A patient comes to see a doctor with multiple complaints. The doctor has a few minutes to hear the story, see the patient, determine what’s really important, discuss options and develop a plan.
Then there’s the next patient waiting.
The time of five minutes seemed like a trivial problem. However, medicine often doesn’t come in five-minute, neat little packages.
Time stress does not only impact how warmly a doctor can communicate with a patient. It also can affect the way clinical reasoning occurs.
As with many situations, doctors will first examine the most noticeable symptoms if time is short. A lengthy and complex history can be broken down into its most salient details. There may be things that are left out because of lack of time to look at all options.
This is not because doctors act negligently. Working under time pressure frequently involves highly efficient decision making. However, efficiency and accuracy do not always go hand in hand.
For a simple problem, a quick check might be suitable. However, a complex patient may require more time just because his/her story is more complex.
There is also an economic reality behind consultation time. Healthcare systems face a challenge in balancing patient access, their staffing, costs, and workload. It isn’t always feasible to increase consultation time by each patient.
Maybe the question should be whether all consultations need to be longer!
It’s whether the correct patients are provided sufficient time.
For some, a 5-minute consultation could be sufficient, while for others, it may be too short.
In medicine, the key resource, sometimes, isn’t another test, another technology.
It’s time.
In your opinion, should the amount of consultation time be related more to the complexity of the patient or be standardised for all?
MBH/PS