Med: The Time Crunch

January 14, 2008

What are two of the biggest complaints people have about their doctor?

1) They don’t spend enough time with the patient

or

2) The wait time was too long

I’ve experienced both, and they are both quite disheartening. But as you’ve probably noticed (at least I have), you’ll never experience both with the same doctor. Not too often anyway. And as I’m sure you’ve been able to piece together, these two are directly connected.

This is one of the most fundamental problems with the health care system (I wanted to use “quintessential,” but first I would like to see everyone have health insurance–CRAZY LIBERAL KURZ IS BACK!).

Primary care physicians are the lowest-compensated physicians around; yet, it is their responsibility to know the patient the best and be their advocate to the other “non-personal” specialties. So on the one hand, you have physicians that need to take a lot of time with their patients. On the other hand, the low compensation means you really need to work to cram in as many patients as possible to be able to make even a fraction of the amount Mr. Cardiologist is going to pull in this year.

The “specialty vs. primary care” debate is worthy of more than just a fleeting reference in this post, and I will try to address that in the future. My point in this post is to explore the counterintuitive fact of medicine: primary-care physicians are the most “people-oriented” of doctors and yet they are pressured to suppress this desire . The result? Extended wait times.

This is clearly evident in the family medicine clinic at which I’m working. My preceptor/mentor is absolutely ADORED by her patients. Why? Because she spends a great deal of time with each one. The tradeoff is, of course, that we get behind schedule every day and her patients have to wait. They’ve learned to deal with it because they like the care; otherwise, they can just go somewhere else. But there we were today, still in the exam rooms seeing patients at 6:30pm because the schedule got delayed. It can be frustrating–and I’m just the useless student! 🙂

Though I was a bit annoyed with a patient today–as was our whole office. He calls around 2pm to say he has an appt., but when the nurses check they say he does not (And really, who calls to say “i have one.” He knew damn well he didn’t). Well, my preceptor agreed to see him anyways–she is a wonderful doctor–but it would have to be at the end of the day. Fast forward a few hours…this same guy is sitting in an exam room getting pretty pissed off (and voicing as much to anyone with an ear) about his wait time. ARE YOU KIDDING ME? You call the office, complain your way to a sympathy appointment, and have the nerve to complain about the slow service? And you just know that these are the same people that complain to all the media outlets and lead to random articles entitled, “Why is my doctor so slow?” or garbage like that.Unbelievable.

Rant over. Have a good night friends.

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