“By the way, Doc, why am I tired, what’s this lump and how do I get rid of my headaches?”
Every patient encounter is a potential deadly disease, disastrous outcome, or even a malpractice suit. As clinicians, we need to have our wits about us as we continually are asked to sort the wheat from the chaff when patients unload their concerns, big and small, on us during our fifteen minute visits.
But something is keeping us from listening to our patients with our full attention, and that something, in my opinion, is not doctor work but nurse work or even tasks for unlicensed staff: Our Public Health to-do list is choking us.
You don’t need a medical degree to encourage people to get flu and tetanus shots, Pap smears, breast, colon and lung cancer screening, to quit smoking, see their eye doctor or get some more blood pressure readings before your next appointment. But those are the pillars of individual medical providers’ performance ratings these days. We must admit that the only way you can get all that health maintenance done is through a team effort. Medical providers neither hire nor supervise their support staff, so where did the idea ever come from that this was an appropriate individual clinician performance measure?
Public health in its broadest sense is what drove down morbidity and mortality in the last 100 years. But most of those things are, at least in many places, easily and successfully done by people without medical degrees.
I don’t mean to be uppety, it is not beneath me to promote those things – I’m doing it gladly, but since I am not a solo practitioner, I believe those things can be done just as well by other staff, if necessary with standard protocols where a physician’s order is required. Ideally I would then just support or explain these things when patients have questions.
People are sick, people are worried about symptoms, treatments need adjustments, information from outside providers could affect our patients’ health or our own assessments and treatment plans for them. This is what we need doctors for, and experienced Nurse Practitioners and PAs.
Medical professionals are trained to diagnose and treat disease. Are there so many of us and are we so underutilized that our healthcare “system” can afford to fill our time with tasks that could easily be done according to protocol by non-providers?
It’s your choice, America. If you think there just might be a doctor shortage, an aging, sicker population and a looming decline in the health of our population – who should do what in healthcare?
A Country Doctor Writes: 
I need my doctor for more than the designated 15 minutes, most days. I surely agree that my doctor should not be occupied with delivering information to me that is more appropriately delivered by non-medical staff.
I predict government overreach will increase, along with more mandates that lack evidence of efficacy but have the blessing of political trends. I foresee more docs bailing from positions with required time-wasters, and going to direct patient care. Which will decrease accessibility.
Or maybe more docs, like me, will be seeking Canadian licensure.
Or, unlike me, retiring early.
Canada seems to do a better job than the US without those mandates, as does Israel. Why don’t we hear that from the Medicare For All crowd?
AMEN! We have become overpaid data processors. No other business would waste medical talent like medical organizations do.
Totally Agree! Often having to stop my own patients with their laundry list of at least 5-7 issues. How I deal-I express understanding and together we prioritize this list and limit to two issues.
Issue 1 is Patient’s pick . Issue 2 open to Doctor’s choice. Usually works – if not patient expresses discontent and open to change doctor.
I also see the need to decompress all the other additional non physician work that is added to my workload- that nursing or medical staff could easily handle . Besides who the heck came up with a 15 minute visit and demonstrated that it was ample.