A physician in Texas posts this photo on Facebook. Caption: “My schedule one morning in January 2014. Never again . . .”
Yay! Another physician breaks free from assembly-line medicine.
High-overhead, high-volume offices sacrifice the sacred physicians-patient relationship and perpetuate a disease-billing management system. This is NOT health care. It’s abuse.
Patients: avoid clinics with 10-minute slots. Go for docs who offer 30-60 minute appointments. Physicians: stop following the same old practice management advice. Follow you Facebook friends. They offer the best support and business tips:
This is so sad!!!!
I can’t believe people practice like this! Every 10 minutes??? We’re doctors, not robots!
And this is what people have to spend their hard earned money on insurance for. Pretty sad, but mostly sad for the exhausted doctor who can’t possible be making a difference in someone’s life with 10 minutes.
Throw in a cumbersome EMR and that’s a recipe for surefire burnout by 10 am!
I was a medical assistant back in the day for a physician who kept a schedule like this. This is an impossible schedule to maintain and just sets up a system where the individuals involved with providing care constantly feel like they are failing. Very demoralizing. Very depressing. Definitely not a practical approach for the patient or the physician (and his/her minions). I used to get chastised for taking “too long” to collect a patient history (even five minutes was considered “too long”) and the physician told me I had to “stop talking to the patients so much.” I told the physician that there was no way to get an accurate history without talking to the patients for more than five minutes… the physician told me I would “eventually grow out of my need to talk to people.” Ha. Wrong.
This makes me want to cry.
This has been normal for the state NHS GPs here in the UK for over a decade! Only now are they burning out as the state wants them to do surveys, audits, med reviews, etc as well as consult with the pt in the same 10 mins!
Obscene.
This is crazy, not only does this burnout the physician but how on earth can any true healing happen with type of schedule, no time to even talk to them no wonder the country’s health sucks and we spend so much money because there is no healing in the business of medicine.
Welcome to my world. Friday, like too many days, I did not get to pee or have a sip of water…eating almost never happens and a “lunch” doesn’t exist… I felt like I was in solitary confinement. Thank God I still love what I do and love my patients—these are the only two things that keep me going.
That’s nuts!
Yes, and the amount of documentation required to be reimbursed adequately for that 10-15 min visit takes about 25 mins each patient unless you can stomach being a fraud (which I cannot) so then you’re perpetually behind on that, so…the cycle is very dissatisfying and makes a lot of us wish we had chosen another career option, but then we realize that our medical school debt is so deep that there is no other option for us, so we carry on… 🙁
When did this great country become a country of wimps and sickly people?
Dear physicians, NPs & PAs: PLEASE rebel when the bean counters try to do this to you.
We write our own stories through the choices we make.
You have the power to say NO!
Pamela Wible, M.D., is the founder of the ideal medical care movement. She teaches physician retreats where she helps physicians reclaim their lives and their careers—so patients can finally get the care they deserve.
When I use the sick care system in the US, it is abuse. Paperwork abuse. “Wasting my time” abuse. “Violating personal information” abuse. “Doing business with people who are impersonal” abuse. It is abuse almost on every level. There is no other business I would continue to business with who treated me like they current sick care system does. Why? Because at the present time I have no choice/. May some day an “Ideal Clinic” will come to my area. But I have hope because of doctors like Pam Wible!
It’s greatly to her credit that she wants to provide good care to regular people. Some doctors convert to “concierge” practices where you have to pay a bundle over your insurance and copay. I wonder if the bean counters can afford the concierge plans…nah, they’re probably ordered to count the beans by those who definitely can.
I’m so glad to see a dr speak up. I’ve been fighting health care for the last few years. Just last year I didn’t have a bowel movement for over 1o months. My GI dr was great and was doing everything in his power to find a surgeon to fix me. I was turned down by 5 right out the gate. The 6th just ran me around for 3 months and kept charging my insurances 500. to 600. for each follow up appt that he spent 5 mins at the longest repeating what he said before but yet still did nothing. Finally my GI dr found a 7th surgeon n he stated he really didn’t want to touch me and I told him I would sign anything that stated if I didn’t make it through the surgery that no one could sue him.
Thank GOD I have a medical back ground and a strong will to live because I would not be here today. Yes I had my colon & lower intestine removed and recovered faster then any of the dr’s could believe but it scares me for people who don’t know how to stand up for them selves or are not able to and don’t have anyone to fight for them.
