{"id":273,"date":"2026-08-24T11:51:01","date_gmt":"2026-08-24T11:51:01","guid":{"rendered":"https:\/\/doctors108.com\/articles\/?p=273"},"modified":"2026-08-30T17:37:40","modified_gmt":"2026-08-30T17:37:40","slug":"reducing-wait-times-small-changes-big-patient-satisfaction","status":"publish","type":"post","link":"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/","title":{"rendered":"Reducing Wait Times: Small Changes, Big Patient Satisfaction"},"content":{"rendered":"\n<h1 id=\"reducing-wait-times-small-changes-big-patient-satisfaction-gains\" class=\"wp-block-heading\"><strong>Reducing Wait Times: Small Changes, Big Patient Satisfaction Gains<\/strong><\/h1>\n\n\n\n<p class=\"wp-block-paragraph\">Most physicians underestimate how much wait times matter. According to a survey from <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/cdscos-new-software-as-a-medical-device-rules-explained\/\">Software<\/a> Advice, nearly two-thirds of doctors believe wait times have \u201cno impact\u201d or only \u201cminimal impact\u201d on their ability to retain <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/can-doctors-refuse-to-treat-abusive-patients-the-real-answer\/\">patients<\/a>. The data tells a very different story. Wait time \u2014 both the time it takes to get an appointment and the minutes spent in the waiting room once there \u2014 is one of the most consistently documented drivers of patient <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/how-to-build-a-patient-referral-network\/\">satisfaction<\/a>, loyalty, and even perceived quality of care. The encouraging part is that meaningful improvement rarely requires a full operational overhaul; it usually comes from a handful of targeted, well-understood fixes.<\/p>\n\n\n\n<nav aria-label=\"Table of Contents\" class=\"wp-block-table-of-contents\"><ol><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#reducing-wait-times-small-changes-big-patient-satisfaction-gains\">Reducing Wait Times: Small Changes, Big Patient Satisfaction Gains<\/a><ol><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#what-the-data-actually-shows\">What the Data Actually Shows<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#where-wait-time-problems-usually-come-from\">Where Wait Time Problems Usually Come From<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#fixes-that-actually-move-the-needle\">Fixes That Actually Move the Needle<\/a><ol><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#1-redesign-the-scheduling-template-around-real-visit-lengths\">1. Redesign the Scheduling Template Around Real Visit Lengths<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#2-separate-phone-handling-from-check-in-duties\">2. Separate Phone Handling From Check-In Duties<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#3-use-automated-waitlists-to-fill-earlier-openings\">3. Use Automated Waitlists to Fill Earlier Openings<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#4-communicate-proactively-when-delays-happen\">4. Communicate Proactively When Delays Happen<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#5-route-appropriate-visits-to-telehealth\">5. Route Appropriate Visits to Telehealth<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#6-use-digital-check-in-and-portals-to-cut-front-desk-time\">6. Use Digital Check-In and Portals to Cut Front-Desk Time<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#7-track-both-time-to-appointment-and-in-office-wait-separately\">7. Track Both Time-to-Appointment and In-Office Wait Separately<\/a><\/li><\/ol><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#the-business-case-not-just-the-patient-experience-case\">The Business Case, Not Just the Patient Experience Case<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#realistic-expectations-for-improvement\">Realistic Expectations for Improvement<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#frequently-asked-questions\">Frequently Asked Questions<\/a><ol><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#what-s-considered-an-acceptable-in-office-wait-time\">What&#8217;s considered an acceptable in-office wait time?<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#does-reducing-wait-times-actually-increase-how-many-patients-recommend-the-practice\">Does reducing wait times actually increase how many patients recommend the practice?<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#is-overbooking-ever-a-reasonable-strategy-given-no-show-rates\">Is overbooking ever a reasonable strategy given no-show rates?<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#should-new-patients-be-scheduled-differently-than-returning-patients\">Should new patients be scheduled differently than returning patients?<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#how-much-can-technology-alone-fix-wait-time-problems\">How much can technology alone fix wait time problems?