Former President & CEO, INTEGRIS Health

Physician/Patient Disconnect

Published in The Journal Record
May 4, 2016

Do you like your doctor? Do you really like your doctor?  Fortunately, as it turns out, most of us do.

In my 40 years of health administration it’s been my privilege to know thousands of physicians. They are as a group uniformly smart, and as a group committed to their practice.  But some surveys tell us there is a growing disconnect between many of us and our physicians.   There are a number of reasons for this but I suspect the main one is time.  Physicians simply are running out of time.  Let me explain.

Medicare pays the average physician 60 percent of cost. Medicaid somewhat less.  In many states Medicaid physician fees fall woefully short of what it costs the average physician to simply open their door, turn on the lights, and pay the staff.  That is why many physicians have simply stopped taking Medicaid patients.  They refuse to subsidize the state government with their hard work.

As a result of the declining reimbursement and ever increasing regulatory pressures, a typical physician’s pathway to economic success depends on throughput. Since they are making less money for each patient visit they need to cram more patient visits into each day.  If you feel particularly rushed by your doctor, if you feel they don’t listen as much as you would like, then we must understand their practice economics are driving this behavior.

As it turns out numerous institutions across the country are beginning to institute physician evaluations by their patients. These evaluations will be summarized and available for prospective patients to view over the internet.  So not only do we get to judge a physician’s competency but we can all weigh in as to our doctor’s friendliness.  Some very bright doctors have marginal bedside competencies and sometimes their office staff is rude and abrupt.  Some physicians have little understanding or appreciation of how their front office treats the patient and how attitudes about our doctors are often shaped by our relationship to their staff.

Recently I called a physician after hours with a question, ultimately getting connected to their answering service. The person I dealt with could not have been less interested in my concern and I suspect many of his patients have been likewise equally turned off.

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