Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
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Dec - 19
Jan - 21
Feb - 8
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How do patients define quality physicians?
16 Jun2009
According to a 2006 study, patients want their doctors to be “confident, empathetic, humane, personal, forthright, respectful and thorough.” But in the age of conveyor-belt medicine, and the standard 15-minute office visit, it’s becoming apparent that today’s physician will have trouble fitting that mold.
From Kevin MD What do patients want from their doctors?
I am astonished. Patients did not talk about performance measures! Kevin talks about "tricks" for short visits.
Why do we insist on short visits? Our payment system discourages physicians from these desirable characteristics – because time is money.
This story should give the quality chiefs food for thought.
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- In: Medical Rants
3 Responses to How do patients define quality physicians?
amidoc
June 17th, 2009 at 9:58 am
So is there any evidence out there which looks at how many physicians have one or all of those traits when patients were asked these questions regarding their own doctors? May be it will be good to know where the physicians are on these 7 traits for their patients. Obviously, their will also be a patient bias when they answer these questions depending upon thier experience.
Also, you would expect every professional interaction (e.g a lawyer to client) to be similar; may be than we can compare how physicians fare in comparison to lawyers, nurses, other professionals etc………..
solo dr
June 17th, 2009 at 8:30 pm
Most office visits on routine patients with HTN or Diabetes can be done in 10-20 minutes. There are times I would like to spend 30-40 minutes with my patients, but the AMA makes a 99213 a suggested time of 15 minutes or 1-3 illnesses. Unlike an attorney or accountant, a doctor can’t charge in 10 minute increments. Both charge for phone calls and emails.
In my area, quality doctors, according to hospital administrtors and other doctors, are the ones who make lots of money by seeing 40+ patients a day and doing lots of procedures to make the hospitals wealthy. I personally don’t see the conveyer belt medicine helping patients in the long term. I also find that my capitated colleagus are good at talking healthy patients out of screening colonosocpy after age 70 and are good at pushing the sickest patients onto other doctors to keep their efficiency and quality ratings high.
Quality should not be measured in time but on outcomes. Providing rapid short visits has a risk of the doctor missing things. Only the large items will be addressed at each visit, max 1-3 things per visit and times is up.
Roy M. Poses MD
June 18th, 2009 at 3:58 pm
Why do so many physicians regard 15 minute (and shorter) visits as inevitable? Such short visits are, as Dr Centor noted, a product of the system used for physician reimbursement. Practically, Medicare sets the payments, and nearly all insurance companies and managed care organizations simply follow the lead. Furthermore, Medicare gave control of payments to the opaque RBRVS Update Committee (RUC), which is dominated by specialists who do procedures. They then manipulated the system to increase payments for procedures, which has resulted in decreased payments for “evaluation and management services,” including office visits.
See our latest post on this subject on Health Care Renewal:
http://hcrenewal.blogspot.com/2009/06/letter-from-ruc-and-my-reply.html
If we could fix the RUC, or eliminate its control of Medicare’s payment system, we could come up with a more rational system that would allow us to spend more time with patients when they need us to do so.