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Doctor visits too short, too rushed

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World News in Nursing Report ran an article about celebrating an increase in the average time doctors saw patients.  The increase was for 32 seconds longer.  That was in 2007.  The article was in response to consumer complaints that began at least as far back as 1995 that doctor visits were too short.  Even back then most consumers saw their doctors for somewhere between 11 to 30 minutes (36.1 percent at 11-15 minutes and 36.8 percent at 16-30 minutes) and unsurprisingly even in 1995 almost 3 percent of consumers saw their physicians for between 1-5 minutes and another 17.4 percent saw their doctor for only 6-10 minutes.  The fact is that today it’s not unusual to run into doctors who are scheduled at 15-minute intervals or for physicians in hospitals to see a patient every 11 minutes.

Time is money.  That’s the primary reason driving the need for more patients and shorter visits.  Non-specialists receive pay for visits rather than for procedures.  In addition, new insurance plans through the health law’s exchanges often pay less, offering instead to provide more patients.  More patients often translates into patients who have had to wait months to see a doctor coming armed with more than one problem to discuss.

According to this article, the crunch came in 1992 when Medicare adopted a formula to calculate doctor’s fees that was supposed to rein in runaway inflation and widespread inequities.  The American Medical Association guidelines suggested a 15-minute consult.  Then doctors in managed care received discounted prices from insurers.  To avoid cuts, doctors increased the number of patients they saw in an hour.  The result is that Americans are seeing the doctor more times a year and ending up in the ER more often.

But it goes beyond that.  Twenty years ago, 70 percent of office visits lasted 15 minutes or less.  In 2010, only 50 percent were that short according to the National Ambulatory Medical Care Survey.  So if patients are actually seeing doctors for longer periods, why do they feel short-shifted?  At least part of the reason lies in the fact that in 1999, doctors let patients speak for 23 seconds before redirecting the patient.  Only a quarter of the patients were ever able to complete a statement.  By 2001, another study found that doctors interrupted patients after 12 seconds.

The doctor-patient relationship plays an important role in changing behavioral patterns.  Patients that feel comfortable with their doctor are more likely to disclose important information that can contribute to their care and are more likely to comprehend information clearly.

So, what’s the takeaway?  You can go looking for a physician who is: able to give you more than 15 minutes of his or her time; willing to let you actively participate in your own care by listening to and respecting your input; and doesn’t require you to set up appointments months (and months) in advance. Or you can hire a private pay physician and get those things as part of the service.  For more information on private pay physicians please read this article on concierge medicine.

Remember, your health is your most important asset.  If caring for your asset means finding the right professional to care for you, don’t you think you’re worth it?

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