Richard Knox had a great story on NPR today looking at how technologies are replacing the oldest form of doctoring – the physical exam. Knox’s reporting focuses on how modern medical training doesn’t emphasize the old-school techniques doctors have been using for centuries.
His conclusion – that medicine has, with technology, sped up considerably at a cost shouldered by patients – echoes a similar concern I have heard from lots of primary care providers. Family medicine in the modern era has become treadmill-like. Rapid, impersonal, 10-minute appointments – at $60 to $100 a pop – are now the norm and they don’t give doctors much time to get to know their patients. Sure, a doctor can learn a lot about a patient by looking at his or her chart – or MRI. But a doctor won’t find out about lifestyle factors, for instance, that can be as every bit as important to health as an elevated cholesterol reading.
Conversations happen at the bedside or while a patient is perched on an exam table. These conversations are critical to managing a patient’s health, but they don’t happen as often as they used to. The shortage in primary care providers – like family doctors and internists who pursue general practice – only speeds up the treadmill even more. Who has time to perform a complete physical when there are 50 more patients outside the door who’ve waited three months to get an appointment? (More on Time.com: Why Medical Malpractice Suits Have Little to Do with Doctor Performance)
A family doctor I interviewed recently was complaining to me about how so few medical students decide to follow in his footsteps and instead pursue specialty medicine which is far more lucrative and can require far fewer hours of work per week. The family doctor I talked to cares for his patients literally from maternity ward to death bed. He delivers babies, cares for children and adults and helps elderly patients determine their end of life plan. It doesn’t get any more old school than that and here’s his prognosis for the current primary care system.
“We’re losing connections with people and patients. We’re losing the relationship, which is critical to primary care. The relationship you have with your patient is what can really help heal them.”
More on Time.com:
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