The Physician-Patient Interactions

The Physician-Patient Interactions

Abstract

This paper discusses the reasons why doctors have limited time with patients and the effect this has on the patient. The increased workload and tight schedule imposed on the doctor leads to reduced interaction with the patient. The patient experiences doubt due to the apparent lack of time by the doctor. The paper suggests that the nurse can improve the physician-patient interactions through action. Using his/her unique position in the health care system, the nurse can alleviate the anxiety felt by the patients by providing relevant information concerning treatments. This will improve the patient’s perception of the health care services provided to him and lead to better patient health.

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Introduction

Doctors play a critical role in the provision of health care services to the patients. Through their expertise and professional knowledge, they are able to diagnose the patient’s disease and prescribe the appropriate medication to cure the disease. In addition to this, doctors provide advice that the patient can follow in order to enjoy better health outcome. The time spent by the doctor in contact with the patient is of great importance. During this time, the doctor carries out the crucial task of gathering information about the patient’s condition and develops a relationship with the patient. A good doctor-patient relationship is necessary for the doctor to be of maximum benefit to the patient since such a relationship will enable the patient to disclose useful information freely and trust the professional judgment of the doctor. Time plays an important role in determining the level of patient satisfaction and bolstering the doctor-patient relationship. Longer visits are associated with better patient satisfaction and doctor-patient relationship outcomes while short visits have a negative correlation. In spite of the great importance of quality time, doctors find it hard to spend adequate time with their patients in the hospital setting. This paper will discuss why doctors find it hard to spend adequate time with their patients and the reasons why doctor visits are so rapid. The paper will explain why patients remain with doubts even after seeing the doctor and what nurses can do to improve the situation and help the patients to feel secure. The Physician-Patient Interactions

Challenges to Spending time with Patient

Health care professionals are busy individuals who have to serve many patients each day. In their endeavor to deliver quality health care services to their patients, most doctors constantly feel the pressure of time. A number of significant factors make it hard for doctors to spend as much time with their patients as they would like. Hospitals have faced an increase in patient number over the years. This increase has not been countered by a significant increase in the number of health care professionals serving the patients. Each doctor is therefore forced to see more patients than the recommended maximum each day. Research indicates that for a doctor to provide all the recommended care effectively, he/she should have a panel size below 1,800 patients (Dugdale, Epstein & Pantilat, 1999). However, the average primary care doctor in the US is responsible for about 2,300 patients while doctors catering for the needs of poor patients though schemes such as Medicaid have panel sizes that can reach up to 3,000 patients per doctor. Due to the significant workload, doctors often feel pressured to rush patients and make quick diagnosis. Many doctors feel that if they do not rush patients, they will not be able to see all the patients scheduled for the day.

Official policy by some health care provision institutions has also contributed to the difficulty that doctors have in finding enough time to spend with the patients. While the primary role of hospitals is to provide medical care to the society, they are also profit-making organizations that aim to make financial returns for the investors. Hospital administrators therefore aim to increase the efficiency of doctors and therefore increase the output of the hospital. Some hospitals dictate the maximum amount of time that a physician can spend with a patient during non-urgent appointments (Chen, 2013). This system is meant to increase the efficiency of the doctor by ensuring that he/she attends to many patients each day. However, such a system makes it hard for the doctor to attend to all the needs of the patient (Chen, 2013). The physician might fail to ask relevant questions that might mean spending more time with a single patient.

The time spent by the doctor talking to the patient has also reduced due to the complication of the modern treatment regimes. The primary care doctor is required to run numerous tests and screen for many conditions (Brownlee, 2012). When a patient gives the doctor his/her symptoms, the doctor will have to carry out numerous tests to confirm the presence or absence of a certain infection. This is necessary to ensure that the patient is not misdiagnosed. The doctor therefore has to dedicate a larger portion of the time allocated to each patient for testing and screening. At the end of it, little time is left for engaging with the patient.

The patient-doctor time is further reduced by some additional duties that the doctor is required to play even as he serves the patient. Physicians are required to carry out some administrative tasks in addition to their major task of offering comprehensive care for the patient (Warde, 2001). Physicians have to fill out reports, authorization requests, and carry out patient reviews. These tasks take time that would otherwise have been spent addressing the needs of the patient. The Physician-Patient Interactions

Why Patients are in Doubt

Due to the limited time spent with the doctor, most patients are left in doubt. In some cases, the doctor will not ask exhaustive questions to the patient since this will increase time. Kannai (2013) contends that for a doctor to provide optimal care to the patient, he must ask extra questions in addition to those directly connected to the patient’s current condition. This question may include varied issues such as nutrition, contraception use mental health condition to name but a few. By asking such questions, the physician will be able to effectively deal with the entire biopsychosocial aspect of patient life.

Patient doubt is increased since doctors are less likely to engage a patient in conversation about his/her health and well-being. While the patient might require some reassurances about his health condition, the doctor, who has time pressures, will not be able to comprehensively address the concerns raised by the patient. Bryant et al (2012) declare that the health care service is not simply a matter of the physician providing a service to the patient but also the doctor helping the patient to actively participate in the process. The doctor should therefore provide valuable knowledge about the patient’s conditions and concerns.

