What If Physicians Had More Time?

Time is one of the few non-renewable resources and the most important one.   For health care providers the delivery of care has gotten incredibly complicated and frustrating and no provider feels as if they have enough time to dedicate to caring for patients.  The focus has been on generating volume not quality.  And while providers have been asked to deliver more there have been layers of MBA and administrative “processes” most of which have never been demonstrated to make health care better and all of which take time away from patient care.  A physician recently shared his irritation with having to complete multiple forms, all documenting the same information, after a simple surgical procedure.  So the administrative leadership of health care has pushed providers to deliver more volume faster and has made it more difficult to do so.  Sounds like a situation in need of a healthy dose of Toyota Lean.

While many physicians and providers assume a defensive position when non-health care management strategies are implemented it may be beneficial for physicians and other providers to embrace the Toyota Lean strategies.  The goal of Toyota Lean is to eliminate waste and enhance value.  If successful one can assume that a great deal of wasted time could be recovered.  And just think of the possibilities.

More time to read.  A theme here at HCR has been that the erosion of the practice of medicine as a profession has been the single greatest detriment to quality health care.   And it is the opinion of HCR that the sine qua non of a profession is the mastery of the body of science, data and literature which forms the foundation of the profession.  What if an hour per day of useless administrative process was eliminated and instead that time was used to review all of the relevant journal articles that had been published that day?  It is likely that there would be more evidence based care.  And it is likely that there would be less anecdotal care which has been show to be inefficient, ineffective and costly.  If one were interviewing applicants to be their personal physician I would hire the one that reads the most.  Physicians need more time to read.

More time to listen.  The value of listening to what a patient has to say has been completely trivialized in the current model of health care.  When a physician is an hour behind in the office because he/she has triple booked appointments to meet volume targets listening to a patient is not a priority.  However, listening is always important.  Always.  Listening establishes the fact that the physician-patient relationship is based on communication that is bidirectional.  If a physician listens he/she can almost always ascertain something about a patient or a patient’s disease that is unique and thus the care can be customized.  Physicians need more time to listen.

More time to explain.  The physician-patient relationship works best when it is based on communication and education.  Patients need to be engaged and active participants in their care.  Patients are appreciative if they are educated with respect to their disease and therapy.  They are also much likely to be compliant.  Physicians need more time to educate their patients.

As health care reform moves forward there is a great deal of effort focused on eliminating waste.  The efforts need to include not just wasted money but also wasted time.  And there is an enormous amount of wasted time.  A system must then be developed where physicians and other providers are enabled to genuinely improve health care in the ways described.


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