Wait times for appointments are difficult to define and therefore measure for improvement because providers use internal metrics rather than patient estimates of how long they have waited, according to The Wall Street Journal. "Any waiting-time measure can be thwarted or misrepresented," Michael Davies, an internist and acting director of high reliability systems and consultation at the U.S. Department of Veterans Affairs, said in the article. For example, a general practitioner might refer a patient to a mental health specialist, but the patient waits a few days to schedule an appointment because she is reluctant to call; those few days may or may not be counted to the average wait time. Anne-Marie Audet, vice president for health-system quality and efficiency at the Commonwealth Fund, recommends that providers ask patients how long they have waited, which can be very different from providers' perceptions. Article