Many Questions - Limited Time
A recent study reported in Health Services Research and referenced in The New York Times, studied videotapes of almost 400 primary care visits. They found the median time for visits was just under 16 minutes and patients tended to bring up 6 subjects. About five minutes was devoted to one major topic, with the other issues receiving as little as one minute. When a patient presented a complex problem, the doctor had two basic choices: limit the time or make another patient wait while he extends the visit. If the doctor extends the visit of several patients a day, he will soon be so far behind that every patient will feel rushed and no one will feel well cared for. This treadmill pace is not good for the patient or the physician and is one reason so few young doctors are choosing the primary care field as a practice choice.
Is concierge medicine the answer? For my friend, who says "I've had three doctors and it just isn't working for me anymore" it probably will solve his problem. He can afford the fee and will enjoy the relaxed pace of his new doctor's office.
But this model is the solution for only a few patients and a few doctors and will only make the primary care doctor shortage worse.
Unrushed quality time is something Physicians want to give and something patients want. With our current insurance and Medicare reimbursement structure, the solution seems a long way off.