A study suggests that time spent with the physician has a stronger impact:
The time spent with the physician is a stronger predictor of patient satisfaction than is the time spent in the waiting room. These results suggest that shortening patient waiting times at the expense of time spent with the patient to improve patient satisfaction scores would be counter-productive.
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We just changed primary dr – we didn’t wait long and he spent time with us..
but he wasn’t through..didn’t like to request test be done – under the insurance co’s thumb. (our opinion)
These do not have to be exclusive goals. Better scheduling and truth when checking in will help to reduce wait times without reducing time spent with the patient. What does get reduce is doctor income.
“We just changed primary dr – we didn’t wait long and he spent time with us..
but he wasn’t th[o]rough..didn’t like to request test be done – under the insurance co’s thumb. (our opinion)”
FOR PATIENTS LIKE THESE, NO MATTER IF THE DOCTOR STANDS ON HIS/HER HEAD OR BREAKS BONES ON SKATES [to be fast], THEY’D NEVER GET SATISFIED, UNLESS THEIR REQUESTED TEST IS DONE! TAKING TIME, EXPLAINING WHY A TEST IS NOT NECESSARY VIRTUALLY AMOUNTS TO NOTHING, BECAUSE THE CLIENT DID NOT GET TO FULFILL HIS/HER AGENDA. THE DOCTOR MIGHT HAVE SATISFIED QUALITY AND EMPLOYERS’ [AMONG MANY OTHER UBIQUITOUS] GUIDELINES, BUT HIS/HER SATISFACTION RATINGS STILL PULLED LOW. HOW PATHETIC…CAN’T WIN FOR LOSING.
People who take histories and do exams don’t have to order tests all the time. Is is an archaic art called “the practice of medicine”.
My brother went to and ortho guy for an elbow problem. He discribed to me a thorough history and exam followed by a referral to PT. He is hacked off because he thinks he needs an MRI. He will go somewhere and get an MRI.
Things like this convince me that the best thing we could do for runaway healthcare costs in American is have less insurance, not more. Eventually the ortho guy may notice his fellows who run a business instead of practice a profession make more money and decide to join them. It will be another one lost from the fold.
A friend told me this story from recently precepting internal med residents at a major ny teaching hospital:
patient comes in w/chief complaint of “I need a nuclear scan”
resident’s full assessment & plan is solely the need for said scan.
attending is suspicious, sees patient, who proceeds to describe how people had injected him with strontium while he was sleeping, and he needed a scan to find it and remove it.
this guy gets to rate his doctors online (www.ratemds.com), just like the bozo with a cold who’s pissed at his doctor for not giving him antibiotics – “I once got that pink pill, the one with the ‘z’ that you take two of on the first day, when i felt just like this, and it really worked like a charm then”
that’s the problem with “patient-centered” care.
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