Time: A ‘Four letter Word” in American Medicine

A “Doctor’s Doctor” is the term used to describe a physician who is sought by medical colleagues when they or their family members are ill. He/She is known to be knowledgeable and talented, respectful and compassionate. He/She will also take the time to listen, to discuss possible diagnoses and the pros and cons of clinical recommendations.

This is what we all want in our own doctors, isn’t it? Yet this crucial ingredient, doctor-patient time, is under threat in US medicine.

The overriding goal for the vast majority of physicians is exemplary care of their patients. We know that patients’ clinical improvement and satisfaction are in part related to the quality time doctors spend with them, enabling a trusting professional relationship.

Sensitivity and compassion are taught to medical students, but pressures in actual clinical practice have often made time the sacrificial lamb in patient care. The “Art and Science of Medicine” has become corporate: “market share,” “productivity,” and “profit and loss” have become buzzwords in medical care, as publicly-traded HMO’s, insurance and health care companies dictate criteria of practice.

Doctors are working under enormous pressures and duress. Many caring physicians can’t keep up the pace of productivity demanded by overseers. They are closely monitored as to how many patients they are seeing in as short a time as possible. This, and long hours, administrative oversight, demanding record-keeping, high insurance rates, and threats of litigation, are constant impositions.

Aside from diminishing quality of care, lack of time is destructive to the doctors themselves, who are increasingly afflicted with burn out, depression, anxiety, marital problems, and substance abuse.

The lack of time with patients caused by practice pressures is particularly severe in the United States, the only developed country without a single payer model of health care delivery. Americans pay more per person than other countries, and yet our outcomes are often not as good as some others. Even with the Obamacare, many American families are rendered bankrupt by uncovered medical expenses. As long as medical practices remain under the control of publicly traded companies, our health care delivery system will suffer.

Surely our country’s patients and doctors deserve better than this.

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