HOW CAN I GET MORE TIME WITH MY PROVIDER?
You may be surprised to learn that the average consultation time with a primary care physician is just over 20 minutes in the U.S. This is second only to Sweden, which boasts the longest average consultation time of 22.5 minutes, and is in stark contrast to Bangladesh with only 48 seconds. While the number two spot may look good, we know in practice that patients often spend more time in waiting rooms than exam rooms.
So, how can you get more time with your doctor?
It is noteworthy to point out that your doctor probably wants this too. Physicians are unsatisfied with appointment lengths and are more likely to experience burn-out with shorter times. Unfortunately, the payment model created by the federal government through Medicare and used across the insurance industry incentivizes providers to offer a lot of short visits. Providers benefit financially by conducting three 15-minute appointments rather than one 45-minute appointment.
Yes, this can mean that your doctor is trying to fatten his or her wallet, but today more physicians are mere employees of a larger healthcare organization (47.4%) than owners of a private practice (45.9%), and only about 15% are in solo practice. These healthcare organizations must make money too. As an employee, someone else (“the administration”) may dictate your physician’s schedule by requiring a level of productivity, which translates to more patients per day and your physician feeling just as rushed and dissatisfied as you do.
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KEY POINTS
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Ask how long your appointment will be.
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Ask if you can book a longer appointment.
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Prepare for the appointment to maximize efficiency during the visit.
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Consider scheduling two appointments when you call rather than one.
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E-mail your provider with follow-up questions.
An important criterion for finding more time is transparency. Does the clinic or provider clearly tell you how long your visit will be? Or can you at least ask? In primary care, routine follow-up visits or sick visits usually range from 10 to 20 minutes while annual physical exams from 30 to 45 minutes. But that is on paper, or I should say, on the computer. In practice, a physician has other demands on his or her time, thus potentially shrinking your 15-minute visit to 8. But the greater the transparency, the greater the likelihood your appointment time will be respected, especially if you commend or complain publicly through online reviews.
Then ask if you can book a longer appointment time. This part is trickier. Schedules are often created by appointment type, not time. If you need a follow-up visit, the scheduler may be required to put you into a 15-minute follow-up slot, not a 45-minute physical exam slot. If you do get push-back, ask if the scheduler can check with your physician. Personally I preferred that my patients requested longer visits when needed. I could provide better medical care, and my patients were happier.
If you are not succeeding in this quest, then try to book two appointments rather than one. You can ask if they have any back to back appointments open, but be prepared to split up your time between a week or two. Also be forewarned, longer visits and multiple visits may mean higher out of pocket costs for you. Nothing in life is free, which is especially true for more minutes with a healthcare provider in the U.S.
Of course, it helps if your doctor runs on time, and if you are both well prepared for the visit. If you must repeatedly retell your medical history because the provider didn’t review your chart, consider finding a new provider. On the flip side, you should be well organized too. Have a list of your concerns which you can share with your provider. You may not get to everything on the list, so prioritize. Note that while you may feel your hair loss is most important, your doctor may be more concerned about your dizzy spells.
Also, see if your provider has email capability for quick follow-up questions, rather than asking everything in the room. That way you can help your provider stay on schedule.
Unfortunately, I cannot promise you will have success. You are challenging one of the worst run service industries in the nation, but things are slowly improving as innovative clinics increasingly find better ways to provide care. You can be a part of this positive change by pushing health care towards where it should, and needs, to be.
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Written by Jill A. Monteiro, MD, MBA
Published June 2020