I work in an Heme/onc clinic and scheduling is a nightmare for us. I don't know where all our hang-ups are and my job is always at the tail end, so the lateness shows up the worst for us. Our patients usually have several "appointments" not just one. For example, 99% go to lab first, then most see MD, then a lot come back to the infusion area for a treatment or an injection. Some see the Coag nurse or the Social Worker. We also have a CT scanner and a CXR machine they may be scheduled for. Rarely does a patient visit all of these slots, but most have at least two (lab + something else), and often three different stops.
Now the patient is only see one time on their card. They may not realize they are scheduled in chemo at 10:15, because their card says 9:30 (the lab time.). Now if they get back to our waiting room at 9:45 and have to wait 15 minutes, they'll complain, even though technically, they aren't late for us. (We take patients on a first come first served basis, so if we can take them early we will.)
Usually I explain to patients that scheduling for us is very complicated, that at most Dr.'s offices, you have one appointment to see the MD only. For us, there are lots of moving parts and there are lots of kinks. The patients usually understand, but not always. And a lot of times they have a right to be mad. We get frustrated as well.
The coag nurse was telling me about a patient who was always an hour or more late. She finally said something to him about it and suggested he reschedule his appointment times. He said, "Well, it never seems to be a problem, you always get me in", to which she responded, "Well when you show up at 11:45, I don't get a lunch that day.". He rescheduled his appointments. Sometimes, just explaining the issue to the patients is enough.
Another problem we have is lunch. The chemo area is not supposed to have anyone scheduled between 11:00 and 1:00 because we take lunch. The nurses go to lunch in shifts and give report on their patients to other nurses. It is very difficult to start a patient during lunch in that it is time consuming and doesn't allow for you to do anything else, when you are already responsible for twice as many patients as usual.
However, if the Dr. sees the patient at 10:45, guess what time they are coming back to see us? Right during lunch. The appt desk will put "sorry, only time for MD" on the memo line, but id doesn't really help, make us feel better.
It really isn't the appointment desk people's fault, they are just worker bees. The system is just very broken.