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How patients and doctors can improve the primary care office visit

Kevin Pho, MD
KevinMD
February 22, 2011
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Consumer Reports recently released a survey of both patients and primary care doctors, regarding their perceptions of each other.

Some interesting findings, as summarized by the WSJ’s Health Blog:

On the issue of respect and appreciation, 70% of doctors said they were getting less of it from patients than when they started practicing. For patients, meantime, the more they reported being treated respectfully and listened to, the more satisfied they were with their physician.

Respect matters. Treating health professionals in a courteous manner definitely helps when receiving medical care. On the flip side, physicians also need to respect patents, as it positively impacts patient satisfaction.  Both parties need to improve in this area.

Doctors said insurance paperwork topped their list of things that interfere with their ability to provide the best possible care. Financial pressure was No. 2.

No surprise here. Primary care doctors are continually inundated with increasing amounts of bureaucratic paperwork. This includes pre-authorization of medications, pre-certification of imaging studies, along with endless forms that both Medicare and insurance companies require. This obstructs patient care, and leads to physician burnout. Burnt out doctors not only leave the field earlier, it worsens the care they give to their patients.

Some 80% of physicians said it would be helpful for patients to bring a family member or friend to a visit in order to make sure important information is recorded and retained; only 28% of patients said they did so. And while 89% of doctors said it would help patients to keep an informal record of treatments, tests, procedures, drugs and changes in conditions, 33% of patients reported routinely doing so.

Good advice here on how patients can maximize their primary care visit. In most cases, doctors are allotted 15 to 20 minutes per visit. And when you consider that some patients have complex medical issues, that isn’t a lot of time. Taking notes during a visit, bringing a list of your medications and having questions already written out in advance can facilitate a patient’s physician encounter.

Patients are big online research fans, with 61% saying they had turned to the internet for information on their medical care. Doctors are not big fans of this kind of research, with nearly half saying it helps very little or not at all, and 8% saying it was very helpful.

Here’s where I think doctors need to change their attitude. No matter what doctors think about online health research, it’s going to happen anyways. As I wrote in AOL News,

With only 7 percent of doctors e-mailing their patients, let alone engaging them on blogs, Twitter or Facebook, the medical establishment needs to realize the influence of the Internet and social media on patients.

Guiding patients to better online sources of medical information should be a new physician responsibility for the digital age. Not only should doctors expect and be receptive to questions patients raise from Web research, they need to proactively engage patients online in order to dispel falsehoods and guide them to legitimate sites.

Resisting that trend will only worsen the disconnect doctors have with patients, and make it more difficult to treat them face to face in the exam room.

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Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, Google+, and LinkedIn.

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How patients and doctors can improve the primary care office visit
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