Reply to S/o What the f do you all want from doctors?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]To be honest, I don't understand why the healthcare system cannot be reformed such that primary care doctors can spend AT LEAST ONE HOUR with a patient per year.

Lawyers make lots of money and manage to spend an hour here and there with a client, c'mon.

Of course our system is broken and our population is chronically ill and too many dying unnecessarily has something to do with the standard of care being 20 minutes/year with one's primary care physician.

Any idiot can see that there is a strong relationship between those things.[/quote]

The average primary care doctor has about 2500-3000 patients on their roster, and that's only possible if they are turning people away. People get angry when you decline to take on new patients, because "what am I supposed to do? I need a doctor!" But so do thousands of other people.

Let's say 2500 patients. One hour a year each is a total of 150,000 minutes a year. 2885 minutes a week, which is 577 minutes a workday (with 5 workdays a week). So if your doctor has a smaller than normal number of patients and spends no vacation ever, and takes no lunch break, he or she can open clinic at 8am and will close after working straight through at 6pm every day -- and there's 23 minutes available left over for using the bathroom and drinking water.

None of that includes phone calls, portal messages, or emails. And given that the average percentage of time spent on paperwork for a US physician is at least 40%, that doc will then work from 6pm until midnight on the paperwork, unless they were doing it at the computer while you were talking.

And none of that includes sick visits, or helping the family who was adamant that they are all healthy and won't take up much time because they are never sick -- until they are, and the 39 year old father has brain cancer, and the children are in trauma from it, and the 38 year old mother has clinical depression, and and and. Because those things don't happen often to one family, but spread out over 2500-3000 people, it's common enough.

What you want isn't possible under the current system, PP. It's just math. Can we design another system? Sure. That would be a great discussion. But being mad at the people trying to hold things together right now, just because they cannot make the impossible happen, is what is breaking them. They are leaving. The numbers just get harder, or you just turn more people away. [/quote]

Not all of the patient's turn up every year e.g. my 20 something kids. If they have something urgent outside of the PCP's limited hours or can't get an urgent appointment,  they end up at urgent care. I'm on my OB GYN's roster but don't have to go every year anymore. [/quote]

And some patients come every 3 months. Look you can argue all day that doctors stink and have this attitude but all it does is cause more burn out and will lead to more doctors leaving. Blaming the doctors won’t really get you anywhere- it’s a systems issue.

I know personally for me, I went to med school seriously a bleeding heart and wanting to take care of patients. I’m in primary care and I do try to listen to patients and take my time but then other patients are waiting and I get backed up. Then I have to return labs which takes time later in the day and I want to be thorough. All of this with my family life is making it so I probably have at most 5 years in this field and I also work part time. So there goes another one and we keep on leaving. [/quote]

Is being a doctor boring when you spend years working on horses day in and day out, and the zebra cases go off to specialists? I used to look at the pediatrician treating my kids for check ups, strep and ear infections over and over and wondered how they did it. [/quote]

No peds but as an internist there is still tons of variety and intellectually stimulating work ups. What is hard is the emotional labor. I just released labs to a patient with detailed explanations. Nothing super concerning. She has an appointment in 2 weeks but yet she demands and calls wants to speak to me. You can’t do this for all 80-100 patients you see in a given week. It’s just exhausting .[/quote]

I can't demand anything of my doctor or require them to pick up the phone. Can't you write "nothing super concerning, see you in two weeks".Bye bye. I'm assuming most of the other 80-100 patients aren't calling you. Is she royalty or something?

[/quote]

I literally wrote paragraphs with detailed instructions. If I don’t write it out and call then the call never happened in the patient’s mind and there’s no proof (I still have to document it too). Plus sometimes the patient doesn’t even pick up. I can see that she read the comments of her labs on my end. But still blowing up asking to explain something I wrote about already. Just exhausting [/quote]

Why did you write paragraphs when you think it's nothing urgent and you're seeing her in 2 weeks anyway. I'm lucky if the doctor writes a sentence. They usually write nothing. Detailed explanations invite questions. FWIW when a doctor calls me it often says "private" because they don't want me seeing their number, and I don't pick up because my phone tells me it's a scam call.[/quote]

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