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mindful minute

We are freed and imprisoned by our thoughts

Mark Fontaine


Are you certain the physician was not in the exam room with you for more than three or four minutes? You’re likely not far off.

The doctor will give you a cursory look and reach for a prescription pad. If you ask a question or protest the prescription of choice you may be cut off.

Patients and physicians feel the time crunch as never before as doctors rush through appointments as if on roller skates. There is a push to see more patients and perform more procedures as doctors are awarded flat or declining reimbursements.

Most primary care doctors’ appointments are scheduled at 15-minute intervals. Some physicians see patients every 11 minutes and have half a dozen examining rooms on the go.

Doctors may have their eyes on the clock rather than the patient.

Short visits take a toll on the doctor-patient relationship. That relationship is the key ingredient of good care. Opportunities for getting patients more actively involved in their own health are missed. There is less of a dialogue between patient and doctor increasing the odds patients will leave the office confused and frustrated.

Shorter visits also increase the likelihood the patient will leave with a prescription for medication, rather than a prescription for behavioral change.

Physicians don’t like to be rushed, but for primary care physicians, time is money. Unlike specialists, they don’t do procedures which generate revenue, but instead, are still paid mostly per visit.

This fee-for-service payment model, rewards doctors who see patients in bulk rather than rewarding doctors for efficacy. Doctors are thinking more about the bottom line and overhead rather than their patients.

The doctor tends to quickly try to identify the chief complaint. The patient is thinking: ‘I’m taking the afternoon off work for this appointment. I’ve waited months for it. I’ve got a list of things to discuss.’

 A study found that doctors let patients speak for only 23 seconds before redirecting them. One in four patients got to finish his or her statement. Doctors often fall short in the listening department. They have a bad habit of interrupting.

 A study in 2001 found primary care patients were interrupted after 12 seconds, if not by the health care provider, then by a beeper or a knock on the door.

Shouldn’t making the patient feel they have been heard be one of the most important elements of doctoring? I have a prescription for doctors–slow down and be mindful. I am confident that both you and your patients will be rewarded.



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