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[IP] Doctor visits growing longer


More time spent with patients than before managed care
The average length of a doctor's office visit has climbed two minutes in the
past decade, a survey found.

By Robert Bazell

Jan. 17   Contrary to the widely held notion that managed care is shortening
the amount of time physicians spend with their patients, a new study finds
office visits are actually growing longer.
AT CLINICS and doctors offices across the country, patients wait and doctors
feel harassed for time.
       Many, like Dr. Charles Hammonds, a gynecologist at Duke University,
the problem is that health plans do not let him spend as much time with
patients as he once did.
       Physicians have to see more patients in the same interval of time,
that clearly is going to shorten the time that one can spend, he said.
       But despite the fears of Hammonds and many doctors that medicine is
becoming an assembly line going faster and faster, a study published
in The New England Journal of Medicine found that on average doctors are
actually spending more time with patients than they did in the time before
managed care.
           We found that was true for primary care and care given by
specialists. It was true for first visits and repeat visits. It was true for
prepaid visits and non-prepaid visits, said the studys lead author, David
Mechanic, a medical sociologist at Rutgers University.
       The Rutgers study, based on surveys of doctors and their staffs,
looked at over 200,000 office visits over 10 years. One survey, by the
National Center for Health Statistics, showed the average length of an office
visit had increased by two minutes since 1989 and 1998 to 18 minutes.
by the American Medical Association, showed it rose by one minute during that
time to 21 minutes.
       The time increased whether or not the patient was covered by health
       The researchers suggest the explanation may simply be that medicine is
getting more complicated.

          And because there is so much health news and drug advertising,
patients often have a lot more questions for their doctor.
       As a consequence I think that doctors, even though theyre spending
more time, feel that they dont have enough time to do all that they would
like to do, Mechanic said.

 Robert Bazell's HealthBeat

       As a result of that and other frustrations like falling income,
show most doctors today are dissatisfied.
       But patients, who are now visiting doctors in this country more than
800 million times a year, seem to have fewer complaints.

         It seems to me that when I have needed to have time spent I get
Barbara Lee Smith said.
       In fact, the latest survey of Medicare patients found 90 percent
satisfied with their care.
       So while doctors feel overwhelmed, patients are feeling pretty good
about getting a few more minutes of their doctors time.

       Robert Bazell is the chief science correspondent for NBC News.
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