DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Fixing health care – Time

“Time is more valuable than money. You can get more money, but you cannot get more time.”

Our favorite retired doc has a great post today – Patients value “thoroughness” in their docs.

This post reinforces a point that I make repeatedly.  Patients want our time and are willing to pay for that time.

What bothers me most about our current payment system is the incentive to see more patients rather than spend the appropriate amount of time with each patient.  As we reinvent medicine, we must reward physicians who spend the right amount of time with each patient.

What do you call an internist who spends enough time with each patient? POOR!

The current insurance payment model makes little sense.  We get paid for a visit, not for the work we do.  We do not get paid for preparation, reviewing consultant letters, reviewing lab results, calling the patient, answering emails or spending an extra 10 minutes explaining the plan to the patient.  Therefore, too many physicians do not spend the extra time to think.

The attractiveness of retainer medicine is that these issues are implicit in the payment system.  Retainer patients buy their physician’s time and access.

We must evolve or revolve to a better system.  Our patients deserve it.  The profession needs it to maintain our self-esteem.  And it probably would save the overall health care enterprise moneys.

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