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(PBS)   Fifteen-minute doctor visits are a problem for health care. No one should be forced to talk to a doctor for that long   (pbs.org) divider line 27
    More: Interesting, doctor's visit, health cares, primary care physicians, American Academy of Family Physicians, medical term, sinus infections, interpersonal relationship  
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1243 clicks; posted to Geek » on 21 Apr 2014 at 3:06 PM (17 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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ZAZ [TotalFark]
2014-04-21 02:26:03 PM
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.

Well I was in my office yesterday, talking with Glynnis the slut receptionist, who still hasn't married any of her baby daddies, when I felt this twinge. So Glynnis said to me, golly Mabel, you look like somebody kicked you in the belly. And let me tell you, Glynnis knows about having things stuck in her belly. And she says, "I saw you leave with the boss after the Christmas party." And I'm wondering what business is it of hers if he and I go off alone afterwards seeing as how he's separated now and

...23 minutes later...

and so yesterday I decided maybe Glynnis knew what she was talking about 'cause she's been knocked up a few times and anyway to make a long story short the stick turned blue.

Doctor! Wake up!
 
2014-04-21 02:41:53 PM

ZAZ: 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.

Well I was in my office yesterday, talking with Glynnis the slut receptionist, who still hasn't married any of her baby daddies, when I felt this twinge. So Glynnis said to me, golly Mabel, you look like somebody kicked you in the belly. And let me tell you, Glynnis knows about having things stuck in her belly. And she says, "I saw you leave with the boss after the Christmas party." And I'm wondering what business is it of hers if he and I go off alone afterwards seeing as how he's separated now and

...23 minutes later...

and so yesterday I decided maybe Glynnis knew what she was talking about 'cause she's been knocked up a few times and anyway to make a long story short the stick turned blue.

Doctor! Wake up!


F*ck your misogynistic attitude. Are you a gynecologist?

If I see  doctor that brushes me off or has a nurse or student translate everything for him I won't be back.
Nobody should accept low standards of healthcare.
 
2014-04-21 03:08:58 PM
The more the doctor is getting paid, the less likely you are to see them for any length of time.  High demand specialists are the worst.
 
2014-04-21 03:16:54 PM
@ hours in the waiting room for 5 minutes of seeing the doctor.
Thanks obamacare.
 
2014-04-21 03:19:36 PM
It's hard to put the patient's interest first when the doctor sees the patient as nothing more than a conduit to extract money from the insurance companies/federal government. In this regard there are basically two types of doctors. The firs type is not worried about lawsuits--they ignore everything the patient says and order whatever test or treatment gets them the most money. These tend to be young doctors who haven't been sued yet. The other kind of doctor is the one who has been sued and therefore is worried about liability. This doctor sees a patent for thirty seconds and if it isn't blatant what is wrong--a broken bone though the skin--immediately says it is beyond their expertise and sends the person away. The first doctor will give you a random treatment and the second doctor won't treat you at all but still bill someone. That's American health care.
 
2014-04-21 03:22:21 PM

worlddan: It's hard to put the patient's interest first when the doctor sees the patient as nothing more than a conduit to extract money from the insurance companies/federal government. In this regard there are basically two types of doctors. The firs type is not worried about lawsuits--they ignore everything the patient says and order whatever test or treatment gets them the most money. These tend to be young doctors who haven't been sued yet. The other kind of doctor is the one who has been sued and therefore is worried about liability. This doctor sees a patent for thirty seconds and if it isn't blatant what is wrong--a broken bone though the skin--immediately says it is beyond their expertise and sends the person away. The first doctor will give you a random treatment and the second doctor won't treat you at all but still bill someone. That's American health care.


Don't forget about the bonuses from referrals, tests and prescriptions.
 
2014-04-21 03:25:25 PM
I have no interest in having a "personal relationship" with my doctors.  I want to see them as little as possible.  I'm no high performance athlete that needs careful monitoring, nor do I have anything crazy that needs intense observation.  Give me an expert system for symptom collection, someone who looks over the output of that, verifies I'm not lying about what I told the expert system and send me on my way with my meds or referral.  Yes, get me a tricorder (Star Trek Universe) or an at home auto-doc (Known Space - probably more realistic).

