The Currency of Time: Easy Access to Care isn’t Enough to Earn Patient Loyalty
By William R. England, Ph.D., Strategic Advisor—Research, NRC Health
nSight
The Currency of Time: Easy Access to Care isn’t Enough to Earn Patient Loyalty
By William R. England, Ph.D., Strategic Advisor—Research, NRC Health
If you’ve ever been told that the next available appointment with a specialist for someone you love is months away, you know that time has value in healthcare.
And if you’ve waited for hours in an ER waiting room before being seen, you know the passage of time can be (sometimes literally) painful.
But in healthcare, time isn’t just measured in speedy access or lengthy delays. It’s also measured by how well time is spent once care begins. Did someone listen to you carefully? Did you understand the diagnosis? Did you leave feeling confident about what comes next?
For years, healthcare has invested heavily in reducing friction and improving access—with notable success, as we will show. But timely access alone does not ensure loyalty.
The challenge is not just getting patients in faster. It is making sure the time they spend in your care is worthwhile.
This nSight introduces the Currency of Time framework, which explores the idea that people often evaluate healthcare in two ways related to time: “time saved” and “time well spent.”
Key Findings
- Healthcare has improved in saving patients’ time accessing care, yet many consumers still face barriers.
- Only 37% of Gen Z and Millennial consumers reported no access challenges in the past year, compared with 59% of older consumers.
- Confidence/trust, understanding/clarity, and reassurance/continuity show the strongest relationships with loyalty (LTR).
- Patients tolerate isolated friction before a visit but become far less forgiving when breakdowns occur across multiple stages of care.
- High-performing organizations do more than save time; they make the time patients spend in their care meaningful.
What is the Currency of Time?
Time is among the most personal and finite resources patients and families possess. In healthcare, it shapes experiences long before a patient arrives and long after the visit ends.
In The Experience Economy, the authors argue that people increasingly judge services not just by their convenience or efficiency, but by the value created through the experience itself.
The Currency of Time framework applies this lens to healthcare through two dimensions: “time saved” and “time well spent.”
- Time saved – reflects whether organizations respect people’s time by offering accessible, convenient, and timely care.
- Time well spent – reflects what happens once care begins: whether patients feel heard, feel informed, are confident in their care, and are clear about what comes next.
Organizations that excel do both. They reduce friction before care and use the time they have with patients to build confidence, understanding, and trust (i.e., they curate experiences that foster loyalty among patients and consumers before, during, and after a visit).
Organizations that fall short risk treating timely access as the destination rather than the starting point and thus risk overlooking how repeated breakdowns across the care journey can quickly erode loyalty.
Is Healthcare Getting Better at Saving Patients' Time?
It depends on who you ask. Since 2019, NRC Health patient experience data (n ~ 67.1 million) show steady improvements in appointment availability, scheduling ease, wait times, and procedures/tests starting on time across all care settings.
Medical practice and outpatient settings saw some of the strongest gains, while inpatient and emergency care continue to lag, despite post-Covid improvement. Younger patients also reported less favorable timeliness experiences, particularly in ambulatory and emergency settings.
Yet from a consumer perspective, access remains a challenge for many people.
So far, in 2026, NRC Health’s Market Insights data shows that 59% of older consumers (n = 78,565) reported no access barriers for healthcare in the past year, compared with just 37% of Gen Z and Millennials (n = 47,725).
Younger consumers report having much greater difficulty accessing nearly every type of care and often expect care much sooner. For routine, specialty, and chronic care, younger respondents are more likely to expect access within one week.
Combining these datasets tells a compelling story. Consumers describe the experience of trying to access care, while patients describe the experience after receiving it. Healthcare may be getting better at saving time once patients enter the system, even as many consumers, especially younger ones, struggle with accessing it in the first place. Younger consumers also expect faster access, potentially raising the bar for what constitutes a timely experience.
Are Efficiency and Human Connection Competing Priorities?
They tend to rise together, but they are not interchangeable. Across NRC Health customers, organizations that performed well on time saved questions also tended to perform well on questions related to time well spent. Nearly half the variation in time well spent was associated with performance on measures of time saved (R² = 0.47).
The relationship was also nonlinear (see: About the Data). Organizations that struggled with time saved almost universally struggled to deliver strong interpersonal experiences. However, among higher-performing organizations, additional gains in time saved translated into comparatively modest improvements in time well spent.
In other words, operational efficiency alone does not guarantee a meaningful experience. There appears to be an inflection point, where easy access simply creates the opportunity to provide care. What organizations do with that opportunity is what ultimately sets them apart.
What Makes Patients Loyal Once They Enter Care?
