The other day, at the end of a very busy session in the office, I realized that I apologized to almost every patient I saw at the beginning of her visit. I apologize because I am constantly running behind.
I usually try to brush it off casually, blaming the computer system or a particularly hectic day, but it’s now the norm for every provider. We are not spending time gossiping in the halls or surfing the internet, but we are always overbooked.
Our office sessions are three hours long, and in that time we are scheduled between 12 to 15 patients, which gives me about 12 to 15 minutes to see each patient.
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This doesn’t account for the emergency patients who are added in, or time spent taking patient phone calls or answering clinical questions from staff members. Most days we work through lunch.
I find it challenging to fit an annual exam into 15 minutes, let alone a new patient visit or an initial pregnancy visit. Fifteen minutes does not allow me time to do a thorough history and physical exam, or provide patient education and health promotion.
I’ve noticed patients have become increasingly dissatisfied with their wait times, especially when compared to the amount of time actually spent with their provider. I don’t blame them. But I don’t know if patients are aware of the frustration providers feel when they are rushed and think that the time allotted per patient is inadequate to provide good care.
So whom does it benefit when we try to squeeze so many patients into so little time? Is it really more important to make money at the expense of patient satisfaction? A patient who is unhappy with her health-care experience will find another provider, or at the very least complain to her friends. Eventually that dissatisfaction will trickle down to affect the bottom line.
Isn’t it time we start measuring health care in quality rather than quantity? Have my outcomes really improved since my numbers have increased? I doubt it, but I know my frustration is at an all-time high.
I wish I didn’t have to waste precious patient encounter time apologizing. But I feel I owe it to them. I also owe it to them not to rush through their visit and onto the next patient.
I didn’t become a midwife to see as many patients as possible, but to provide excellent women’s health care, even if it means missing my lunch, or getting home from an evening session long after my kids have gone to bed. But why should we as providers have to choose between quality care and our personal sanity?
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.
