Home > Issue 28: July 2012 > The time factor: my doctor is in a hurry!

The time factor: my doctor is in a hurry!

Many a time when we go and see a doctor, there is a feeling that the doctor is in a hurry or rushed, distracted or doesn’t really care about the patient. Health systems are increasingly facing the issue of inadequate time being given to patients by doctors. It is a global phenomenon. Proper interactions between the patient and the doctor are an integral part of medical care. Research shows that outcomes of medical care are more successful when a trust is gained between the patient and doctor through spending adequate time and understanding the life and health of the patient.

Ironically, at present many of the doctors do not give adequate amount of time to the patients. In our efforts to improve patient care, we developed and implemented a Code of Professional Conduct for clinicians at ADK Hospital. In the Maldives, this is the first such initiative taken by a healthcare provider. One of the key factors of the Code is to spend enough time with the patients. Subsequent protocols of the hospital also reiterate this matter since if the Code and the Protocols are to be adhered, a significant change in the time spent with patient should happen. A change in a culture is always a challenge.

We conducted an audit at doctors’ OPD’s to determine the amount of time doctors spend with patients. Given that the doctors have to take a patient history, examine the patient, write the records and produce a prescription, obviously time is needed to ensure all these are done. In most cases the average time spent per patient is 5 minutes or less for the departments that the audit was conducted. This is a very little amount of time spent on patient care. Efforts need to be put into to ensure that this is changed. Continuous monitoring and making doctors to understand the importance of the time factor is crucial. In fact, it is the doctors who gain from a little change in their current habits.

There are many reasons why this change needs to occur. It should occur across the whole health system in the Maldives as well. For example, the time factor contributes to

Patient satisfaction. Patient’s who visit doctors who spend more time and involve patient in care are seen to be more satisfied with the care that they got and are less likely to leave that practice of that doctor.

Outcome of diseases. Although no concrete evidence is shown in research, there are some research findings that indicate that longer consultations have lead to more understanding of the disease by the patient and hence lead to better outcomes.

Rational prescribing. Studies have shown that shorter consultations have longer prescriptions. Doctors who spend more time with patients are shown to prescribe medication and investigations more rationally than those who spend less time.

Doctor satisfaction. There is ample research that shows longer visit lengths foster better patient interactions that lead to better satisfaction for doctors. In fact, studies show that good patient relationships increase doctor’s confidence and satisfaction and hence lead to better quality of care as well.

Lower risk of malpractice/negligence claims. It is also seen that doctors who tend to have better patient relationships, given the above factors as well, have found to be less likely to face malpractice and or negligence charges.

So what is the ideal amount of time a doctor should spend with the patient on a visit? There is no concrete evidence as to what it the optimal time for a doctor’s visit. What is seen is that longer visits allow time for more attention to many aspects of care. Patient participation and education increases thus leading to better outcomes.

For us, understanding this aspect of care and adhering to existing protocols and standards addressing the issue will be a start towards an improved quality of care.

Categories: Issue 28: July 2012
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