One of the core services offered within the healthcare industry is time. Time to ask questions of our physicians, one-on-one time with our physical therapists, and time for our providers to actively evaluate and make recommendations for us as patients. As a core service, time is both a driver of revenue and costs within the healthcare model, making it one of the most important and most scrutinized variables by physicians, practice administrators and insurance payers.
The notion that a correlation between the amount of time providers spend with patients and the quality of service provided is conceptually valid and serves as a platform for many of the ethical debates waged in today’s healthcare arena between providers and insurance companies. If providers are increasingly paid less by insurance companies for the time they spend on their patients, it’s easy to see that incentives will be in place to increase the volume of patients seen, and decrease the amount of time seen with each patient. From a qualitative standpoint this sets the stage for the ethical and political battlefield between providers, patients and payers.
Interestingly, a recent systematic review of 5 studies performed in the United Kingdom has called into question the correlation between time spent between provider and patient and the quality of care delivered, bringing another variable into the equation – the way that the time is used. Appearing in the Cochrane Library, the review suggests that patient satisfaction was not significantly higher when more face time with physicians was made available and physicians did not practice in a manner significantly different depending upon the amount of time they spent with their patients.
Now, I don’t believe this review in any way wipes out the validity of the argument that there is a correlation between time and quality in healthcare – it simply stands to reason that providing more time allows for the opportunity to provide better care. It does however bring to the table fodder for discussion about the “elements” of time that are important as relates to quality of care, rather than simply the time itself.
Some patients might feel like they spend more time in the waiting room than actually talking with their doctor, but a new review of studies suggests that these consultations would not be much different if patients had more face time with their physicians.
In five studies conducted in the United Kingdom, doctors did not discuss more problems, prescribe more drugs, run more tests, make more referrals or do more examinations when they had a few additional minutes with patients.