Apparently it takes mammals on average 21 seconds to pee regardless of their size, based on Georgia Tech researchers watching different animals urinate. Therefore, you may have much more uninterrupted time to empty your bladder than you do to tell your doctor why you are seeing him or her on a visit.
A study published in the Journal of General Internal Medicine showed how soon doctors interrupt their patients during appointment and how many don’t even give their patients a chance to first explain the reason for the visit. Before you say anything and ask any questions, let me continue.
For the study, a team recorded and analyzed 272 randomly selected patient-doctor encounters at the Mayo Clinic and affiliated clinics in Minnesota and Wisconsin. The majority of the time the doctor did not even ask the patient the purpose of the visit: 64% of primary care visits and 80% of specialist visits.
Even when doctors gave patients the opportunity to explain the purpose of the visit, most of the time doctors interrupted the patient: 19 (63%) of the 30 primary care encounters and 8 (80%) of the 10 specialty care encounters.
These interruptions came pretty quickly: a median of 11 seconds with a range of 3 seconds to 234 seconds. (3 seconds?!?) And most of the time (59%), the interruption wasn’t something like “I see, tell me more” or “that must be hard for you” or “I really have to go pee” but instead a closed-ended question, that is, a question just seeking a “yes” or “no” response.
How then can a doctor really tell why you are there and provide proper care? Even the best medical record systems can’t always provide enough information on a patient before a visit. Last I checked mind reading is not part of any medical record system, although who knows what Google is working on these days.
After all, you may want to wait until you actually see your doctor before fully revealing and explaining the purpose of your visit. Think about it. Would you tell the appointment scheduler that you have intense and uncontrollable farting? Would you tell the receptionist at the clinic with others in the waiting room that you have intense and uncontrollable farting, unless, of course, they have already noticed? Moreover, telling someone about intense and uncontrollable farting in 11 seconds or less can be like releasing one in a room and then immediately leaving. Without the opportunity to offer more accompanying details, brief statements can lead to lots of misunderstanding and misinterpretation.
A doctor’s visit shouldn’t feel like a Shark Tank pitch. In fact, guests on that television show typically get more time to talk uninterrupted than 11 seconds.
Does this mean that many doctors are just naturally uninterested in listening to you? Not necessarily. Sure some doctors may not care to listen to patients. Every profession has its bad apples. Also, there are doctors who will make assumptions about you without bothering to even listen to you. They may stereotype and judge you based on your appearance or other superficial characteristics. But when a majority of doctors aren’t taking the time to listen, it is a systems problem and not just an individual doctor problem.
Fifteen minutes is just not enough time to see a patient. As I have written for Forbes previously, this is less time than it takes to go to the bathroom, even when you don’t have the runs. With so little time to complete a patient interview, a physical exam, and associated documentation and so many patients to see each day, it would be no surprise if doctors were to eye the clock nervously when a patient begins to speak. A doctor mindful of how little time there is may be consciously or unconsciously trying to fast-forward the visit.
Moreover, doctor fatigue, stress, and disgruntlement being such major problems, as I also described previously for Forbes, it should be no surprise that many may be less inclined to listen. After all, think about the last time you were very stressed and someone wanted to tell you about their problems. Was your response, either openly or in your head, “you think you’ve got problems, let me tell you about my problems”?
Ultimately, this rush-rush situation is driven by insurance reimbursement and administrators who don’t actually see patients but are trying to increase revenue. Ironically, such rush-rush ends up costing everyone a lot more money.
Imagine if a restaurant were to handle customers in the following manner. Instead of giving you time to read the menu and discuss the options, the restaurant said, “you look like a duck confit person, our records show that you ate duck confit before, therefore you will eat duck confit.” Except the consequences of a missing key medical information and providing the wrong diagnoses and care are much greater than getting duck confit when you really wanted string beans, unless you are severely allergic to duck.
Medical costs, productivity losses, suffering, and deaths go up when patients don’t receive the right diagnoses, preventive care, or treatments. When you feel unheard, you may seek alternative providers, who at least will take time to listen to you (or at least pretend to listen to you) regardless of whether they provide legitimate evidence-based care. This results in hospitals and clinics losing revenue and more people with jade eggs in their vaginas.
The system needs to change to instead provide financial incentives for longer and more meaningful patient visits. Improving doctor well-being should be at the front of fixes for the health care system. As a friend often says, you can’t save someone else from drowning when you yourself are drowning.
When you have more time to pee uninterrupted than explain your problems to your doctor, something is really, really wrong with health care systems. It’s going to result in higher costs and greater health problems. And it will leave a lot of patients pissed off.