Last week I had my annual physical at the same clinic where I’ve been a patient since returning to Idaho nearly 12 years ago.
It’s interesting to reflect on how the experience has changed over the years; unfortunately, not for the better.
During my first few yearly visits I was greeted by a cheerful receptionist that verified the basics (name, address, insurance, etc.) before handing me off to the nurse to take my vitals. Then I spent much of an hour with my primary care physician where I updated him about my health over the past year while he conducted a detailed physical examination. We even had time to chat about our hobbies!
That’s not the case any longer. The last several years have seen a dramatic change in the interaction between the patient and his or her primary care physician and other supporting health care professionals.
This year, after arriving at the clinic, I first encountered a patient access specialist who stoically received my information and scanned it into the system. Then I was handed off to the nurse who took my vitals in one room before walking me to the exam room. In the exam room, she sat at a computer with her back to me and asked a series of questions where she dutifully entered the answers in the EMR. During the entire Q & A period she only looked in my direction once! As she was leaving the room, she mentioned in passing that my primary care physician was running a little behind.
I spent nearly 25 minutes patiently waiting for my primary care physician (the 3rd one I’ve had in 12 years) to enter the exam room. Finally, she hurriedly arrived and went straight to the computer to review my medical record. During the truncated exam, she spent the majority of the time typing in information I relayed during our discussion. I’m pretty sure she types faster than I can! Honestly, that’s not a skill I want her – or any physician – to need in order to successfully perform her duties.
After approximately 17 minutes in the room, the exam was complete, and I was sent on my merry way until next year.
I want to make it clear that everyone I encountered at the clinic were very professional. But, it felt sterile and impersonal – not something you want in a medical “home.” Moreover, nobody really seemed to enjoy their job. There was no laughter and very few smiles. I really felt bad for all the employees. You could tell they were overworked and stressed and doing what they could to stay on top of the patient load. I think it’s safe to say the provider satisfaction level was also low.
My experience is not unique. I’ve talked with others and they’ve noticed the same changes in their interactions with their primary care physicians.
There are solutions to the problem, but it requires structural changes that are costly and potentially difficult to implement. Nevertheless, this problem must be solved as health care in the U.S. strives to focus more resources toward preventative medicine.