I have several health issues and I just moved to another state set up dr’s appts to get established as a new patient and was so surprised when they didn’t ask for my medical records which I paid for and brought with me to each appt. The only thing that was asked was what current meds do I take and my vitals taken. The dr came in spent 4 1/2 mins with me and never knew that I just had 2 major surgeries within 10 weeks of this visit also did not know that I have MS, COPD, Peptic Ulcer Dis & history of stomach cancer. So yes Dr. Wible you are so right and how sad this is not to mention most people who have not experienced real health issues understand that if it continues like this their will be more people who will be diagnosed late with a major illness or disease because 5 mins is not long enough for any dr. to gather the needed history to know if a patient needs to be watched for certain things like cancer, diabetes, heart disease etc. I pray that more doctors speak up and do what’s right for the patient that’s what a doctor took the OATH for and for those that just want the money and don’t really care about patients then I pray someone they love and care for never get treated the way they treat their patients. That’s my #1 question when a dr makes a statement to me that I question is are you treating me like I was your mother, daughter, wife or sister? And if they don’t hesitate or look surprised then I usually will trust their advice. Thanks so much for speaking up and I’m trying to get a web site set up with my daughter to help anyone with advise or anything that we can assist them with as a patient to understand you can terminate a dr just like you would a bad mechanic if your not comfortable with how you are treated.
Ruby, has any doctor ever hinted that there are things you can do to help yourself heal? “All healing is essentially the release from fear.” ACIM
I had such bad luck with MDs in my youth that I had to learn how to care for myself. I eat very well, and simply – see Genesis 1:29. And I work to let go of all grievances and maintain an untroubled mind, because just as stress/fear leads to tension and dis-ease, a peaceful mind fosters radiant health.
Best wishes for a happy, healthy life. There is a great deal of information about diet and health on the internet. We are blessed to live in this age.
i think we could work together… to advocate. we all have a story and as patients are really powerless, unless we work together to change the broken system. We are the customer, buying a service.
lmk if you have a interest. ty and good luck
Yes you can terminate a being a patient of a Dr you don’t like but then you gotta worry about DR shopping! The new thing they crumingly added to stop drug addicts, but did they realize it can keep patients stuck with a bad Dr or not getting the right care etc? My guess is they don’t care.
Congrads to you. I hope you method spreads like wildfire. It will be a relief for a both patients and doctors to be able to work as a trusting team. I think my doc was bullied. If that is the case, I am sorry and I hope someone who might be able to help him reaches out to him. I can not imagine his suffering hurts any less than mine. I hope he sees he really has a choice. I did not have that option. Sorry county doc… The corporate is eating you alive, and you let them throw me to the wolves. I will work to change that for us all. I did not sign up for “care” like this.
Please spread you ideals more and congrads and thanks for caring.
I’m so upset I just don’t know what to do. I’m in severe pain daily from multiple serious medical conditions I injured my back badly AND have degenerative disc disease, I have extremely painful fibromyalgia, peripheral neuropathy and I suffer severe debilitating migraines for which my Neurologist told me take 800 mg of ibuprophen even though I told him not only doesn’t it work at all, I have an ULCER which contraindicates it’s use and even my pharmacist said that dose should not be taken daily for more than 2 WEEKS! My migraines last anywhere from 12 hours to 2 weeks straight where I’m in bed w ice on my head all day unable to even watch TV! My back is so bad I only sleep 4 hours and in that 4 hours have to switch position 6 times because laying in one position too long the pain wakes me up! I’m getting worse and no Dr. will help me! they all just prescribe NSAIDs or tell me I just have to live w the pain! I’m sufferring here for no good reason! I have never abused drugs nor would I yet I feel like they care more about that chance then helping me. I live alone there is no one to help me. The pain has increased to an unbearable level and I’m discgusted w Drs. I’m now in so much pain I can no longer even prepare meals for myself but all they do is write a script for an NSAD! which I feel like throwing in their face. I have xrays and mri to back up that I”M IN REAL PAIN. please help. I never imagined people would be allowed to suffer like this in America! I only get to see my daughter 2 times a year and I was in bed the whole last time in unbearable pain! HOW is this fair? Why make me suffer because of druggies, freaking let them be druggies if they want it’s THEIR life, don’t make law abiding people suffer because they “might” become addicted. shame on you lousy Drs that let people suffer! SHAME on you, next time you have an abcessed tooth or a root canal take no meds n see how you like it, then magnify that to someone who has to suffer every DAY in level 7 to 9 pain unending for YEARS! With NO relief! You should be embarrassed to call yourself Drs! lousy cruds