When multiple aspects of a patient experience were modeled simultaneously, confidence/trust and understanding/clarity showed the strongest associations with loyalty. Reassurance after the visit and communication during the visit remained important, while timeliness/access before the visit had a much smaller effect on someone’s likelihood to recommend.
This doesn’t mean timeliness is unimportant. Patients certainly notice when organizations (dis)respect their time. But the findings reiterate that timely access may be the price of admission, but loyalty depends on whether patients leave feeling heard, informed, confident, and reassured about what comes next.
But experiences (even exceptional ones) occur within a larger care journey. So, how much friction are patients willing to tolerate before loyalty begins to erode?
Patients Are Less Likely to Forgive Repeated Breakdowns
The clearest illustration came from examining friction across the care journey. The topline finding was this: patients tolerate isolated problems, but don’t tolerate repeated failures.
Friction encountered
Likelihood to recommend (LTR)
No friction (top-box on all questions)
98%
Before the visit only
95%
Before + during the visit
79%
Across the full journey (before, during, after)
58%
Loyalty declined slightly when just one issue with access arose, then declined dramatically once problems extended into the care experience itself, and even further when they persisted after care.
Patients seem to understand that healthcare is complicated, and systems are imperfect. But they are less willing to forgive repeated failures that undermine confidence at multiple stages of an experience.
Here’s a maxim: “Respect my time. Use it wisely while I’m in your care. Help me understand what comes next.”
Recommendations for Healthcare Leaders
- Continue investing in access, and understand what it means. Consumers, especially younger ones, continue to report barriers to care. Evaluate where your consumers experience the greatest friction and prioritize improvement efforts accordingly.
- Measure more than efficiency. Track whether patients leave informed, confident, and reassured—not just how quickly they are seen.
- Design experiences that build confidence. Focus on clarity, trust, and guidance after care. These factors have the strongest relationship to loyalty.
- Manage the entire journey, not just the encounter. Examine where friction accumulates before, during, and after care. Repeated breakdowns drive the largest drop in loyalty.
- Address generational gaps. Younger consumers report worse access and timeliness across most care settings. Closing these gaps will become increasingly important as healthcare utilization continues to evolve.
- Understand both consumer and patient perceptions of time. Combining post-visit patient feedback and consumer intelligence data provides the most comprehensive view of how easy or hard it is to access healthcare when needed.
The Bottom Line
Healthcare has made good progress toward respecting patients’ time. Patients are increasingly reporting more timely experiences once they seek care, even as many consumers continue to encounter barriers to getting seen in the first place.
The challenge, then, is not simply one of getting people through the door faster. The organizations that thrive are those that pair efficiency with great experiences by building confidence, clarity, and connection across the care journey. Patients may recall how long they waited. But they are even more likely to make future choices based on whether the time they spent in your care felt worthwhile.
About the Data
This analysis combines information from tens of thousands of NRC Health syndicated Market Insights consumer surveys with millions of patients’ worth of experience data, collected across NRC Health partner organizations since 2019, providing both the consumer perspective on obtaining care and a patient perspective on receiving it.
Questions were grouped into two overarching domains reflecting the Currency of Time framework. Time saved captured ease-of-access experiences, including appointment availability, scheduling ease, responsiveness, wait times, and whether visits, tests, or procedures began as expected. Time well spent captured what patients took away from the experience, including listening, respect, being well informed, reassurance around next steps, and confidence/trust in caregivers.
Four complementary analyses informed this nSight:
- Trend Analysis: Examined changes in timeliness and access measures across care settings and generations from 2019 to present.
- Relationship Analysis: Examined the association between time saved and time well spent across organizations. Both linear and nonlinear models were evaluated to assess whether improvements in timeliness yielded diminishing returns to time well spent. Sensitivity analyses excluding influential observations produced substantively similar findings.
- Loyalty Driver Analysis: Used multivariate logistic regression to identify which experience domains were most strongly associated with loyalty (defined as a 9 or 10 on Likelihood to Recommend) while controlling for demographic factors.
- Care Journey Friction Analysis: Examined how breakdowns, accumulating before, during, and after care, impact LTR. Before-care measures focused on access, scheduling, and wait times; during-care measures were grouped into communication, understanding, confidence, and emotional support; and after-care measures captured reassurance and continuity through discharge preparation, follow-up guidance, questions about medications, and understanding of next steps.
Together, these analyses explored how healthcare organizations are improving access and timeliness, how operational efficiency and interpersonal experience relate to one another, which aspects of an experience most strongly influence loyalty, and how friction across the care journey impacts patient perceptions.
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© NRC Health 2026