Friday, December 31, 2010

Primary care needs more than 15 minutes for patients, KevinMD.com

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.

More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of what we do in my specialty.

In primary care we seldom spend more than 15 minutes at a time with an established patient. Yet we are required to cover infinitely more details and consider more outside authorities in every visit today than when I first started practicing medicine. Between health insurance and office administration, there are now many more mouths to feed from the office charges than there were then. Sometimes it feels like we are not alone in the exam room even for the short time we do have.

Except for doctors in concierge medicine or micropactices, most of us cannot change the amount of time we have with each patient. Even if we hope to change the system, the patients we see today deserve the best we can give them in today’s 15-minute visits.

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