Medicine
It's rare that an article published in Business Insider "goes viral" in my Twitter and Facebook networks, but "Why Your Doctor Always Keeps You Waiting," by family physician Sanaz Majd, touched a raw nerve among friends and colleagues. In the article, Dr. Majd described "a day in the life of Dr. Tardy," a caring, competent family doctor who "doesn't like to take any shortcuts when it comes to patient care" and always seems to be running late. This hypothetical physician's typical half-day schedule consists of seeing patients in 20-minute time slots regardless of how much time they really need. The patients' complaints are the norm for a primary care practice: diabetes, heartburn, high blood pressure, depression, upper respiratory infections. By the end of the morning, Dr. Tardy is running more than a hour late.
By the time Dr. Tardy ends her morning, she is scheduled to see her first patient of the afternoon. It's a relief to reset the schedule once again, but this means that not only does she not have a break in the day (which doesn't really bother Dr. Tardy), but she also has no time for returning patient messages, reviewing lab results, or refilling prescriptions. This means tacking on about 2 hours at the end of her day to complete these tasks after her jam-packed afternoon schedule. And this is a typical morning for a primary care physician in the United States. Are you tired yet?
Keep in mind that the typical family doctor adheres to this grueling schedule most days of the week and earns a small fraction of a subspecialist's or hospital executive's salary, and it is unsurprising that despite a growing shortage of primary care physicians, family and general internal medicine residency programs struggle to recruit U.S. medical graduates to fill their existing slots, much less expand to meet anticipated future demand.
How to make a family medicine career more appealing and sustainable is a big project with a long-term horizon. But what can we do right now to reduce patients' waiting times while we wait for our current health system to transform into something resembling sanity? One of my residents, Dr. Troy Russell, is tackling the problem of redundant medical history taking with an innovative solution called Project C.A.R.E.S. (Communities Aided by Research and Education Solutions). In brief, he proposes to provide patients at with automated check-in kiosks that can transfer self-reported health history information directly into their electronic medical records, and measure the effect of this intervention on waiting times and patient satisfaction. If this pilot project is successful, it could inspire other underserved health clinics across the country to do the same. Please read more about the project and consider helping him and his team reach their 30-day fundraising goals to make this idea a reality.
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UPDATE 2/10/15 - Possibly due to the widespread interest that Dr. Russell's social media campaign generated in Project C.A.R.E.S., Fort Lincoln Family Medicine Center's parent institutions have agreed to fund this project internally. The private fundraising campaign has been suspended, and all donations to date will be refunded.
- Medical Resident Work Hours
An Institute of Medicine (IOM) panel has recently recommended further changes and modifications to the work rules governing medical residents. The recommendations go beyond the current rules, enforced by the Accreditation Council on Graduate Medical Education...
- Two Types Of "scut Work"
When I was an acting Medicine intern in Manhattan's Bellevue Hospital at the turn of the century, all employees who provided the hospital's "ancillary services" went home between the hours of 5 PM and 8 AM. It was the job of the on-call interns...
- Two Types Of "scut Work"
When I was an acting Medicine intern in Manhattan's Bellevue Hospital at the turn of the century, all employees who provided the hospital's "ancillary services" went home between the hours of 5 PM and 8 AM. It was the job of the on-call interns...
- Electronic Health Records: Medical Progress, Not Panacea
Yesterday, the family medicine residency program where I serve as a faculty preceptor "went live" with their new electronic health record. They posted a sign at the front desk that read in part: "Pardon Our Progress," as if we were starting a major construction...
- Taking The Pulse Of Primary Care Medicine
Previous posts may have implied that restoring an adequate supply of U.S. primary care physicians is all about money - that is, less student loan debt and reducing the salary disparity between "front-line" clinicians and subspecialists. If only it were...
Medicine
Project C.A.R.E.S. offers an innovative solution
It's rare that an article published in Business Insider "goes viral" in my Twitter and Facebook networks, but "Why Your Doctor Always Keeps You Waiting," by family physician Sanaz Majd, touched a raw nerve among friends and colleagues. In the article, Dr. Majd described "a day in the life of Dr. Tardy," a caring, competent family doctor who "doesn't like to take any shortcuts when it comes to patient care" and always seems to be running late. This hypothetical physician's typical half-day schedule consists of seeing patients in 20-minute time slots regardless of how much time they really need. The patients' complaints are the norm for a primary care practice: diabetes, heartburn, high blood pressure, depression, upper respiratory infections. By the end of the morning, Dr. Tardy is running more than a hour late.
By the time Dr. Tardy ends her morning, she is scheduled to see her first patient of the afternoon. It's a relief to reset the schedule once again, but this means that not only does she not have a break in the day (which doesn't really bother Dr. Tardy), but she also has no time for returning patient messages, reviewing lab results, or refilling prescriptions. This means tacking on about 2 hours at the end of her day to complete these tasks after her jam-packed afternoon schedule. And this is a typical morning for a primary care physician in the United States. Are you tired yet?
Keep in mind that the typical family doctor adheres to this grueling schedule most days of the week and earns a small fraction of a subspecialist's or hospital executive's salary, and it is unsurprising that despite a growing shortage of primary care physicians, family and general internal medicine residency programs struggle to recruit U.S. medical graduates to fill their existing slots, much less expand to meet anticipated future demand.
How to make a family medicine career more appealing and sustainable is a big project with a long-term horizon. But what can we do right now to reduce patients' waiting times while we wait for our current health system to transform into something resembling sanity? One of my residents, Dr. Troy Russell, is tackling the problem of redundant medical history taking with an innovative solution called Project C.A.R.E.S. (Communities Aided by Research and Education Solutions). In brief, he proposes to provide patients at with automated check-in kiosks that can transfer self-reported health history information directly into their electronic medical records, and measure the effect of this intervention on waiting times and patient satisfaction. If this pilot project is successful, it could inspire other underserved health clinics across the country to do the same. Please read more about the project and consider helping him and his team reach their 30-day fundraising goals to make this idea a reality.
**
UPDATE 2/10/15 - Possibly due to the widespread interest that Dr. Russell's social media campaign generated in Project C.A.R.E.S., Fort Lincoln Family Medicine Center's parent institutions have agreed to fund this project internally. The private fundraising campaign has been suspended, and all donations to date will be refunded.
- Medical Resident Work Hours
An Institute of Medicine (IOM) panel has recently recommended further changes and modifications to the work rules governing medical residents. The recommendations go beyond the current rules, enforced by the Accreditation Council on Graduate Medical Education...
- Two Types Of "scut Work"
When I was an acting Medicine intern in Manhattan's Bellevue Hospital at the turn of the century, all employees who provided the hospital's "ancillary services" went home between the hours of 5 PM and 8 AM. It was the job of the on-call interns...
- Two Types Of "scut Work"
When I was an acting Medicine intern in Manhattan's Bellevue Hospital at the turn of the century, all employees who provided the hospital's "ancillary services" went home between the hours of 5 PM and 8 AM. It was the job of the on-call interns...
- Electronic Health Records: Medical Progress, Not Panacea
Yesterday, the family medicine residency program where I serve as a faculty preceptor "went live" with their new electronic health record. They posted a sign at the front desk that read in part: "Pardon Our Progress," as if we were starting a major construction...
- Taking The Pulse Of Primary Care Medicine
Previous posts may have implied that restoring an adequate supply of U.S. primary care physicians is all about money - that is, less student loan debt and reducing the salary disparity between "front-line" clinicians and subspecialists. If only it were...