There was a time that when a doctor used to see his/her patients for 20 – 25 minutes, but that’s unfortunately shrinking now. Doesn’t matter who you are and how much time you want to spend at your physician’s office. Getting the most out of your doctor’s appointment has been significantly affected by insurance companies, because the doctors aren’t financially encouraged to take time for critical thinking with their patients. Instead, they will get paid for sending them to get as much tests as possible. How can you avoid getting caught up in this?
Insurance companies make it hard for doctors to spend time with their patients
Spending time asking questions and finding more about the medical history of the patient will not be reimbursed by insurance companies, but the number of patients they put through the office will get compensated. If insurance companies and the government would pay doctors an extra couple hundred dollars for critical thinking time, instead of paying for the $1,500 test, scan, or image, the health system would get better results, have lower costs, people would have better care and the doctor-patient relationship will get significantly improved.
Doctors could have the option of getting out of insurances and adopt concierge medicine. This requires that the patient pays an annual fee or retainer to the primary care physician, in exchange for which the doctor will provide enhanced care and commitment to the patient, in an adequate time. This is not a solution, though, for every physician and should not be the norm.
When doctors don’t spend very much time, they get rushed and work with stereotypes: what age is the patient, gender, what they do for a living and make quick thoughts about what may be the cause of their illness and what tests could prove their theories. You might have heard, more than a couple of times, the phrase “let’s order this scan or these tests and see what they show”.
Doctors are not always to blame here. Every other day, something comes down the pipeline and some regulations will interfere with the best medical advices. If a doctor considers that the best course of action is an MRI or an ultrasound, but the insurance people who have to act by strict regulations, not necessarily by medical considerations, think that there aren’t enough conditions to ask for this kind of testing, then the examinations are not going to be approved and the financial and reimbursement frustrations will ensue. These types of situations drive the doctors crazy as they want to make their ends meet and take care of their patients.
Is it the doctors’ fault that they’re moving faster and jamming more patients, or is it just that the whole health care system is on the verge of collapsing and the quality of care has gone down?
Tips on making the most out of your doctors’ visit
Considering this, patients should take some extra steps for preparations when going to see a doctor: think about how to make your visit more productive, what kind of questions you should be asking, bringing all relevant test results or list of medications that you are taking.
How to get the most out of your doctor’s appointment?
- Have a written list of all of the medications, instead of the doctor going through one of those bags, with the old bottles and look at everything. Make a list of all the allergies that you have, make a list of all the medications that you take and be very specific about the reason why you’re there.
- Talk frankly about what’s bothering you: If you feel that your doctor is not hearing you, don’t be shy to say: “Doctor, I need your help with these symptoms. What’s the diagnosis, should I get this test?”. Just questioning the doctor can stop the whole rush and basically get them to devote time to you. Put your finger right on the issue when you sense the doctor is on automatic pilot and not really hearing you. Break them off out of that by asking the question: “doctor, I know I’m a little bit young and I know I’m not at high risk for cancer, but could this be that?” or “You know, I’ve been told I’ve had this condition for two months… they’ve been treating me, it’s not getting better, could it possibly be something else?”. Get them to use their critical thinking they got their training for and break them out of that automatic pilot.
- See them in their early office hours. Doctors are a little more tired when you see them at 3 or 4 o’clock. Try to get an appointment with them at 7 or 8 a.m., as one of the first patients.
- Ask for a second opinion: There are circumstances when doctors tend to send their patients to do a biopsy without sufficient risk factors. This should be each patient’s choice to decide if they feel that the statistics are in their favor and they could wait for a palpable lump to appear or be subjected to a lot of biopsies with 90% false negatives. In these circumstances, having a second opinion could help you make a better and safer decision.
The fact is that some doctors are under pressure to meet financial quotas imposed by the hospitals and insurance companies. However, this doesn’t mean that they’ve abandoned their vocation of helping their patients and improving their lives. Knowing what to ask and how to present all the facts of your illness when going to the doctor, will create a bigger and more comprehensive picture that will help them put the puzzle together and know which course of action to recommend.