

Designing the Wait: A Strategic Shift

Healthcare leaders need to see the digital front door not just as a tool, but as a touchpoint. The user interface is a moment of care. And it should reflect that.

Here’s what transparency could look like:

"A nurse is reviewing your message now." "Your test results are being flagged for review." "Estimated time to reply: 2–3 hours." "Here’s what typically happens next." Furthermore, wait times are massive opportunities for patient education.

These updates can be driven by natural language processing (NLP) models that extract signal from EMR workflows, large language models that generate patient-friendly updates, and AI-powered triage systems that estimate delays and automate follow-ups.

More importantly, these technologies can adapt to patients’ language preferences, literacy levels, and even emotional tone—creating a digitally mediated but deeply human connection.

Making Invisible Work Visible

Other sectors figured this out long ago. Uber doesn’t make rides faster—it makes waiting feel shorter. Amazon shows package progress not to improve delivery, but to reduce buyer anxiety. In both cases, transparency builds trust.

Healthcare’s trust problem isn’t about competence. It’s about silence.

A recent McKinsey survey shows that 40% of patients who switch physicians do so not because of poor outcomes, but because of poor experience. Showing the work behind the scenes can curb that churn.

The Business Case: Low-Cost, High-Return

These are not expensive changes. They require no operating room renovation, no new capital expenditures. They are digital overlays on existing infrastructure. The payoff, however, is real:

●  Reduced no-show rates through better communication.

●  Increased patient loyalty via improved experience.

●  Enhanced clinician efficiency by automating routine updates.

●  Stronger brand trust in a noisy competitive landscape.

If You Can’t Eliminate the Wait, Design It

We may never fully eliminate delays in healthcare. But we can—and must—better design how waiting feels to the patient.

That starts with leadership. With seeing perception not as fluff, but as function. With recognizing that the human experience of care doesn’t begin in the operating room—it begins in the waiting room, the inbox, the app.

Because patients don’t leave when they wait. They leave when they feel forgotten.

And we now have the tools to make sure they never do.

By Michael M. Karch, MD | Mammoth Orthopedic Institute | Harvard Business Analytics Program | MIT Executive Machine Learning Program