<\/a><\/li><\/ol><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#research-sources\">Research Sources<\/a><\/li><li><a class=\"wp-block-table-of-contents__entry\" href=\"https:\/\/doctors108.com\/articles\/for-doctors\/reducing-wait-times-small-changes-big-patient-satisfaction\/#disclaimer\">Disclaimer<\/a><\/li><\/ol><\/li><\/ol><\/nav>\n\n\n\n<h2 id=\"what-the-data-actually-shows\" class=\"wp-block-heading\"><strong>What the Data Actually Shows<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The relationship between wait time and satisfaction is not subtle. Research on outpatient clinics found that patients who waited less than 10 minutes had about a 77% chance of giving the highest possible satisfaction score, but that figure dropped to 53% once total waiting reached 60 minutes. A separate large ambulatory study covering over 11,000 survey responses across 44 clinics found that longer wait times were associated with lower satisfaction not just with the wait itself, but with the perceived quality of care and confidence in the provider \u2014 a finding that held true even when the clinical outcome was identical.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There&#8217;s a fairly consistent <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/pf-and-esi-compliance-for-clinic-and-hospital-staff\/\">threshold<\/a> where satisfaction begins to drop sharply: research points to somewhere around 19 to 22 minutes as the point where dissatisfaction accelerates, and one analysis found that patients who wait 60 or more minutes are 24 percentage points less likely to recommend the facility, regardless of the clinical quality they received. Separately, 97% of patients have reported frustration about waiting too long to see their doctor, and negative comments about long waits are linked to a 7.8 times higher likelihood of a patient becoming a passive or actively negative reviewer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The pre-visit wait matters too. The average U.S. patient now waits around 31 days for a new-patient appointment across major specialties in large metro areas, a figure that has been trending upward. Combined with a long in-office wait once the patient finally arrives, this creates a compounding frustration: a patient who waited a month for the appointment, then sits in the waiting room for another 30 to 45 minutes, is far less likely to remain loyal to the practice than the actual clinical care would suggest they should be.<\/p>\n\n\n\n<h2 id=\"where-wait-time-problems-usually-come-from\" class=\"wp-block-heading\"><strong>Where Wait Time Problems Usually Come From<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Long wait times are rarely caused by a single failure \u2014 they typically stem from a combination of <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/why-online-booking-isnt-optional-for-clinics\/\">scheduling<\/a> design flaws, <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/front-desk-is-your-first-impression\/\">front desk<\/a> bottlenecks, and workflow inefficiencies that compound throughout the day rather than one isolated bad decision.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Overbooked schedules: intentionally double-booking to hedge against no-shows can protect revenue on paper, but when most patients do show up as scheduled, providers fall behind within the first few hours of the day.<\/li>\n\n\n\n<li>Front desk understaffing: when the same staff member is juggling check-ins, phone calls, and <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/professional-indemnity-insurance-why-doctors-need-it\/\">insurance<\/a> <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/mandatory-nmr-registration-what-doctors-need-to-do-now\/\">verification<\/a> simultaneously, delays compound at the very first touchpoint of the visit.<\/li>\n\n\n\n<li>Poor visibility into daily <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/informed-consent-in-india-what-makes-it-legally-valid\/\">capacity<\/a>: overlapping appointments or a lack of real-time insight into how the schedule is actually tracking creates bottlenecks that aren&#8217;t caught until they&#8217;ve already caused a backup.<\/li>\n\n\n\n<li>No differentiation between visit types: treating a 10-minute follow-up and a 45-minute new-patient workup as interchangeable in the schedule template guarantees some days run over.<\/li>\n<\/ul>\n\n\n\n<h2 id=\"fixes-that-actually-move-the-needle\" class=\"wp-block-heading\"><strong>Fixes That Actually Move the Needle<\/strong><\/h2>\n\n\n\n<h3 id=\"1-redesign-the-scheduling-template-around-real-visit-lengths\" class=\"wp-block-heading\"><strong>1. Redesign the Scheduling Template Around Real Visit Lengths<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Rather than a uniform appointment slot for every visit type, building schedule templates around actual, historically observed visit durations for different appointment reasons reduces the compounding delay that happens when a 15-minute slot consistently needs 25 minutes.<\/p>\n\n\n\n<h3 id=\"2-separate-phone-handling-from-check-in-duties\" class=\"wp-block-heading\"><strong>2. Separate Phone Handling From Check-In Duties<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">One of the most commonly cited, easily fixable bottlenecks is a single staff member trying to answer phones, check patients in, and handle insurance questions all at once. Delegating these to different roles \u2014 even informally during peak hours \u2014 removes a major source of front-desk-driven delay.