The reduced time spent by a patient and physician has negative effects on patient-physician relationships. Due to the time pressures during the consultation, patients are likely to view doctors as unconcerned about their ailments. Doctors are exposed to significant time pressures as they attempt to serve as many patients as possible. Kannai (2013) confirms that the pressure of time is a universal concern for doctors. Time pressure results in physicians not giving the patient enough time to explain the reasons for their visit. The patient might perceive that the doctor does not care about his/her condition further damaging the doctor-patient relationship.

The inability to understand what has been communicated to them also adds to the doubts that the patient have concerning their disease and treatment. Once a diagnosis has been made, doctors spend some time conveying crucial information about the patient’s condition and treatment to the patient. However, most of this information is too technical for the average patient to understand and since the doctor does not have enough time, he will not break down the information into a form that the patient can understand (Brownlee, 2012).

Role of Nurses

Due to the rushed physician visits, many patients remain unsatisfied with the services provided. This dissatisfaction might lead to insecurity about the treatment prescribed by the doctor. Lack of the faith in the doctor will have a negative impact on the health outcomes of the patient since he/she might fail to follow the recommendations offered. Nurses can play a role in making the patient secure and restoring faith in the treatment option offered by the doctor. Since nurses interact with patients for longer durations than the doctor does, the nurse can try to involve the patient in the treatment process. The nurse can elicit additional information from the patient on issues such as medical history and treatment preference. He/she can then pass on the information provided by the patient to the doctor in a concise manner. Involvement of patients in the consultation effort will lead to better diagnosis and treatment efforts. The reason for this is that the patient brings expert knowledge about his health condition, symptoms and experiences with treatment and medication (Bryant et al., 2012).

Nurses can help alleviate the anxiety felt by the patient about his/her health condition. Since the nurse has the relevant technical knowledge, he/she can interpret the findings made by the doctor concerning the patient’s health condition. This will help the patient to actively participate in the process and provide knowledge on the areas of concern to the patient (Bryant et al., 2012). This move will ensure that the patient has faith in the health care system as a whole.

Nurses can play a crucial role in facilitating knowledge sharing between the patient and the physician. Both the doctor and the physician have knowledge that can be used to improve the health care services provided. However, the time constraints make it hard for this knowledge to be shared adequately between the two parties. Since the nurse interacts with the doctor and the patient on a regular basis, he/she can facilitate knowledge sharing (Warde, 2001). The nurse can ask follow-up questions and elicit additional information from the patient after the doctor has interacted with the patient. If any relevant additional information is obtained from this interaction, the nurse can communicate the same to the physician. The nurse can also explain physician instructions and information in a language that the patient can understand. The patient should be allowed to ask questions if he/she needs further clarification on some issue.

Nurses can also train patients on how to effectively elicit information from their doctors. Most patients do not know how to ask the relevant questions and this impedes on their ability to obtain the necessary information from doctors. The nurse can train the patient to ask relevant questions during the doctor’s visit. When trained, the patient will be able to adequately utilize the limited time with the doctor. Research by Dugdale et al. (1999) revealed that patients who were trained to be more effective in obtaining information from their doctors had a higher level of satisfaction with the services provided by the physician compared to the untrained patients.

The nurse can also assist in some of the administrative tasks to free up some time for the doctor-patient interaction. This move would require significant dedication from the nurse since nurses also face significant time pressure due to the significant workload they have (Bryant et al., 2012). However, when dealing with return patients, the nurse can ensure that the medical records are well updated saving up some minutes for the doctor. The doctor can use the additional time to confer with the patient on issues of concern to the patient. The Physician-Patient Interactions

Conclusion

This paper set out to highlight why doctors spend little time with patients and why patients remain with many doubts after visiting a doctor. The paper has revealed that the workload for most doctors has increased over the years. In addition to this, commercialization of the health care system has contributed to the reduction in time spent by doctor with the patient as doctor efficiency is of primary concern. The reduction in time has negatively affected the doctor-patient relationship and led to increased doubts by the patients. The paper has illustrated how nurses can help to improve the doctor-patient relationship by addressing some of the major informational concerns expressed by the patient. The nurses can also facilitate information exchange between the patient and the nurse therefore reducing the concerns that patients feel.

References

Brownlee, S. (2012). The Doctor Will See You – If You’re Quick. Web.

Bryant, S., Lande, G., & Moshavi, D. (2012). A Knowledge-Based View of Improving The Physician-Patient Relationship. Academy of Health Care Management Journal, 8(1), 9-19.

Chen, P. (2013). For New Doctors, 8 Minutes Per Patient. Web.

Dugdale, D., Epstein, R., & Pantilat, S. (1999). Time and the Patient–Physician Relationship. J Gen Intern Med, 14(1), 34–40.

Kannai, R. (2013). Measuring Up: Musings of a Family Doctor on the Employee Time Clock. Annals of Family Medicine. 11(5), 477-480.

Warde, C. (2001). Time is of the Essence. J Gen Intern Med, 16(10), 712–713.

The Physician-Patient Interactions

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