The only medical professional you should establish any kind of "relationship" with is your psychologist, and they bill by the hour.
 
2014-04-21 03:34:39 PM
www.11points.com

It could be worse...
 
2014-04-21 03:42:09 PM
Meh. There can be bigger issues with docs than the amount of time they spend with you. . .

My first doctor kept looking up medications on his iPhone while deciding what to prescribe me. Slightly disconcerting when you know more about the medication he wants to give you than he does. He also refused to do any "testing," which bugged me. I'd like to know something is actually wrong before you start throwing meds at it.

Second doctor is way better. More referrals, but at least she actually listens and is more on board with, "Hey let's check this out before writing out a drug you might not need."
 
2014-04-21 04:08:21 PM
Maybe it's because when you talk to a Dr. for 15 minutes, get no xrays and/or a quick prescription and then get a $250 bill, you think twice about really needing to go again...
 
2014-04-21 04:12:55 PM

worlddan: It's hard to put the patient's interest first when the doctor sees the patient as nothing more than a conduit to extract money from the insurance companies/federal government. In this regard there are basically two types of doctors. The firs type is not worried about lawsuits--they ignore everything the patient says and order whatever test or treatment gets them the most money. These tend to be young doctors who haven't been sued yet. The other kind of doctor is the one who has been sued and therefore is worried about liability. This doctor sees a patent for thirty seconds and if it isn't blatant what is wrong--a broken bone though the skin--immediately says it is beyond their expertise and sends the person away. The first doctor will give you a random treatment and the second doctor won't treat you at all but still bill someone. That's American health care.


What kind of physicians have you been seeing?  In my 40 odd years on this planet I've never experience this attitude from any general physician.
 
2014-04-21 04:43:29 PM
If you could choose only one, do you want a doctor who is friendly or one that is good?
 
2014-04-21 05:15:31 PM
They literally train docs to do this in school. I just got done with a test ( im on the train ride home now) that tests "patient examination." They set you up with some actors that play patients and you have to interview then examine, diagnose and counsel them. They give you 14 mins per patient. Then a buzzer goes off and you walk out, document the encounter, your findings, differentials, and the plan. They give you 9 mins for this. Then a buzzer goes off and is on to the next patient.

This test cost 1300 to take. Plus airfare.

/It's been a long day
//grouchy
 
2014-04-21 05:16:02 PM

Havokmon: Maybe it's because when you talk to a Dr. for 15 minutes, get no xrays and/or a quick prescription and then get a $250 bill, you think twice about really needing to go again...


I don't feel qualified to post in this thread because I haven't been to the doctor in over 6 years, but hell with it; this is Fark.

My insurance puts an accumulating $750 toward my medical expenses annually before I have to pay my deductable. Last time I looked, it was over $7500 banked. I may have to get a limb amputated just to get my money's worth out of that policy. They probably wouldn't cover a lobotomy for cosmetic reasons. I wonder if I could have them grow a new liver for $7500.
 
2014-04-21 05:37:41 PM

BigLuca: They literally train docs to do this in school. I just got done with a test ( im on the train ride home now) that tests "patient examination." They set you up with some actors that play patients and you have to interview then examine, diagnose and counsel them. They give you 14 mins per patient. Then a buzzer goes off and you walk out, document the encounter, your findings, differentials, and the plan. They give you 9 mins for this. Then a buzzer goes off and is on to the next patient.


14 minutes is a lot, in the real world. The average is 12. I saw a doctor earlier this year for my knee. The first appointment lasted exactly three minutes, he never touched me exact to tap my knee--refused to go any further without an MRI--an imaging place he probably had an ownership interest in. The follow-up to the MRI lasted five minutes.