<\/p>\n\n\n\n<h3 id=\"3-use-automated-waitlists-to-fill-earlier-openings\" class=\"wp-block-heading\"><strong>3. Use Automated Waitlists to Fill Earlier Openings<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Smart scheduling tools that automatically offer earlier openings to waitlisted patients can advance appointments by <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/the-mtp-act-whats-legal-whats-not-in-2026\/\">weeks<\/a> in some cases, improving access without requiring the practice to add providers or hours.<\/p>\n\n\n\n<h3 id=\"4-communicate-proactively-when-delays-happen\" class=\"wp-block-heading\"><strong>4. Communicate Proactively When Delays Happen<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">When patients know what to expect, perceived wait time drops even if the actual wait doesn&#8217;t change. A brief, honest update \u2014 \u201cthe doctor is running about 15 minutes behind, thank you for your patience\u201d \u2014 measurably improves how a delay is experienced, compared to leaving patients to wonder in silence.<\/p>\n\n\n\n<h3 id=\"5-route-appropriate-visits-to-telehealth\" class=\"wp-block-heading\"><strong>5. Route Appropriate Visits to Telehealth<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Routine check-ins, medication refills, and certain follow-ups don&#8217;t require an in-person visit, and shifting them to <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/why-patients-are-choosing-telehealth\/\">telehealth<\/a> where clinically appropriate frees up in-person slots for patients who genuinely need a physical exam \u2014 reducing pressure on the in-office schedule overall.<\/p>\n\n\n\n<h3 id=\"6-use-digital-check-in-and-portals-to-cut-front-desk-time\" class=\"wp-block-heading\"><strong>6. Use Digital Check-In and Portals to Cut Front-Desk Time<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Letting patients complete intake forms, verify insurance, and check in digitally before arrival reduces the time-consuming manual steps that otherwise happen at the desk, and has been associated with modest reductions in no-show rates as an added benefit.<\/p>\n\n\n\n<h3 id=\"7-track-both-time-to-appointment-and-in-office-wait-separately\" class=\"wp-block-heading\"><strong>7. Track Both Time-to-Appointment and In-Office Wait Separately<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Many practices track one of these metrics but not both, even though total perceived waiting time \u2014 the combination of how long it took to get the appointment and how long the patient then sat in the waiting room \u2014 is what actually shapes overall satisfaction. Measuring both separately makes it possible to diagnose which stage needs attention.<\/p>\n\n\n\n<h2 id=\"the-business-case-not-just-the-patient-experience-case\" class=\"wp-block-heading\"><strong>The Business Case, Not Just the Patient Experience Case<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Reducing wait times isn&#8217;t purely a courtesy \u2014 it has a measurable operational and financial dimension. Automated appointment <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/7-ways-to-reduce-no-shows\/\">reminders<\/a>, often paired with the same scheduling systems used to reduce wait times, have been linked to no-show reductions of up to 78% in some implementations. And because dissatisfaction with wait times is one of the more common reasons patients switch providers, addressing it proactively is directly tied to patient <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/medical-records-retention-how-long-clinics-must-keep-files\/\">retention<\/a>, not just same-day comfort.<\/p>\n\n\n\n<h2 id=\"realistic-expectations-for-improvement\" class=\"wp-block-heading\"><strong>Realistic Expectations for Improvement<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Industry polling suggests meaningful progress is achievable without radical change: one 2026 poll found 77% of practice leaders reported improved or at least consistent wait times, attributing the gains to better staffing decisions, schedule redesign, and updated scheduling systems \u2014 not, in most cases, a wholesale reinvention of how the practice operates.<\/p>\n\n\n\n<h2 id=\"frequently-asked-questions\" class=\"wp-block-heading\"><strong>Frequently Asked Questions<\/strong><\/h2>\n\n\n\n<h3 id=\"what-s-considered-an-acceptable-in-office-wait-time\" class=\"wp-block-heading\"><strong>What&#8217;s considered an acceptable in-office wait time?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Research suggests satisfaction begins declining meaningfully once waits exceed roughly 20 minutes, with a steeper drop-off after 60 minutes. Aiming to keep the large majority of visits under that 20-minute threshold is a reasonable benchmark for most practices.<\/p>\n\n\n\n<h3 id=\"does-reducing-wait-times-actually-increase-how-many-patients-recommend-the-practice\" class=\"wp-block-heading\"><strong>Does reducing wait times actually increase how many patients recommend the practice?