Quality Blog #4: Quality and Reduction in Patient-Provider Contact

There is one aspect of quality I find very important to mention. Over the past years, the amount of time doctors spend with their patients has decreased. This includes outpatient and inpatient settings. Physicians used to spend more time assessing and treating patients. Standards in the health care industry have changed over time. Patients are spending less time in hospitals and receiving more outpatient treatment. Patients are also limited to the amount of time they are able to visit with their doctor.

This could be for several reasons. Physicians reduce time spent with patients in order to see more patients throughout the day. They also reduce patient visit times to reduce waiting times. Although reducing the amount of time physicians spend with patients seems beneficial, this practice could affect quality.

Additionally, managed care organizations have contributed to the reduction in time patients are able to spend with physicians, especially in inpatient settings. In 2008the average length of stay (LOS) in an inpatient setting was 4.6 days (HHS, 2009). The average length of stay for managed care patients was 3.8. Managed care organizations have played a huge role in the standards we have set for health care professionals. There is a maximum length of stay that is placed on hospitals. If patients are in the health care facility over the maximum length of stay, facilities are not paid for the costs accrued those additional days (Kongstvedt, 2007). Other payers like Medicare and Medicaid have adopted similar practices as a method of reducing costs. These methods of reducing costs could negatively affect quality.

I have had experiences in which I have felt rushed by physicians. During these experiences I did not feel that I received the quality of care I needed. I felt as if I walked out of the office with more questions than what I entered with.

Patients want to feel that clinicians care about their needs (Pozgar, 2005). This is a right of the patient. The patient has the right to receive compassionate care and often when patients are rushed this may not be the indication. When physicians do not spend an adequate amount of time with patients, quality is jeopardized. This issue could also increase the amount of errors in the health care industry. With the pressure to discharge a patient quickly, employees are prone to make more mistakes. Also, if providers are able to increase the amount of time with patients, errors can be corrected in a timely manner and more problems with the patient’s health may be found. If reducing the amount of time we spend with physicians will reduce quality, it is important to reevaluate some of the standards we have set for our health care system and find alternatives to reducing costs while not jeopardizing quality.

References

Kongstvedt, Peter. (2007). Essentials of managed health care. Jones & Bartlett Learning.

Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.

U.S Department of Health and Human Services, Agency for Healthcare Research and Quality. (2009). 2008 national statistics:outcomes for all discharges