Yeah, dominicans are often late, and that is a challenge if you work with an appointment system, but sometimes the patient is the one who has to wait for the doctor. Many doctors work at multiple places, E.g., at a public hospital in the morning, and then a clinic in the afternoon. Some even work in the evening. Also they might work in multiple cities. I remember in my hometown there was no dermatologist so there was one who´d come twice a week. They´ll tell you she´d come at 2 but she often showed up at 3:30 and even later. What you do is you show up, take a number with the secretary, and then you might even have time to run a couple of errands in between.