“Honey, I’m home!”
“Hello dear. How was your day at work?”
“Good evening. Please tell me your two most important needs for our conversation. We have a limited time to relate and address those needs. Some needs may need to wait until tomorrow evening.”
“What are you talking about? “
“Dear, I have a schedule to keep. I have 15 minutes blocked off for arrival greeting and daily activity updating. Besides that we need to discuss plans for the remainder of evening so we stay on schedule.”
“Honey, if you don’t stop this, we are going to have to renegotiate terms with a marriage counselor.”
Hopefully, none of you have experienced this conversation in your own marriage.
I don’t believe any of you would tolerate a spouse trying to schedule a 15 minute welcome home appointment allowing only two concerns to be discussed. So why do you tolerate this conversation with your doctor?
Don’t Blame The Doctors
Our healthcare system has devolved from a time when the patient – physician relationship was valued and nurtured. Patients were not rushed through the doctor’s office as they are now. Doctors may now see 25, 30, or more patients in a single workday.
Don’t blame the doctors for being greedy though. Realize that it is not greed which drives this treadmill medicine, but doctor’s desperate attempt to stay afloat as multiple stressors decrease reimbursement while increasing costs and paperwork.
In primary care’s daily grind, the situation is even more ridiculous than this couple above. Not only is time limited, but the insurance company lurks in the shadows like a mother-in-law who can’t let go (no offense to mother-in-laws). As soon as the doctor thinks about prescribing or ordering tests for a patient, the insurance “mother-in-law” steps out of the shadows and compels alternatives. Sometimes they may say, “sorry, that is not an option” or they may penalize the doctor for ordering truly necessary tests.
What if your doctor offered more time for the relationship and left the insurance “mother-in-law” out in the waiting room during your visit?
Direct primary care is that “relationship medicine” you want. A model of healthcare where physicians ask their patients how much time they need. For a sore throat, 15 minutes may be plenty. For a complex issue, 30 or 45 minutes may be required.
During that extra time, doctors open more opportunity for dialogue and listening to the patient. A relationship builds. Don’t you want to be heard? Don’t you want to know that your doctor understands?
Rather than rushing you off to a specialist after 15 minutes, the doctor has time to care for your needs. The doctor can even answer your questions while they manage your care. A primary care physician given this time often does not need a specialist. Instead, they address your needs themselves quicker and more economically. With that time, they can get to the root of your illness rather than covering it with the first band-aid they find.
At the end, they ask if there are any other questions rather than rushing out the door. Multiply this over months and years. Then you have a trusted friend standing with your during health crises, someone who knows you and you know has your back.
You And Your Family Deserve More
If your doctor can’t offer you more than 15 minutes every 3 months and can’t see you for three weeks when you are sick, maybe it is time to try direct primary care. You can get in usually within 24 hours to be seen and visits usually run 30 – 45 minutes. If that is not enough, you may even get a house call out of the deal.
Concierge Medicine is relationship medicine, what everybody really wants when they walk in the door.