SEATTLE – While healthcare costs are causing many doctors to spend less time with their patients, some local physicians are experimenting with treatment models that allow them to know their patients better without breaking the bank.
A new study from John Hopkins University and the University of Maryland found physicians-in-training spend an average of just eight minutes per day with each patient. But, three Seattle practices are bucking the trend and finding unique ways offer patients more face time.
Cutting out the middle man
First-time patients at Capitol Hill Medical are often caught off-guard when Dr. Vy Chu, a primary care physician, comes into the waiting room and calls them back for their appointment. They are even more surprised when Chu checks their vitals, draws blood and gives vaccinations – tasks typically completed by a nurse.
“We made a decision not to employee a medical assistant or a nurse,” Chu said. “It reduced our overhead by a lot, allowing us to see less patients per day and spend more time with each one.”
Besides the two employees at the front desk, patients exclusively interact with doctors at Chu’s private practice.
Rising health care costs have increased pressure on providers to treat more patients in less time, Chu said. Most doctors know exactly how many patients they need to see each day to break even.
“It’s all about the bottom line,” Chu said. “Medicine is a business and at the end of the day you have to see enough patients to run the business.”
Still, Chu has strived to create a practice where doctors develop a closer relationship with patients.When he chats with patients while measuring their vital signs Chu said he learns much more about their overall health than a nurse could transcribe in a chart.
“If you start moving too quickly you begin to wonder ‘Am I missing anything? Am I really attending to every aspect of their needs? Am I exploring every option with them? ” Chu said.
Coming to you
Nurse practitioner Happy Salinas-Santos is doing something many assume is extinct in the medical community – making house calls. Santos has established a new pediatric and women’s health care practice in West Seattle in which she examines and treats patients in their own homes.
Santos has been treating families at Odessa Brown Children's Clinic for years, but she recently started her own practice so she could spend more time with patients.
“It’s tough when you’re working for larger health care organizations because there are lots of productivity standards,” Santos said. “You want to spend more time with patients in primary care to prevent the big health concerns.”
Santos said she learns a lot about her patients by observing their home environment. She can see what they are eating, what medications they take and what toys they play with. Newborn babies are also exposed to fewer germs if they are examined in their own home.
“There’s so much more going on in a child’s health than what we can see in a limited time office appointment,” Santos said.
Santos can afford to dedicate an hour and a half to a single patient because she has no administrative staff and her malpractice insurance is significantly less than a doctor’s.
Medicine when you want it
For those who can afford it, concierge medicine offers access to a physician that is hard to match. For a membership fee, patients are able to contact their doctor 24/7 and enjoy longer appointments times.
Virginia Mason started the Lewis and John Dare Center in 2000 after patients began asking for concierge medicine.
Doctors see just a handful of patients each day with much longer appointment times. A physical, for example, includes 90 minutes with a doctor.
“We spend a lot of time going over things in great detail,” said Dr. Leland Teng.
Patients have access to their doctor’s email addresses and cell phone numbers. Just the other night, Teng got a call from a patient visiting India. A fly had landed on the woman’s head and laid eggs that later hatched into worms crawling out of her skull. Teng was able to advise the women to trap the worm without killing it so it could be identified by an Indian physician and she could be properly treated.
“I like to hear about the problems earlier so we can take care of it,” Teng said. “We can put out a little fire before it becomes a big fire.”
For such direct doctor access, patients pay $250 each month in addition to insurance coverage. While Dare Center doctors bill insurance for medical procedures, the membership fee covers non-medical program expenses.
Making the most of your doctor’s visit
No matter where you are treated, Chu said there are a few things you can do to ensure you get enough time with your doctor.
First, make sure to show up on time or even early. When you’re late, Chu said doctors have to cut into your appointment time.
Chu also recommends patients describe all of their medical concerns when booking an appointment and not hesitate to ask for extra time with the doctor.
“Advocate for the time you want,” Chu said. “If you feel at the end of the visit that it was rushed then you may want to go somewhere else.”