While women and girls all over the world are seeking gender parity, and rightly so, evidence of gender-based socializations still exist. If you are over 50 years old, most likely you still act upon the gender-specific behaviors which were assigned to you. Men instinctively know they are not supposed to talk about personal issues – not about their emotional setbacks, or relationship failures, or about the state of their health –not even with the best man at their wedding or their fishing buddy. Female behaviors include the opposite. Women share with each other their relationship problems, their latest diet, or information about a vaginal cream that works miracles. A woman will discuss details of her health and illness with a female stranger next to her in the slow line at the grocery store. It seems par for the course that women will naturally assume they are entitled to conversational and lengthier discussions about their health and related issues when they visit their primary care physician or medical specialist. I know you keep searching for that special doctor with whom you can linger and chat about all the details of your ailment – one who will also inquire about your children by name, or ask how you are doing because she remembers that on your previous visit you mentioned your anxieties about impending retirement and your sleeplessness.
The average patient gives up 121 minutes of their own time for a medical visit
Recent published reports by Harvard Research and the National Institutes of Health (NIH) confirm conclusions from earlier surveys and physician’s self-reports that the time a doctor spends with the average patient is 13 to 17 minutes. In one of my recent visits, after the physician clocked in with me, she left the room twice and took 3 phone calls during my allotted time with her. None of those interruptions had anything to do with me or the reason why I was in her office. My experience is backed up by Forbes.com and Mobius.com, trackers of such data, who report that the amount of time spent with patients is more like 10 minutes for primary care or GP visits and 20 minutes for a specialist. In juxtaposition with the time that you actually get to spend with the doctor, Harvard Research counters with a flipside analysis that the average patient gives up 121 minutes – that is a little over 2 hours of their own time, for a medical visit – counting time for making or securing an appointment, completing forms, your idle time in the waiting room, sitting in the examination room, and traveling to and from the doctor’s location if you have direct transport. If you have to use a bus, train or other public conveyance, the time used up can be half day.
Maybe by Medical School edict, or common practice, or perhaps though agreements made during coffee break chats at medical conferences, over the last three decades medical practitioners across the globe have gradually settled upon a time frame of 15-minute intervals for seeing patients. Maybe we should stop begrudging medical practitioners their pursuit of good and even lucrative business outcomes, which have led them to apportion their workday into profitable time slots. On top of that, analysists of the practice of medicine-as-business point out the influence of Medicare requirements on the way US doctors now skew ‘patient care’ away from patient care. As with any profession, there are some physicians who may ignore the norm and give patients their due. I can only imagine the stress that builds up for the doctor who functions by the 15minute hamster-wheel, if any of the visits consume more than 20 minutes, and lunch time rolls around to find them already 2 or 3 patients behind for the morning schedule with afternoon appointments beginning to arrive and restlessness spreading in the waiting room.
Female patients are viewed as needing too much time from their doctors
I hear from my physician friends(both men and women) that female patients expect too much time from their doctors. I believe and understand their viewpoint. Male patients are deemed easier for time-management purposes since the average man seems anxious to get in and out quickly before he is forced to disclose anything of real consequence. But if you think that a female physician will spend more time chatting with you and listening to your story, think again. Switching from a male doctor to a female doctor will not buy you more face time in your doctor’s office. The 15minute time slot is not about to change. And the news going forward does not offer a reprieve. A report in the Annals of Internal Medicine five years ago already documented that within those 15 minutes, only 53% of the time will be spent talking to you or examining you, which boils down to roughly 8 minutes of doctor-patient interaction. During the rest of the time, he or she is filling out paperwork in front of you, or in more modern parlance, uploading information into the computer, double checking or downloading your test results, ordering other tests, and entering prescription orders. And yes – checking their smartphone screens or fielding internal calls from the secretary with reminders that the waiting room is full. To break it down further, you most likely have a grand total of 2 or 3 minutes to say something cohesive about your state of health, share your medical concerns, ask questions and receive lucid answers.
