Industry Voices—Patients aren't cattle, so deliver a personalized process and improve patient outcomes

social determinants
It’s critical for physicians to ask their patients questions that can give them more insight into why they’ve booked their appointments. (noipornpan/GettyImages)

On average, doctors spend only 11 seconds gathering information from their patients on their symptoms and problems before interrupting them.

What’s worse, according to the Journal of General Internal Medicine, only one in three doctors ask their patients to explain their medical concerns.

How can you diagnose a patient when you don’t know the patient’s symptoms, their general concerns and the contributing factors that have led them to come to the doctor’s office in the first place? This process is not only dehumanizing for the patient but it also leads to patients having less faith in their physicians and less trust in the healthcare industry as a whole. 

So, what’s causing these challenges in the healthcare industry, how can physicians overcome them and how can we get closer to a care model in which we treat patients with the respect they deserve and less like cattle? 

Physicians face significant administrative burdens and ‘click’ fatigue

Today, healthcare providers are experiencing death by a thousand clicks. In the face of already-overwhelming administrative burdens, using inefficient electronic health records (EHRs) in which simple medical tasks sometimes require dozens of clicks, physicians feel less like doctors and more like data entry specialists.

Furthermore, independent providers have additional burdens of running their practice, which include everything from marketing to site selection, finding the best supplies and maintaining proper patient flow. Not to mention the entire revenue cycle management that comes with accepting insurance. As important as updating a patient’s medical record is, these types of additional outside stressors are impacting the average physician’s ability to spend time with their patients and provide personalized care.

In medical school, physicians don’t learn the business side of running their own practice. However, many physicians now find themselves spending hours on care coordination with other providers rather than with their patients. Primary care providers feel burned out trying to provide care for their patients by referring them to specialists for their needs, and they’re frustrated by not being able to address their patients’ concerns because they can’t reach other providers or easily schedule appointments. 

Meanwhile, physicians are now forced to be billing experts as well. What does this mean? In order to get reimbursed, doctors have to manage the entire revenue cycle, resulting in situations that don’t make clinical sense but make a difference to the financial health of their practice. An example is understanding the complicated diagnosis codes system used by insurance companies for reimbursement. If a physician uses a code for back pain versus a code for back strain, it could result in a nonpayment rejection from the insurance company even though the time, evaluation and treatment were identical.

Patients bear the brunt of the administrative burden

But it’s not only the physician who suffers. In most hospitals and care clinics, the average amount of time a doctor spends with a patient is only five minutes. In fact, a recent study found that doctors spend less than half of their working hours with their patients. And as any physician knows, the less time you spend with your patient, the less you understand your patients’ needs.

As a result, patients are feeling increasingly dissatisfied with the state of the healthcare industry. "Nearly three-quarters of employed Americans (73%) say the healthcare system is 'in a state of crisis' or 'has major problems'" in Gallup's most recent survey.

When physicians are spending more time on administrative work and less time with patients, the patient can feel rushed and like their doctors don’t take their concerns seriously. Worst of all, this can result in healthcare and medical errors, which can lead to misdiagnosis and poor patient outcomes. 

How physicians can help their patients feel heard

Today, only 34% of patients trust their physicians. To gain your patient’s trust, you need to establish a rapport, showcasing empathy and a willingness to listen.

This is why it’s critical for physicians to ask their patients questions that can give them more insight into why they’ve booked their appointments. Physicians should have the time to ask their patients a series of open-ended questions such as What made you come in today? Or, when did you first notice something wasn’t right? These questions may seem simple but because they are open-ended, they provide an opportunity for patients to make connections about their symptoms that more direct questioning will miss. 

Additionally, it's important to pay attention to your patient's body language. If a patient seems easily distracted, or has a hard time looking you in the eyes, they may be suffering from mental health issues contributing to their symptoms. Mental health and physical health go hand in hand, and one impacts the other. To determine if a patient is suffering from a mental health issue, you might ask: I notice that you look stressed; how does that impact you? Your patient might think that their exhaustion is caused by a thyroid issue, for example, but really, they’re facing a mental health issue, and that can be easily missed.

How technology can help doctors get to know their patients

Another way that physicians can communicate better with their patients is by leveraging health technology. The best clinics use online or in-app communication to schedule appointments and allow patients to provide their doctors with detailed information about their health concerns before they even arrive for their appointments. 

This gives patients the opportunity to discuss their background and dive into often-overlooked details. They can then narrate into their medical record so that physicians will have context before they meet with them. It sets the stage for what’s important to the patient and helps shape the general flow of the doctor’s appointment so that the visit ends up hitting all of the important points that the patient wants to cover. 

Health technology can also remove much of the burden of administrative work for physicians. A health platform can display a patient’s relevant medical record right away and connect physicians to a network of specialists for referrals. This cuts down on the time a physician would spend having to chase down a patient's results or old medical records. By removing this stress from the physician’s workload, the doctor can focus on being more present with their patient and working together to address the patient’s health concerns. 

The key to delivering patient-centered healthcare is multifaceted. Providing a platform for patients to express themselves along with using technology to reduce the administrative burden on providers and their staff goes a long way to reduce frustrations for patients. Easily accessing data about your patients before their appointments, carefully listening and looking for clues during the appointment and ensuring that doctors answer their patients’ concerns helps develop a plan of action to address the patients’ needs. These elements are critical to maintaining a healthy provider-patient relationship. Your patients and your physicians deserve this.

Caesar Djavaherian, M.D., is co-founder and chief medical officer at Carbon Health, a California-based network of primary care and urgent care clinics.