Last week, the world celebrated National Doctors’ Day, an annual holiday to recognize doctors and the incredible work they do to help people live longer, healthier lives. As the chief medical officer for MCHC Health Centers, seeing patients is only one part of my job. I am also responsible for taking care of the doctors who take care of the hundreds of patients who walk through our doors every day. As I work hard to support doctors so they have what they need to provide excellent care, it is clear to me that patients are not the only ones who need some love and compassion–doctors do, too.
Right now, we face a doctor shortage. There are more and more patients and not enough doctors to see them all. Our healthcare system has done its best to keep up by placing an emphasis on volume and efficiency, but that’s not ideal for everyone. I appreciate the advances in technology that allow us to provide more access to care, but sometimes I worry that doctors will eventually be replaced by artificial intelligence or robots!
The biggest consequence of the current system is that we’re starting to lose the close-knit patient-doctor relationships that are vital to quality care. Most doctors would love to spend half an hour chatting with each patient when they come in for a visit, but the demands of the profession rarely afford them the time. This isn’t the fault of doctors or any one person or institution; it’s the reality of our healthcare system where we are continually trying to do more with less.
I sense that people are starting to expect less from doctors because everyone generally understands that physicians are under intense pressure to see so many people. But spending time forging relationships with patients is important. When a doctor really knows someone, they’re able to provide higher quality, more efficient care–and that leads to better results.
Let’s say somebody visits their doctor because they’re experiencing heart palpitations. Any number of diagnostic tests (some more invasive than others) can shed some light on the situation, but if a doctor has the time to sit and speak with their patient, the doctor might learn that the patient is facing overwhelming pressure due to personal problems, which may help explain the palpitations without the need for expensive and stress-inducing tests.
Strong patient-doctor relationships also build trust. When I was serving as a battalion surgeon in the Marine Corps in Iraq in 2007, one of my patients was critically injured in combat. He was being treated by a big team of talented people. But when I showed up to check on him, his whole body relaxed with relief because his doctor was there, and he knew that someone who cared about him was going to help him get through a tough situation. That’s the power of a close, trusting relationship.
So how do we revitalize the patient-doctor relationship and start making medicine a little more personal? The shift is already happening as our healthcare system slowly transitions to value-based care, where the primary criteria that determine success or failure are moving away from volume and efficiency and toward positive results for patients, including a lower incidence of disease.
Federally Qualified Health Centers and other clinics that implement a team-based approach to care are already ahead of the game, and we are providing a good model that others can look toward for inspiration. In these environments, teams of providers work together to care for groups of patients, who get used to seeing the same team of providers whenever they visit. This builds trusting relationships that lead to better results. It’s also more convenient for patients, who can get quicker access to care and, if appropriate, see multiple providers in one day.
Rather than feeling pressured to see a lot of patients, doctors will eventually see fewer people, but spend more time with them. The idea of focusing on results instead of how many patients we can treat is gaining momentum and I believe it’s the future of medicine—even if it takes us a little while to get there.
In the meantime, people have a choice about what insurance they carry and which doctors they see. When people find a provider they like or a doctor they feel cares about them, they’ll follow that provider from practice to practice, even when there are more convenient options. These types of choices send a message and will gradually shift the culture of medicine in the right direction.
As doctors, we all aspire to do what’s best for our patients. Over the course of my career, I’ve learned that taking the time to sit and talk with folks is some of the best medicine out there. Unfortunately, that’s much easier said than done within our current system. But I’m optimistic that in the next decade or so, a shift toward value-based and team-based care will give doctors more opportunities to build deeper relationships with their patients—and that’s going to be better for everyone.
Dr Matthew Swain is the chief medical officer at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people in Lake and Mendocino Counties.