In an article in The New England Journal of Medicine, an internist with 20 years in practice wrote that he was surprised to learn that in 2008, they handled an average of 20 phone calls and 17 e-mails a day. In addition to those, they spent three to six hours a day on patient visits.

Many experts in primary care have been trying for years to get one message through.

The job of primary care medicine is broken. That is why we already have a critical shortage of primary care physicians. Reimbursement is a major part of the problem but that’s not all of it. Patients can do little about the big picture. However, you can do your part as a patient in helping your primary care doctor help you.

What Can You Do?

1. Remember what you came in for. It is too easy to forget something. Make notes. A recent study said it was best to make your notes on the same day as the visit. If that doesn’t work, the night before should do it.
2. Provide specifics. Rather than say this hurts more than anything you ever have had to deal with, try the 1-10 scale, 10 being most. “This is an 8 for me.” That’s actionable information your doctor can use. Tell your doctor what you can’t do because of this problem. “I can’t pick up my toddler.”
3. Understand that you and your doctor may not be able to deal with what you are concerned about in one visit. Notes help the two of you set priorities that day. Your doctor can tell you what it will take to handle the others later.
4. Plan your exit. To make the most of your time with the doctor, be sure you understand what your next steps are until you see the doctor again. The doctor will tell you if and when you should come back.
5. Being an active patient in the ways described above makes your visits more productive for both of you.

USA TODAY

“When internist Richard Baron was invited to give a talk about what’s happening in primary care, he had an idea: Why not count up exactly how many patient visits, phone calls and e-mails he and his four associates handle in a year?

“Thanks to the electronic health record system his practice uses to store, retrieve and manage patient information, the task was not as herculean as it would have been in the old days.

“But the totals took even Baron aback. In 2008, he and his associates each handled an average of 20 phone calls and 17 e-mails a day. That’s on top of an average of three to six hours a day spent on patient visits. (Emphasis added)

“Even though I’ve been doing this for 20 years, this is really a surprise,” Baron, who reports his findings today in The New England Journal of Medicine, said in an interview.”

Source: USA Today, April 28, 2010

Citation: New England Journal of Medicine, Volume 362: 1632-1636, April 29, 2010, Number 17.