The next part of the NY Times’ excellent “On being a patient” series: Why doctors’ don’t listen.

Ms. Wong had come across a bane of the medical profession: the difficult doctor. These doctors may be arrogant or rude, highhanded or dismissive. They drive away patients who need help, and some have been magnets for malpractice claims.

And while such doctors have always been part of medicine, medical organizations say they fear that they are increasingly common – doctors, under pressure to see more patients, are spending less and less time with each one and are replacing long discussions with laboratory tests and scans – and that most problem doctors apparently have no idea of their patients’ opinions of them.

Patients usually do not confront doctors. Instead, most rant to friends or family members about their experiences or simply change doctors. But in most areas of the country, there is an abundance of patients. If a few patients leave a medical practice, plenty more can take their place, so doctors may never even know what their patients think.

Pretty easy to see why. Doctors are rewarded (i.e. paid) by quantity. There is incentive to order tests and perform procedures rather than spending time with the patient. With Medicare reimbursements being pressured daily, the government is essentially forcing doctors to practice conveyor-belt medicine.

Fix the reimbursement system, and you’ll see these communication problems magically vanish.

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