But most patients have more than one issue to discuss, said Dr. Alex Lickerman, an internist who has taught medical students at University of Chicago and is director of the university's Student Health and Counseling Services.
“The patient is thinking: ‘I’m taking the afternoon off work for this appointment. I’ve waited three months for it. I’ve got a list of things to discuss.’
“The doctor is thinking, ‘I’ve got 15 minutes.’ There is almost a built-in tension,” Lickerman said.
Studies show that doctors’ visits have actually not gotten shorter on average in recent decades. The mean time spent with a physician across specialties was 20.8 minutes in 2010, the latest year available, up from 16.3 minutes in 1991-1992 and 18.9 minutes in 2000, according to the National Center for Health Statistics; that includes visits with internists, family docs and pediatricians, which all increased by about two and a half minutes.
In 1992, most visits – about 70 percent -- lasted 15 minutes or less; by 2010, only half of doctor visits were that short (the data is from the National Ambulatory Medical Care Survey, an annual nationally representative sample survey of visits to physicians).
This doesn’t necessarily mean the patient experience is improving. Medical schools drill students in the art of taking a careful medical history, but studies have found doctors often fall short in the listening department. It turns out they have a bad habit of interrupting.
A 1999 study of 29 family physician practices found that doctors let patients speak for only 23 seconds before redirecting them; only one in four patients got to finish their statement. A University of South Carolina 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.
Yet making the patient feel they have been heard may be one of the most important elements of doctoring, Lickerman said.
“People feel dissatisfied when they don’t get a chance to say what they have to say,” he said. “I will sometimes boast that I can make people feel they ‘got their money’s worth’ in five minutes. It’s not the actual time or lack of time people are complaining about – it’s how that time felt.”
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.
Fri, Apr 18 2014