15-Minutes or less Visits Take Toll on Doctor-Patient Relationship

 Patients – and physicians – say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements. 

It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. 

And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.

“Doctors have one eye on the patient and one eye on the clock,” said David J. Rothman, who studies the history of medicine at Columbia University’s College of Physicians and Surgeons.

By all accounts, short visits take a toll on the doctor-patient relationship, which is considered a key ingredient of good care, and may represent a missed opportunity for getting patients more actively involved in their own health. There is less of a dialogue between patient and doctor, studies show, increasing the odds patients will leave the office frustrated.

>READ FULL ARTICLE about the struggle for control from medscape.com

Remote Patient Visits/Prescriptions - Playing with Scorpions

Prescribing by Phone Is Like Playing With Scorpions

Can you practice medicine over the phone? What is an appropriate way to use communication technology to help treat patients? Recently on Medscape Connect, an all-physician discussion group, members discussed how they had used the phone and other devices to diagnose, prescribe, or otherwise deal remotely with medical issues.

A primary care physician started things off: "Given my experiences with my own patients, I always insist they come into the office before I prescribe antibiotics if I haven't just seen them. Have you had experiences where you were glad you made your patient come in to your office before treating them based on what they told you over the phone, or a time when you wish you had?"

READ FULL ARTICLE from medscape.com

Electronic Patient–Physician Communications Face Barriers

Telephone calls and emails by patients can be very efficient, but these electronic communications may never be widely used unless physicians are reimbursed for them and are given extra time to do the work, according to a new study published in the August issue of Health Affairs.

Despite the potential advantages associated with e-communications, a 2008 study has found that less than 7% of physicians regularly communicate with their patients electronically.

READ FULL ARTICLE from medscape.com