On September 28th I began a series, Saving Time, to talk about a great challenge in modern medicine: the time pressures on clinicians who strive to provide expert and compassionate care to each patient.
Compared to 30 years ago, routine tasks consume increasing amounts of time:
Just look at how the explosion of tests and treatment options has transformed brief end-of-visit “R & R”—review and recommend—into lengthy patient discussions.
I remember the days of jotting notes and orders in hospital charts before dashing off to my office. Today's clinicians have to type their way through drop-down boxes—and then wait with crossed fingers until the data go through. Meanwhile, piles of billing and insurance forms await them.
Like the skull housing a swelling brain, the 24-hour day exerts constant pressure on clinicians’ bulging to-do lists, threatening the viability of time-honored tasks that represent the art of medicine: eliciting a complete history; tailoring explanations and advice; fostering trust through personal relationships; and just “being there” with patients—especially when medicines fail.
The practical problems of time are exacerbated by an evolving culture of hurried medicine, as I'll explain in my next post.