Telehealth offers opportunities for the average patient to ‘visit the doctor’ without the hassle and frustrations of time loss
We can help ourselves by acknowledging the part of the equation that we can control. Many changes occurred in our lives during 2020 and continuing, due to the Covid19 pandemic. Some of those changes will be with us forever, even as the Covid is threatening to do the same. One of those adjustments has been the arrival and normalization of Telehealth. Granted that most people with acute or chronic conditions need to or want to visit the doctor’s office regularly. At the same time Telehealth offers opportunities for the average patient to ‘visit the doctor’ without the hassle and frustrations of exchanging 2 hours or more of your time for 8 minutes with the doctor. If you have the option, and you don’t have to be monitored in person, you should embrace Telehealth. And definitely choose Video over telephone for your tele-check-ups; use telephone only for follow up questions or to leave messages with the receptionist for a callback. Increasingly, as medical services and offices embrace technology, you will be able to complete those tasks online in many instances.
Take a load off your doctor and Learn to communicate
The year 2020 proved that tele-visits can be practical and a worthwhile experience. Preparation is the key. Think about it – there are some common symptoms that lead the average person to visit the doctor. The list includes Pain (particularly headache, stomach and muscle pain), Fever, Nausea, Dizziness, Lightheadedness, Cramps, Depression and Anxiety, among others. None of which a doctor can “see” even if you visit the office. Take a load off your doctor and remove the onus on him or her to guess magically what those symptoms mean. You can help yourself between visits, by keeping detailed notes of your health concerns, symptoms, changes in your body and in bodily functions, and transcribing the details into a quick reference list to have in front of you during your videoconference with your doctor. For example, learn the vocabulary about pain – its location in your body – its frequency and time of day – Is it constant or intermittent? Does it stay in one spot or move around? How long does it linger? Does it hurt more or less when you are quiet or active? Does it feel hot or cold, sharp or dull, stabbing or pulsing or throbbing? Is it deep or shallow? Use the same type of relevant analysis with all your symptoms. Sharpening your ability to communicate works wonders so that your doctor does not have to spend time fishing for your input. If you haven't already done so, learn to monitor your own blood pressure, your daily temperature, and your oxygen levels. Adequate tools for the purpose are affordable and available at the nearest pharmacy – or even at your favorite online marketplace. Remote technology can even monitor your pacemaker if you have one. And modern Glucose Monitors guarantee no more finger-sticks for chronic diabetics.
Keep a personal health log to improve outcomes of your doctor’s visit
I’m not ruling out visits to the doctor’s office entirely. But how less stressful it is to be able to take a hold of our health-monitoring tasks and only visit the doctor’s office when it is absolutely necessary. And then you can put your 2 or 3 minutes of interaction to best use. Have your notes in hand so that you don’t omit anything. It gives your doctor the signal that you mean business and are ready for meaningful dialogue. As long as you don’t confuse your doctor with your hairdresser or barber who have a full hour or more to chat with you monthly and pick up where you left off each time. Your doctor is not in that wheelhouse. If you suspect your ailments are related to Anxiety and Depression, then you owe it to yourself to consult the other type of doctor who charges by the hour. To get the best from your physician, it is helpful to maintain a personal health log. If you are old-fashioned, a small notebook works fine. If you have a smartphone, use it instead. That way, before you attend your next appointment whether on Zoom or in the doctor’s office, you should document your detailed symptoms and pharmaceutical reactions as they occur to you over time – daily if necessary. Then closer to the visit, create your quick checklist of symptoms, descriptions and questions and let the doctor see you ticking them off. There’s an App for that. You can launch a Notes App on your iPhone or iPad; or an Android App which will help you have your health log handy. Here is a link to some options for Android Notes apps.
The Doctor will see you now. Just remember, if you are lucky you have 8 minutes of real time. The clock is ticking.