im on ssd at age 41.losin my houde 2 medivsal drbt forclosure,have a hunny anf 3 kids,born asthmatic,and on ssd cause of mac deg,criplled from type 2 diebettes,veftarian,weigh 220,im 5 ft2,non s,okin,heath famatic,hav gerd,constantly sob,had 2 lung blood clots,lung nodulr,phemonia 3 times last yr,spents 2 monrhs in hospital.2 months nurseyin home.never knew I was diebetic til my legs and feet sweellwd like the incredible hulk,losy my ability to walk,clean hose,get out of bed,now im slpeepin doenstrairs,usin a wheelchair,barey a walker sleep downstrs pull out of sofa sleeper n2 my wheel chair 2 get up,wash up on my habdicap toilt,use no rinse shampoo,payin for my own nebulixer,poertable, plug in oxygen ,and my wheel vhair.know both my asthma specialist and fam grs say I no longer hav asthma when lots of other drs,specialts,ct scans,blood wk tell otherwise,my dr of 40 yrs retired 2 yrs back in feb 2016.i hav the scars in my lungs via ct scan proff of asthma ct scan,other dr records,hav a 10 cm cyst lrft on my splrrn,13 fibroid cysts,not biopsied yet,my drs wanna cut off my meds/oxygen,not hiv out referals,if they do they no longer takr the ind/im lungs r 2 risky for anthejia,i hav str8 medicare,lookin 4 u of m drs/henry fd drs,instead of beaumount drts
This type of abuse is from the MD MD/student right down through nursing pracice (and nursing students!) to the medical assistant who has a practice manager standing in the halls of a large group office (PCPs). To make sure your have that patient in and out in 15 minutes! Does anyone know how long it takes a poor old fragile patient in their 80s or 90s just to get into the exam room? This is abuse and bullying of human beings in general. It is introduced in education. For example I am treating patients for one illness yet when I catch that illness in clinical, I will be discharched if I miss more than so many days out. I was told to return, and don’t tell anyone! This is a nurse instructor! How lovely, return and infect more patients. No extension on time to finish assignments due so without a doubt all medical students from the nursing assistant to the MD are being abused and it must be stopped in all training institutions (that’s where it begins) and all places of employment (which endangers those in the health care field and their patients. This is epidemic! If the head professors/instructors of these institutions and the practice managers of employment were the ones held accountable perhaps there would be change but these abusers always seem to threaten the victim. So just as “sleep and rest” is necessary to sustain human life,without it the mind will go insane until eventually death occurs by any means (auto accident, suicide,etc) so let it be written into educational and employment protocols and agendas. Just as we fill in schedules for classes, we need to include blocks for sleep & rest into the cirriculms and work schedules. As far as 15 minute appointments? I miss the old fashion days when I was a kid my doctor would come to the house when I was too sick to leave. That’s old fashion, but he was such a good doctor! Most likely because he wasn’t part of big business-he was practicing on his own.
Primary care is being held hostage to a tertiary care medical model. This is the main issue. We suffer from a huge lack of leadership in medicine now. The answer from the powers that be is just to keep doing more of the wrong thing. We all have a responsibility to stand up against human rights violations bullying, abuse. If we are complicit with the abuse, we become the perpetrators.
Family physician EMR issues:
Our EMR works OK at the main surgery but not at the branch surgery in a nearby town. Due to slow internet and software issues it is always slow and often unbelievably slow.
This makes it impossible to access important parts of patient files like hospital discharge letters, within the allotted appointment time.
The printers are so slow it can take 5 minutes to print out a simple letter,and 30m minutes to print out an incoming 8 page document.
When the internet is down we can’t access the patient files or appointment lists.
This detrimentally affects patient flow.
How can the doctors,nurses,and secretaries get the message through to non-cinical management and the practice owners that this is a really important issue for patient care and clinical staff well-being.
Please help me. I have been seeing my current primary for over 2.5 years, I have been prescribed antibiotics among many other medications I’m allergic to (penicillin, ceclor…) to several times in the last year.
At each visit/follow up the doctor spends literally less than 2-3 minutes The first time he did this I said “Hey! I have some concerns” He stood halfway out of the door, rolled his eyes, and said whatever he thought he needed, to get into his office. It wasn’t busy at all…No patients waiting (I recorded the last visit.)
