The short, shoddy state of primary care today

Whenever I see a patient, the length of the appointment is typically anywhere from 30 minutes to an hour — sometimes even longer.

Maybe that sounds excessive. But I firmly believe every patient should get the individualized attention they need for a thorough evaluation — no matter how long it takes. And while I realize not all doctors have the luxury of this kind of time, I can’t imagine any physician affording their patients much less than my own bare minimum.

So suffice it to say, this latest study surprised me — and not in a good way, either.

It’s the largest review of primary care appointment lengths to date — covering more than 175 papers, in six languages, from nearly 70 countries. The data from this study represents 28 million appointments globally. And results show that the average primary care visit lasts only five minutes tops, in half the world.

If you find that shocking, well, join the club. I don’t know how a physician could possibly know what’s going on with a patient in just five minutes. It’s mind-boggling to me, really.

Maybe I don’t work as quickly as other docs, but… five minutes?! That’s outrageous by any standard.

And as if that weren’t bad enough, it unfortunately gets worse. The average appointment length is a mere 48 seconds in Bangladesh. Even in the United Kingdom, appointments average under 10 minutes long. The U.S. is on the high end at just over 20 minutes. And Sweden comes out on top, at 22.5 minutes — still rather brief, at least by my watch.

Personally, I couldn’t imagine getting anything done in that little amount of time. And frankly, it’s no wonder so many people report horrible experiences with their physician. Because if you’re spending more time in the waiting room than in the exam room with an actual doctor, then there is something seriously wrong…

So it’s no surprise that nothing of significance ever gets discussed at these appointments. Lifestyle or diet issues? Forget it. In this situation, lifestyle recommendations that ultimately make the most difference to your health in the long-term (healthy diet, nutritional supplementation, exercise, etc.) are the first to get axed when you’re up against the clock.

Instead, quick-fix solutions—multiple medications, expensive equipment, surgery, etc.—are the go-to treatment recommendations.

You just can’t provide a thorough examination in five minutes. But you can write a prescription based on a cursory diagnosis. Which, let’s face it, is exactly what Big Pharma would like all office visits to look like.

I can’t imagine a greater disservice to patients.

I know everything about my patients and their families… and I wouldn’t have it any other way.  Relationships must be formed and trust needs to be established. That is what opens the door to the real healing.

The only silver lining here is that maybe now we’ll stop ignoring the obvious shortage of primary care doctors worldwide. Because there’s no question that it’s dragging down the quality of care.

Granted, the link between appointment times and health outcomes hasn’t been studied much. But how could there not be a correlation?

Nevertheless, this study reported no significant links between primary care visit length and ER visits, patient satisfaction, or number of tests ordered. A result that I find pretty baffling, to be honest.

Either these physicians are just really, really good at their jobs and can work at lightning-speed… or patients are so used to getting the shaft that they just don’t expect much out of their doctors anymore. I know where my bet would lie…