News and briefs: Are longer visits with patients a cure to their ailment?

Because of an injury, Suzanne Koven, MD, was forced to reduce her workload and see fewer patients per day. This meant she had more time to spend with each patient at Massachusetts General Hospital where she practices internal medicine. Koven recently wrote an article for The Boston Globe about how the opportunity to spend more time with each patient affected her practice. She says that she felt more relaxed and her patients appeared more relaxed.

“I felt less tempted to order tests, write prescriptions, or send a patient to a consultant. These things all have their proper place. But during those three weeks, I realized how often I had used them simply to move things along,” Koven says.

Like Koven, most physicians would love to spend more time on a patient’s issue, but the current healthcare system does not promote this practice. In a fee-for-service industry, physicians benefit from seeing as many patients (and ordering as many tests) as possible.

Koven gives an example of spending 30 minutes talking to a patient about heartburn. In that time, Koven realized that the patient’s diet and life stressors were aggravating the heartburn. This was discovered without any costly tests. And instead of increasing the patient’s medication dosage, Koven gave the patient tips to improve her lifestyle. This course of treatment sounds preferable to most patients who don’t realize that Koven took a financial hit by spending an extended amount of a time with a patient that didn’t result in any additional services.

As healthcare shifts to accountable care and pay-for-performance initiatives, physicians may be encouraged (and rewarded financially) to spend more time with patients to find the root cause of the problem before sending them off for costly and unnecessary tests.