When he was out in the hall I could hear him dictating notes, he had the speed and cadence of an auctioneer. I didn't take out my watch but my guess is three minutes tops for the dictation. So I'm going with 6-8 minutes per appointment.

No wonder orthopedic surgeons are currently the highest paid specialty. When I walked out the door I wondered if that was the moment I was supposed to go "moo".
 
2014-04-21 06:07:35 PM
CS1B

I was at my doctor's office today, because in this state all prescriptions expire in one year, and you cannot renew the prescription unless the patient has seen the doctor again for follow-up. So I am there for what should have been 15 seconds as I tell my doctor "no worsening symptoms...no new symptoms...continuous monitoring...thanks for the Rx renewal, laters", when my doctor feels the need to get his 15 minutes worth in.

I know his assistant already faxed the Rx to Wal-Mart even before the doctor came in. I was thinking of bailing right then and there, but figured there may be some repercussions to that act.

/CS1B

CS2B

I found a review for my doctor online, and it says he was suspended for such-and-such, etc., and when I looked into it, what had happened was the posting reviewer had mistaken my doctor for another doctor who has a very similar name.

I swear to FSM we wouldn't need doctors at all, except that people are such farking nitwits.

/CS2B
 
2014-04-21 06:14:50 PM

Kanemano: If you could choose only one, do you want a doctor who is friendly or one that is good?


Why not both?  The family GP (and the family pediatrician) are overworked and overbooked, but they still make a point of sitting down at every appointment and wanting to know if we have any additional concerns/questions.  Our GP no longer sees new patients, as his workload was staggering.  We feel lucky to have him, and he rarely gives bad advice, and he hates giving out prescriptions unless he absolutely feels it is necessary.  Once, the regular GP was booked for a semi-emergency, and I went to see another GP in the practice.  He opens the door, and says, "So what's so wrong with you that we needed to adjust our schedules?" and then proceeds to spend 30 seconds looking at me, tops, before leaving.  I sat there for another ten minutes before the nurse appeared.  She told me that my prescription was waiting at the front desk.  Never saw the guy again.
 
2014-04-21 06:58:35 PM
You people are real farkers.
As a real doctor, I'd like to advise you that you get the healthcare you deserve.
That is all.
 
2014-04-21 07:26:39 PM

Zeben: You people are real farkers.
As a real doctor, I'd like to advise you that you get the healthcare you deserve.
That is all.


Can I get a LOR? That would be swell, thanks.
 
2014-04-21 09:20:31 PM

BigLuca: They literally train docs to do this in school. I just got done with a test ( im on the train ride home now) that tests "patient examination." They set you up with some actors that play patients and you have to interview then examine, diagnose and counsel them. They give you 14 mins per patient. Then a buzzer goes off and you walk out, document the encounter, your findings, differentials, and the plan. They give you 9 mins for this. Then a buzzer goes off and is on to the next patient.

This test cost 1300 to take. Plus airfare.

/It's been a long day
//grouchy


Ah Step 2 CS.  One of the more blatant ridiculous money-extractors imposed upon medical students.  $1300 for a test that 97% of American medical students pass on their first try.  But don't worry, once you become a resident, it's all champagne, caviar, and lamborghinis, at least according to everyone else in this thread ;)
 
2014-04-21 09:32:59 PM

Havokmon: Maybe it's because when you talk to a Dr. for 15 minutes, get no xrays and/or a quick prescription and then get a $250 bill, you think twice about really needing to go again...


Where are you going to the doctor? Do you not have insurance?
 
2014-04-21 09:42:33 PM

worlddan: BigLuca: They literally train docs to do this in school. I just got done with a test ( im on the train ride home now) that tests "patient examination." They set you up with some actors that play patients and you have to interview then examine, diagnose and counsel them. They give you 14 mins per patient. Then a buzzer goes off and you walk out, document the encounter, your findings, differentials, and the plan. They give you 9 mins for this. Then a buzzer goes off and is on to the next patient.

