Natural Phenomenon Which Kills Both the Doctor and Patient

Insurance cuts re-imbursements and doctors cut time with patients - a natural phenomenon, which nevertheless kills both, doctor and patient.

Ever since the cut in re-imbursements, doctors have answered with the only weapon they knew: cutting time with patients.

A decade later most doctors’ lives are set - set on the road to be overworked and underpaid if not right down poor.

There simply is only so much time you can cut seeing a patient. And the bad part about this is: you will never ever increase your income that way. It is mathematically not possible. At best you can keep up with what you made before, by working like a horse.

But here is what you for sure will do and have already done by actual survey:

You will get stress.

You will only be able to squeeze so many patients in and thus limit your income.

You will make the patients feel like they are not taken care of and not listened to.

You will create the feeling amongst your patients that you have not found everything or at least not the right reason of their symptoms because of no chance of telling you ALL their story. (It would not matter whether that is true and whether you have definitely found everything - it is the patient’s perception that counts.)

You will create a feeling of dissatisfaction with patients and believe you me, they will be taking longer to get well because they have less certainty of their treatment. Call it the placebo effect or magic or voodoo - a trust in the doctor, which largely comes from actions which the patient can observe and evaluate and make him feel comfortable, will have a significant impact on his recovery.

You will open the door to misdiagnosis, by not having understood all, or by simply not having done all tests, because you had no time to ask the question behind the question and thus did not order some test which might have found some important facts or which might have found that all is OK and that a big problem is ruled out. You will again have missed putting the patient at ease.

The above paragraph might also indicate that you would have missed out on huge - immensely huge income from these additional tests, visits and treatments. And all that while not doing right per the patient.

You would have opened the door for lawsuits coming your way from one or two patients who sued for millions because he got sick and some lawyer sells him the idea that his previous doctor (you) could/should have prevented that with proper diagnosis.

You are losing invaluable patient referral. Oh yes, even though you might believe that due to insurance participation, patients have no choice than to go where the insurance sends them and that that is the reason why referrals are not what they used to be. Perhaps there is some truth in it but not enough to justify the overall low referral rate in the country compared to 20 years ago. As we said above, patients feel not cared for, not listened to, not checked enough, not understood. Truth or not is not important. What is important is the perception of the patients. None of that latest high tech equipment will make even for a friendly smile. Thus much, much less referrals and the need for expensive and almost unworkable marketing.


Besides the above points, I have observed that most doctors are not on the up and up to what tests should be administered for what symptoms. Doctors have ceased to be good investigators because of the time restraint they put themselves into. Doctors also are not aware of the new age of referring. That is my made-up name but what I am referring to is how thousands of doctors bring highly paid services on an ON DEMAND basis into the practice and be perfectly clear with the Stark Law. This gets them paid for services which they thought they could only refer out with no reimbursement.

I found that doctors are simply too busy - by their own design - to keep up with what is happening in their backyard. And when they finally find out they are too busy to check it out and thus when they finally act on such new services or new ways, it is something everyone does and just like buying Microsoft stocks today, makes hardly any difference at all.

Summary:
Ironically, cutting patients’ time is the exact limitation to not only less income for the doctor and more stress for him but also less health and more risk of being severely injured at advanced age for the patient.

By the way, the increased time you need to spend with the patients is not in doing the tests or the treatments, no, I am not saying you should work slow during those actions. The increase in time is needed to explain why the patients needs the tests, or actually to find out that he needs those tests or treatments in the first place. It’s the time you need to find out where the patient comes from, what are his deep fears and desires and hidden questions, by talking and talking and talking. Not chit-chatting about the weather but precise questioning which discovers sub-standard health conditions.

That’s the bottom line.