One of the biggest changes is the amount of time allotted to an office visit. “In the practice of internal medicine as recently as a decade ago, seeing 15 or 20 patients a day in the office was considered pushing the limit for a conscientious physician. Today, 50 patients a day is common and reports of 70 or more are not unheard of,” he said.
Further, he said, “In a tightly run managed care setting, the average outpatient visit with a primary care physician is six minutes.”
This comes at a time when the whole nature of the visit to the doctor has changed for many patients. It used to be that the greatest causes of suffering and death were acute diseases, especially infectious ones, said Ludmerer. You got pneumonia, went to the doctor, did what you were told. “That allowed for a more paternalistic, authoritarian role for the physician and a more passive one for the patient,” he said.
Now, the prevalence of acute diseases has been overtaken by chronic ones – such as cancer and cardiovascular disease — that may not be cured, but can be managed and controlled over time. They call for patient involvement that is greater than ever, including reading about medical issues on the Internet and in print and preparing questions based on that information.
“Best results are obtained when patients are motivated and become knowledgeable about matters like what to do to prevent a complication,” he said.
Given all of this, you may well find yourself needing more of an information exchange with your doctor at the same time that you have fewer minutes in which to get it.
It’s a challenge. But rather than being a disappointed patient, become a smarter one. That calls for taking steps before, during and after your visit with the doctor.
First of all, a good office visit starts at home, said Dr. Lila A. Wallis, clinical professor of medicine at Weill Medical College of Cornell University in New York City and past president of the American Medical Women’s Association (AMWA) an organization of female physicians and medical students.
She recommends that you prepare and maintain a detailed, accurate record of your health and your family’s health. In her book, “The Whole Woman: Take Charge of Your Health in Every Phase of Your Life” (Avon, 1999, $17.50), she provides a format on how to do that. If it sounds like a lot of work, consider whether it isn’t just as important to keep track of your health as your tax records or repairs on your car.
“You not only know what’s going on with yourself, you are a better patient,” Wallis said.
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Tags: acute diseases, medicine, pharmacies