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/e-prescriptions-in-india-are-they-legally-valid\/\">evidence<\/a> is mixed on this specific outcome \u2014 one study found that reducing wait times improved satisfaction but did not meaningfully change how likely patients were to recommend the practice to others, suggesting wait time is one factor among several that drive <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/why-referrals-dry-up-without-abdm-integration\/\">referral<\/a> behavior, not the sole determinant.<\/p>\n\n\n\n<h3 id=\"is-overbooking-ever-a-reasonable-strategy-given-no-show-rates\" class=\"wp-block-heading\"><strong>Is overbooking ever a reasonable strategy given no-show rates?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It can help offset expected no-shows, but it carries real risk: if more patients show up than anticipated, the practice can fall behind within the first few hours of the day, ultimately creating the same wait-time dissatisfaction it was meant to protect against. Using no-show-reduction strategies (reminders, easy rescheduling) alongside conservative overbooking tends to work better than relying on overbooking alone.<\/p>\n\n\n\n<h3 id=\"should-new-patients-be-scheduled-differently-than-returning-patients\" class=\"wp-block-heading\"><strong>Should new patients be scheduled differently than returning patients?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Generally yes \u2014 new patients tend to require more time and are more sensitive to delays, making a poor first impression particularly costly. Building extra buffer into new-patient visit templates, specifically, is a commonly recommended practice.<\/p>\n\n\n\n<h3 id=\"how-much-can-technology-alone-fix-wait-time-problems\" class=\"wp-block-heading\"><strong>How much can technology alone fix wait time problems?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Technology (digital check-in, automated waitlists, scheduling software) can meaningfully help, but research indicates it fails without organizational adoption \u2014 rolling out new tools with minimal staff <a href=\"https:\/\/doctors108.com\/articles\/for-doctors\/telemedicine-guidelines-2020-what-doctors-can-do-online\/\">training<\/a> tends to result in staff reverting to old processes and wait times remaining unchanged.<\/p>\n\n\n\n<h2 id=\"research-sources\" class=\"wp-block-heading\"><strong>Research Sources<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Mobius MD <\/strong>\u2014 Doctors: Patient Wait Times Are a Bigger Problem Than You Think \u2014 <em><a href=\"https:\/\/www.mobius.md\/blog\/patient-wait-times-are-a-bigger-problem-than-you-think\">https:\/\/www.mobius.md\/blog\/patient-wait-times-are-a-bigger-problem-than-you-think<\/a><\/em><\/li>\n\n\n\n<li><strong>MedLaunch <\/strong>\u2014 10 Key Patient Wait Time Statistics Clinics Can&#8217;t Ignore \u2014 <em><a href=\"https:\/\/medlaunch.health\/blogs\/medical-insights\/patient-wait-time-statistics\/\">https:\/\/medlaunch.health\/blogs\/medical-insights\/patient-wait-time-statistics\/<\/a><\/em><\/li>\n\n\n\n<li><strong>MedLaunch<\/strong> \u2014 7 Strategies to Reduce Patient Wait Times and Enhance Care \u2014 <em><a href=\"https:\/\/medlaunch.health\/blogs\/patient-care\/reduce-patient-wait-times\/\">https:\/\/medlaunch.health\/blogs\/patient-care\/reduce-patient-wait-times\/<\/a><\/em><\/li>\n\n\n\n<li><strong>AJMC<\/strong> \u2014 Wait Times, Patient Satisfaction Scores, and the Perception of Care \u2014 <em><a href=\"https:\/\/www.ajmc.com\/view\/wait-times-patient-satisfaction-scores-and-the-perception-of-care\">https:\/\/www.ajmc.com\/view\/wait-times-patient-satisfaction-scores-and-the-perception-of-care<\/a><\/em><\/li>\n\n\n\n<li><strong>Phreesia <\/strong>\u2014 Infographic: The High Cost of Long Patient Wait Times \u2014 <em><a href=\"https:\/\/www.phreesia.com\/insights\/infographic-the-high-cost-of-long-wait-times\/\">https:\/\/www.phreesia.com\/insights\/infographic-the-high-cost-of-long-wait-times\/<\/a><\/em><\/li>\n\n\n\n<li><strong>Glenwood Systems<\/strong> \u2014 Championing the Fight Against Long Patient Wait Times \u2014 <em><a href=\"https:\/\/www.glenwoodsystems.com\/post\/fight-against-long-wait-times\">https:\/\/www.glenwoodsystems.com\/post\/fight-against-long-wait-times<\/a><\/em><\/li>\n<\/ol>\n\n\n\n<h2 id=\"disclaimer\" class=\"wp-block-heading\"><strong>Disclaimer<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>This article is for general informational and educational purposes only and does not constitute operational, clinical, or legal advice. Scheduling and workflow changes should be evaluated against each practice&#8217;s specific patient volume, staffing, and specialty before implementation.<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Most physicians underestimate how much wait times matter. According to a survey from Software Advice, nearly two-thirds of doctors believe wait times have \u201cno impact\u201d or only \u201cminimal impact\u201d on their ability to retain patients. <\/p>\n","protected":false},"author":1,"featured_media":274,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"advanced_seo_description":"Most physicians underestimate how much wait times matter. According to a survey from Software Advice, nearly two-thirds of doctors believe wait times have \u201cno impact\u201d or only \u201cminimal impact\u201d on their ability to retain patients. 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