Dissatisfied Patients
Patients are often frustrated that when they make an appointment for a certain time, they are kept in the waiting room for too long before they see the doctor. The reason for long wait times is because doctors are forced to fulfill their patient quota (described below) just to make a profit after insurance interference.
Even after sitting in the waiting room, it isn’t uncommon for doctors to schedule their patients in 10 or 15 minute intervals. While this means more patients are seen per day, it also can mean poor quality of medical care. Take, for example, Cholene Rajauski, who went to see her primary care physician for a sore throat, but was rushed out in four minutes or less. "He looked inside my mouth to the back of my throat, told me that it was inflamed, then told me to go see the nurse for a prescription and that was it. He was gone. I've never been in and out from a visit faster," said Cholene.
"I hate feeling like I am being rushed in and rushed out. I know that I've been scheduled for a set amount of time but I want to use that time to talk about my concerns and not feel like I'm only being half listened to then being rushed out the door."
Although doctors may feel pressure to see the maximum number of patients, experts say that taking the time to listen to patients is actually one of the most important aspects of “doctoring." Studies also show that listening is vital, and that it’s not so much about the actual time spent on patients, it’s the feeling that they’ve been heard and not dismissed.
For patients like Cholene, it's apparent that doctors have one eye on the patient, and one eye on the clock. Unfortunately, Cholene had a severe tonsil infection that nearly went overlooked.
The Primary Care "Quota"
In response to the time limit, many doctors say they feel exactly the same way.
The unfortunate fact is that under the current payment system in U.S. health care, most primary care practices must function at maximum capacity to make a profit. The profits are so slim that physicians have to meet the quota, but none of them like functioning under a the quota.
In most cases, doctors only make money by prescribing, testing, scanning, and rushing patients out the door as fast as possible. This is dangerous in terms of unnecessary testing and prescribing, and it’s also dangerous because communication in the doctor-patient relationship is vital to high-quality patient care. But, it’s not the physician’s fault the system works this way. Doctors are actually very unhappy about it too.
Insurance
Due to there being more insured Americans, experts say that doctors feel more pressure to see a large number of patients within a short period of time. Rushed doctors and anticipating patients who want answers for their medical complaints and problems equals tension in the doctor’s office. Many patients schedule appointments months in advance, take time off of work, and expect that they will receive more than a few minutes of their doctor’s time to talk about their medical concerns. Moreover, patients typically have multiple medical concerns when they visit their doctor, but doctors commonly want to get to the “main complaint." This creates a serious disjuncture between patients and doctors–one that is causing burnt out doctors and disgruntled patients.
Primary care is a growing problem in modern health care. However, with every problem there's an opportunity and that opportunity lies within direct primary care, an alternative primary care model. The key difference between traditional primary care and direct primary care is that direct primary care does not accept insurance. Rather, patients pay an affordable monthly fee of around $150 for 24/7 direct access to their doctor through personal cell phone and email, hour-long office visits and after-hours/weekend visits.