Sat, 21 Apr 2012
Distracted Doctors

An article from Newsweek, via The Daily Beast, The Doctor Will See You-If You're Quick describes how stressed the relationship between patients and doctors has become today in the US.

Unhappy patients gripe about their doctors’ brusque manner and give them bad marks on surveys and consumer websites like HealthGrades and Angie’s List. They tell tales of being rushed out of the office by harried doctors who miss crucial diagnoses, never look up from their computers during an exam, make errors in prescriptions, and just plain don’t listen to their patients.

A number of reasons are highlighted, including health care reforms, aimed at reducing costs (mixed results there), medical insurance changes and an assembly line mentality. A lot more people are in the system now, and the number of, and complexity of, treatments has also risen hugely. No wonder things are getting stressed.

While specialists could often combat falling fees by doing more procedures, primary-care doctors get paid by the office visit, so all they could do was cram more appointments into a day and increase their panel size—the number of patients in their practices. For primary-care doctors to do a good job, says Bodenheimer, panels should be below 1,800. Today the average primary-care doctor in the U.S. is responsible for about 2,300 patients. At so-called Medicaid mills—clinics that see mostly poor patients covered by state Medicaid plans—panel sizes can reach 3,000 per doctor.

Similar issues arise in the UK, although much mitigated by the National Health Service, even though it is certainly extremely imperfect.

I'm in the process of sorting out a doctor (General Practioner) at the moment, so this has some resonances for me. The health service is one of those things that always gets people worked up. Health is important to everyone, but it's also very expensive, and getting much more so. Affording it is getting harder but working out where to compromise and reduce costs is no easier either.