Years ago, when you saw your doctor, they reviewed your chart, checked that you were up to date on your routine immunizations, performed a physical assessment, and had their team follow up on health maintenance items that needed to be scheduled. This is what we expected from our healthcare providers, and it was part and parcel of the basic customer service in the relationship between doctor and patient.
However, times have drastically changed. Medical visits have become shorter and shorter, and one result has been diminished quality of patient care.
Most of us chose healthcare to be of service and to practice at the top of our capabilities. Is this what we signed up for?
The Curse of the 15-Minute Visit
Imagine being in the room where some insurance executive pitched forcing doctors to see patients in 15-minute increments. Did everyone think it was a stroke of brilliance, or did someone mention that patient care might suffer if doctors didn’t have time to do what they were trained to do?
Ask anyone who has been a patient in the last few years how much time their provider spends with them, and they might roll their eyes, sigh, or tell you how it seems the visit is over before much of anything gets done.
And if you inquire about how long it’s been since their doctor touched them, they may not even remember. It seems the days of your provider listening to your heart and lungs are long gone and forget about them recommending you get an updated tetanus shot. And breast and prostate exams? Who has time for that unless the doctor is a specialist?
The Medical Conveyor Belt
What gets compromised when we provide care in a world where everything is maximized for speed? Is accuracy out the window? Do patients feel less cared for? As mentioned above, does general health maintenance get left to the patient to track and schedule?
If a patient feels that their provider is stressed and doesn’t have much time, they may feel obliged not to “bother” the doctor with their questions. The doctor-patient relationship should be one in which the patient feels seen and heard, resulting in the provider making recommendations that address the patient’s concerns.
Meanwhile, the nurses and others who support doctors and nurse practitioners also feel hurried. They may be tasked with keeping the provider moving from room to room, including interrupting patient visits or using other strategies to keep the medical conveyor belt moving.
Can patients and providers sometimes both feel satisfied with the results of 15-minute visits? Yes, it’s possible, but the overall anecdotal sense is that no one is happy with what these changes have brought about unless you ask the investors, who are laughing all the way to the bank.
What is Lost in Healthcare?
Did any of us go to medical or nursing school so that we could learn how to whisk patients through shorter and shorter visits? Did we choose a healthcare career to serve the interests of patients or corporations? Where in the Nightingale Pledge or the Hippocratic Oath is it mentioned that we need to minimize our face time with patients to increase profits?
So much is lost when patients are given less. The loss that healthcare providers experience includes:
- The loss of job satisfaction.
- A lessened sense of accomplishment.
- The feeling that we are no longer fulfilling the personal mission that led us to become healthcare professionals in the first place.
Mental illness and suicide among physicians are astronomically high, and studies show that nurses are 18 percent more likely to die from suicide than the general population. Are shorter visits and the challenge of doing less with more the sole cause of these alarming statistics? Absolutely not. However, we can easily conclude that when we healthcare providers are under increased stress to perform more efficiently, complete more tasks in less time, and focus on corporate profits instead of patient outcomes, the anxiety and burnout do us no favors in terms of our mental health and well-being.
What Can We Do?
A single nurse or physician can’t do much to fight back against this movement. Even if every nurse and doctor in a particular practice filed a complaint with corporate, the powers might tell them to find work elsewhere and replace them with others willing to perform those jobs.
We can, however, vote with our feet. We can look for employers who value patients and staff and prioritize everyone’s satisfaction. In terms of policy, we can communicate with lawmakers to raise awareness of the realities that we face. Legislators only know what we’re going through if we tell them, so whether we’re patients, nurses, or doctors, our opinions and experiences matter.
As patients, we can choose to see providers who take their time with us and our loved ones. We have the right to ask for what we want, and we also have the right to fire our doctor and find another.
Nothing will change within this paradigm of the 15-minute visit and the diminishing of our satisfaction unless there’s enough noise made about what’s gone wrong. Corporations have deep pockets, but we are also responsible for doing what’s right and saying what needs to be said.
In many ways, healthcare has been heading in the wrong direction for far too long, and it’s up to us — individually and collectively — to force this unfortunate reality to change.
The post State of Healthcare: We Didn’t Sign Up for This first appeared on Daily Nurse.
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