It's April again
and again I find myself in the the midst of "changes" with respect to my work/career.
I enjoy being a doctor. I'm realizing I can't compromise my ideals when it comes to practicing medicine. I can't be "bullied" by insurance companies and the current state of healthcare in America. That's the conclusion that I came to after pondering ....after seeing that PBS program on medicine/alternative medicine.
Do you know that the average doctor spends about 6 minutes per patient during a regular visit at the clinic? 6 minutes is not enough in my opinion. One barely gets to exam and talk briefly with the patient. It is not enough time for more complicated emotional/social issues.....for patients with chronic/complicated illnesses. It is not even enough time to take about exercise and nutrition. I want to be able to allow patients to ask questions....to understand what it going on....it is THEIR bodies afterall. I am not the one living in their bodies, so it's not right if I'm the ONLY one who knows what is going on.
Like today at work......i think it was worth it to spend more time reassuring a patient and explaining to a her why we need to order an ultrasound guided biopsy of her breast to examine something "suspicious" on her mammogram. Of course, we are doing that to see if it is breast cancer. I could clearly see that this was stressing out the patient......she's getting tension headaches from the stress of worrying about her breast. I don't think it will be cancer......(hope it isn't)........but i took some extra time to ask her how this new breast "lesion" was making her feel. I took time to explain the procedure and to give her an idea of what comes next after the breast biopsy. I think I owe her that....that extra time.
I would hate to just tell her that there's something "suspicious" in her breast ...that we need to biopsy it....so here is the order for the biopsy ....schedule an appointment as soon as possible and i'll see you once the biopsy is done. I think i CAN say that in 6 minutes or less ......probably in an impersonal, "sterile" manner......not allowing for questions. All to get her in and out of the exam room promptly.
But i don't think that would be fair to her. Especially since there might be a language barrier with the staff at Breast Center and at the general surgeon's office. They might not be able to explain things in spanish so she can feel informed about the procedure..etc. I know it feels horrible to be in the dark about one's health.....to not understand what is happening....to be SO misinformed that one thinks "I must have something horrendous. I must be dying" ...when one actually is far ...far from dying.
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5 comments:
where were you when my wife had the kindney stone! that's exactley what I needed... we got a bunch of doctors who were in and out- impersonal and cold, not time to really explain or answer questions.
All I could do was translate stuff like "now we have to go to this other place so they can do some other kind of test..."
Just from reading your blog as long as I have I already knew without you're saying it that you care about your patients and take the time... I don't think you could do it any other way. This world needs more Dr. Vodka's!
Yes, apparently doctors in Syracuse make $60 a minute to see patients. Dr. Dibble was in with me for about 6 minutes to say hi and tell me his nurse will be irrigating my ear. I got charged $60 to see him and $95 to have his nurse spray water in my ear.
*growl*
HMm...
I suspect doctors the world over see patients for an average of just 6 minutes.
But...
I do think, after seeing a great many patients come and go in my local doctors surgery at times, and even having a superfast info-conversation with my own doctor about such things...that many patients don't really require more time, and those that do, usually get it...
Adding to that... perhaps for better or worse, your gp (do you call them gp's in the U.S.? It stands for general practitioner) is like a gateway to further treatments, from specialists with more time and knowledge to look for that specific ailment... and of course psychologists/ psychiatrists nearly always give you around an hour of their time... mental illness requires such.
S.x
PS: i think you do a wonderful job, and are definitely one of the most awesome people i've ever met.
*grins bashfully*
well six minute doctors should post such on their doors. and then it would be ez to avoid them and know when we find wonderful, patient and undertanding doctors like you. thanks for all the info you've provided recently.
I was just thinking about this post again, and my comment above.
When i realized the vast difference in GP's between our countries.
U.K. visits to yr doctor are free. When something is free like that, then i think the number of people wanting an appointment vastly increases. Many of those people can easily be dealt with in 6 mins or under, because their problems are very minor... i even remember seeing advertising campaigns and newspaper articles about patient time-wasting...
So as health services in the U.S. are not so free... i imagine that most people really DO wait until they are feeling genuinely poorly before visiting you... and that would obviously require whatever time you can give.
In that case, 6 mins is an incredibly short and vital period. And quite probably...not long enough.
S.xx
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