14 minutes is a lot, in the real world. The average is 12. I saw a doctor earlier this year for my knee. The first appointment lasted exactly three minutes, he never touched me exact to tap my knee--refused to go any further without an MRI--an imaging place he probably had an ownership interest in. The follow-up to the MRI lasted five minutes.

When he was out in the hall I could hear him dictating notes, he had the speed and cadence of an auctioneer. I didn't take out my watch but my guess is three minutes tops for the dictation. So I'm going with 6-8 minutes per appointment.

No wonder orthopedic surgeons are currently the highest paid specialty. When I walked out the door I wondered if that was the moment I was supposed to go "moo".


You went to a surgeon for a consult and you wanted him to just slice you open and find the problem?
 
2014-04-21 11:36:11 PM
really depends on who you see I guess.  I love my Dr.  We are friends from way back, our kids went to the same school.

Last visit, he tells me he thinks I am developing insulin resistance due to a change in my appearance.
He was correct.  Much better to figure that out now then after I am a full blown diabetic.
So find someone good, and stick with them I guess.
His annuals are at least 30 minutes per visit. For cause are shorter of course, but still thorough.
 
2014-04-22 12:32:40 AM
Every year I see my doctor for a full checkup (mild hypertension and hyperlipidemia). I've rarely been out of there in under 50 minutes. History is reviewed, current issues checked, etc. Very thorough, even time for some jokes and shooting the shiat. My doc is quick, but in the sense of being efficient, not cheap. I wouldn't say I have (or want) a "personal" relationship with him, despite him being very familiar with my prostate, but he's very good about keeping details about me on the chart and referring to them in future visits, which at leasts gives the appearance that he gives a shiat. Reading some of the comments above I feel very grateful to have a doc/system that allows this much time and attention.
 
2014-04-22 10:40:15 AM
My GP doesn't accept health insurance; for a flat $100 fee she'll spend as much time as necessary to diagnose what's going on with you (follow up visits are free however, and lab work & prescriptions are covered by health insurance). She's the one that noticed my PSA score was starting to climb and sent me to a urologist, who found and removed my cancerous prostate before it could spread. I asked her once why she didn't accept health insurance and she said the same thing TFA did; that insurance companies pressure doctors to a "one problem per patient per visit" routine and then want the visits kept as short as possible, and she'd much rather find out everything at one time.
 
2014-04-22 01:08:46 PM
moothemagiccow:

You went to a surgeon for a consult and you wanted him to just slice you open and find the problem?

What I want from a doctor is (a) a rational diagnosis that is explained in intelligible language and (b) a rational treatment plan based upon that diagnosis. Instead, this is the typical patient experience:

http://www.cancerschmancer.org/frans-story
 
2014-04-22 10:31:52 PM
CSB time.

Took my roommate to a nephrologist today. It's a regular thing. He's got a slew of health issues that somehow result in kidney stones as a secondary effect. Doctors swear left right and center his bloodwork shows he should have no kidney stones, but they're there none the less.

Gets into the dude's office, he's in there for an hour. The doc spends maybe five minutes of that time talking directly to him. The rest of that time is spent in other rooms with other patients, at the front desk, or yelling at someone on the phone calling them a bastard. He spent most of the visit calling my roommate by female pronouns (He looks _nothing_ like a girl,) and thought he was in highschool until he actually looked at the chart and realized he was 30.

Tried to bring up multiple details and symptoms flagged by other doctors that may influence this doctor's diagnosis on why the stones were happening. He dismissed them immediately because they weren't in the chart, or because he'd never heard of X chronic problem before. So obviously we're lying and making things up.

Finally wrapped up by showing us the door with a shot in the dark prescription and a "See me again in three months."

Tried to get a copy of the ultrasound they did to pinpoint what stones there were and where, to show his urology specialist? They threw out the images and only had lab results on file.

I know doctors are being pressed by insurance companies to speed things up, I know they're not being compensated for as much as they think they should. But he gets this kind of treatment wherever he goes. Really makes me re-consider even having health insurance at all if this is the best we're going to get for it.
 
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