You arrive on time: 8:20 a.m. for your 8:30 appointment. You’ve done your part; you showed up early, brought your insurance card, and maybe even filled out the forms online. You expect to see your doctor at 8:30. After all, that’s what the schedule says. But the clock, like the system, runs on its own rules. At 8:35, you’re still at the front desk. They’re scanning your card, verifying your insurance, checking your co-pay, and asking you to sign a privacy notice that no one has read in 20 years. You finally sit down.

At 8:45, a medical assistant calls your name. You walk down the hall, step on a scale that may or may not be accurate, and have your blood pressure taken once, quickly, on one arm. You’re asked if you smoke, drink, or feel depressed. Boxes are checked. Numbers are entered. The assistant smiles politely and says, “The doctor will be in soon.”

It’s now 8:55.

Your 15-minute appointment is already over, and you haven’t even seen your doctor.

The illusion of time

Somewhere in the back, your doctor is running between rooms, reviewing labs, signing off refill requests, and opening your chart. They’re trying to remember who you are, why you’re here, and what’s new since the last visit. You’re the 8:30, but also the 8:45 and 9:00, because almost every slot is double booked just in case patients “no-show.” The 15-minute visit was never 15 minutes with your doctor. It was 15 minutes total for everything: the check-in, the vital signs, the documentation, the billing, and, somewhere in there, the medicine. Your doctor may actually have five to eight minutes to talk with you and do a quick exam. Their 15 minutes includes the time to review your chart, see you, send you out the door, and jot notes in the EMR too.

Medicine under fee-for-service is about time: how much we have with each other, how much we need, and how much we’re allowed. But when the metric became the minute, the profession started losing its meaning.

From the ER to the exam room

I’ve spent most of my career as an emergency physician, a world defined by chaos, not calendars. I always thought there was something enviable about primary care. The idea of scheduled appointments, predictable flow, and patients who came at appointed times for care rather than crisis sounded like the saner side of medicine. But this past year, working in a variety of primary care offices, I’ve realized it’s not the sanctuary I imagined. The schedule isn’t built around patients. It’s built around numbers: around billing targets, efficiency scores, and productivity benchmarks. It’s built around how many visits can fit into a day, not how much care can fit into a visit.

It’s not even built around the physician’s time. Every system push seems to demand more: more patients, more coding, more refills, more emails, and more follow-ups. The unspoken hope is that most of those patients are healthy enough to require little thought, little explanation, and little time. Because time, in this model, is the one thing nobody can afford. What I once thought was the luxury of scheduled care has revealed itself as another version of the same farce, just with appointments and co-pays instead of stretchers and triage tags.

How we got here

The 15-minute visit was not born from medical evidence or patient need. It came from spreadsheets: from productivity targets, RVUs, and the illusion that more visits mean better access. In the fee-for-service world, time is a cost. The longer the visit, the lower the revenue per hour. So administrators did the math: Divide the hour by four and you get four billable units. It looked tidy. It made sense on paper.

But the human body doesn’t fit in 15 minutes. Neither does grief, fear, confusion, or chronic disease. Diabetes doesn’t respect appointment lengths. Depression doesn’t follow billing cycles. A child with a fever, a parent with a question, a patient with three medications and no idea why they’re taking them; none of that fits neatly between 8:30 and 8:45. And yet, we’ve built an entire system pretending it does.

The doctor’s side of the farce

Physicians know the absurdity. They live it. Every day, they face the quiet math of impossible choices:

• Spend two more minutes explaining a diagnosis, or stay on schedule.
• Ask about mental health, or risk falling behind.
• Return the call from the lab, or finish documenting the last visit.

Behind every patient encounter lies a stack of unfinished notes, unsigned orders, unclicked boxes, and pop-up reminders. The “efficiency tools” meant to streamline care have become digital taskmasters that steal what little time remains. Many doctors now finish their day long after the last patient leaves. They sit in dimly lit offices or at kitchen tables, catching up on charts until midnight. The next morning, the cycle starts again. When people ask why doctors seem rushed or distracted, this is why. The 15-minute appointment isn’t just a farce for patients; it is a slow-motion betrayal of the people trying to provide care.

The patient’s side of the farce

Patients feel it too: the impatience, the hurry, and the sense that the doctor is listening but not hearing. They bring lists, printouts, and questions from the internet, only to be told, “We’ll have to schedule another visit.” Some adapt by rationing their concerns: “I’ll only bring up one issue today.” Others give up entirely, convinced their doctor doesn’t care. But most doctors do care; they are just trapped in a system that punishes them for showing it. And so the farce continues: two good people, a patient and a physician, forced into a performance neither one believes in.

The efficiency trap

Every attempt to fix the 15-minute visit has made it worse. We’ve added scribes, templates, nurse triage, telehealth, portals, and automation, all meant to save time. But none of them address the real problem: Time itself has become the enemy. Efficiency is not the same as effectiveness. In medicine, faster is not better; it is often dangerous. Diagnoses are missed, medications are mismanaged, and subtle signs are overlooked. Empathy takes time. Listening takes time. Healing takes time.

Yet every new reform begins with the same assumption: How can we make this faster? Never: How can we make this meaningful?

The way out

There is a way out, but it requires courage and honesty. We have to stop pretending that efficiency will save us. We have to admit that medicine is not a transaction but a relationship. And we have to recognize that the 15-minute appointment was never about the physician’s time. It’s about the patient’s needs, which have been quietly sidelined. The real question isn’t how much time doctors deserve, but how much time patients require. Why have we decided that people don’t need more time and more expertise?

A patient might need not just a doctor, but a mental health counselor, a nutritionist, a social worker, or a care coordinator, with each contributing their own piece to the puzzle. Instead, we’ve built a model where one physician is expected to do all of it in 15 minutes or less. That’s not care; that’s compression. Real reform means aligning appointment structures around what patients actually need and giving every member of the health care team the space to contribute fully. A physician can’t address nutrition, anxiety, social stress, and chronic illness all in one slot, but a team can. That’s the model worth building: not faster care, but fuller care.

It also means redesigning the clinic around what patients really need, not what billing codes require. Some visits can be handled virtually. Some can be managed by nurses or care coordinators. But the moments that matter, the ones that define trust and shape decisions, must remain human, unhurried, and real.

We can’t algorithm our way back to compassion.

A 15-minute warning

The 15-minute visit is not just a scheduling problem. It’s a moral one. It reflects a system that values documentation over dialogue, billing over bonding, and efficiency over empathy. It’s the quiet erosion of what medicine used to be: a conversation between people who trusted each other. If we want to restore that trust, we have to reclaim time, not from patients but for them. We have to re-humanize care by giving space to the parts that don’t fit in a drop-down menu.

Because when we finally stop pretending that 15 minutes is enough, we might rediscover what those minutes were supposed to mean.

Mick Connors is a pediatric emergency physician.