He’s not even stepping completely in the exam room. Doesn’t examine me if I have a sore throat, earache or whatever.
I have requested medical records for my own files and they full of inconsistencies, don’t make any sense and I have actually read on one visit he states I’m obese due to high calorie consumption. (I have gained 50 lbs since I fell down stairs over a year ago due to nerve damage in the lower back causing my legs to give out.) I just recently fell again about 2 months ago. I have RA and haven’t been referred to a Rheumatologist almost 3 years later…I have mobility issues and I’m waiting on a referral to an ortho surgeon, I have one for the back and another for my knees. I had seen pain management which consisted of painful facet joint injections which caused electrical shocks up my spine with each injection and then they didn’t work at all. (*this is in my med record stating I didn’t want to go back to pain management because he only wants to give injections????)
I currently don’t receive ANY medication for pain. I can’t stand for more than 5 minutes without my lower back going numb, followed by my buttocks, then my legs, I’m terrified of becoming paralyzed.
I’m not losing weight & I don’t over eat, my brother who is a dietician and health nut said I’m not getting enough calories and my body is in starvation mode. I haven’t had labs done in over a year and am being prescribed a statin.
He has failed to get me referred to specialists. I have difficulty getting to some appointments due to the distance and they are aware of this reason. I live in a small rural town and unfortunately this doctor is one of the “better” ones. The one prior to him, flat out called me a liar when I brought in my allergy testing papers listing all the items I tested allergic to. He proceeded to prescribe an antibiotic I’m highly allergic to. I apologize for the longevity of this, I’m in tears as I’m writing this.
Thank you for your time.
I am sorry again. I just need to figure out which way to go at this point.
The first thing you need is a new doctor. A guy who won’t even enter the exam room with more than half his body is not the right guy. Where do you live? You need a great family doc or primary care nurse practitioner. Someone who cares. That’s the magic. As long as you keep going to people who don’t care, can’t care, or have no time to care, you won’t get health care.
Hi, a yr and a half ago in March of 2016, I injured my knee when I miss stepped on a walk with our dog’s. The pain however was incredible. I’m not a ‘run to the doc for everything’ kind of person but ‘I knew’ something was wrong. I went to my primary and explained it and how bad the pain was. She just said it’s not broken and sent me to P.T., unknowing of what it might be? I did what I was instructed to do while the pain increased, range of motion decreased, among other change’s throughout my body. Went back to her again saying something IS wrong. She said,’oh, still limping?’ Sent me back to P.T. again this time with a script for Tramadol to deal with pain when I’m at work. Well, I could never have worked had I taken it. I tried it on a weekend ‘at home’ and was very loopy and disoriented like a drunk driver! I saw her again insisting it be looked at with x-ray’s etc. I went from an x-ray, to an MRI to an Ortho Surgeon, to surgery on April 15th! I had dealt with this injury a full year in severe pain before with a disrupted walk/stance etc before finally having surgery. It was a severely torn Meniscus in my Left knee and has now progressed into a full blown nightmare. I’m 6 month’s post-op and have been in P.T. the entire time (spending a small fortune there as well) have OA in that knee really bad, a Baker’s Cyst behind the knee causing sleepless night’s every night, which I didn’t even know was there till they pulled my file at P.T. but I had told the Dr. about that pain for month’s following surgery,then had to beg for an injection which I finally received at the end of August and was told it would take a month to work, (if it worked), which as of today, has not. My Physical Therapist is livid that I’ve been allowed to limp around a year and a half in awful pain, can’t do stair’s still, other side of my body is now all messed up from compensating for the bad knee all of this time and she has pulled my operative report and MRI to see what it said and how they can try to help. Today, I’m calling the surgeon’s office to tell them the injection failed so now what? As a patient, if you aren’t familiar with the world of medicine, it’s hard to know what right’s you do have and what question’s to ask but, talking to people seem’s to help as I’ve gained more information through therapist’s, people wo ‘have been there’ etc. I’ll will be curious to see how long it takes to be fully healed from all of this, if I don’t end up having a full knee replacement now, as my P.T. said the operative report as well as the MRI show one of the worst knee’s she’s seen in 30 yrs. and I’m only 51 and had NEVER had a problem before all of this took place. It’s affected my personal life, social life, work, everything! Unacceptable in my opinion!