There is growing concern that physicians are spending less time with patients. One study at Johns Hopkins earlier this year documented that physicians in training are now spending about eight minutes per day with each of their hospitalized patients. The reasons are complex: Things that used to be done by doctors, such as drawing blood, are now done by non-physicians; restrictions on duty hours limit the amount of time trainees can spend in the hospital; and managing the electronic health record now consumes a great deal more physician time.
While the reductions in time for patient contact have been apparent for many years, some of their consequences are still just emerging. It is becoming increasing apparent that when speed is of the essence, patience, curiosity, and compassion can cease to be virtues. Instead they often become expensive liabilities that must be weeded out in the name of increased efficiency. What will medicine look like in the future? As products of this system, will today’s young physicians come to resemble customer care providers at the health care counter of the local department store?
The patient – call him Mr. Jones – was a middle aged man, successfully treated for cancer, which was now in remission. He returned for a routine follow up visit and was being seen by a fourth-year medical student, Joe. Joe’s mission was to perform a focused history and physical examination and review Mr. Jones’ laboratory and radiology results. After consulting with his attending physician, Dr. Smith, he would reassure Mr. Jones that everything was going well. The whole visit should not have taken more than 15 or 20 minutes.