Sunday, October 2, 2011

My own brush with the healthcare system

So this week I've had the not so distinct pleasure of having to visit the Doctor. In and of itself not pleasant, but even less so given the hours and hours I spent waiting around, feeling like death-warmed-over, for my 5 (not even 15) minutes of fame with the doctor.

It was actually very interesting - this office is highly computerized and looks very efficient - seriously except for my prescriptions there was not a piece of paper in sight, computers and flat screens in every room. But unfortunately the image is where the efficiency ended. I waited for an hour in the waiting room (during which 3 people were called back ahead of me and ~2 left), and then another hour in the exam room. Now if you assume that we were all seen in the order we were called back, that implies they are seeing about 4 patients an hour. Might be fine if we we getting good quality time with the DR, but it was your typical 5 minute brush off. Now don't get me wrong, they were all very courteous, but what I don't get is what's happening the other 40 minutes of the hour when the dr isn't with a patient? Even if the others spent twice the time with her that's only 35 minutes of active patient time.

I did notice lots of other staff milling around, seemingly waiting until they could perform their next task, or working (?) on computers. Then I had to wait several more minutes when it was finally "my turn" while the Dr herself was on the computer.

Obviously I don't have the exposure to make any real conclusions, but as the healthcare debate rages, I've got some questions.
1) Is the administrative burden on doctors so high that spending a 2:1 ratio on paperwork vs patient care is the norm?
2) If this is the reality, are they just understaffed? Makes me wonder if those stories I'm hearing about fewer people going into medicine are correct.
3) if the doctor is the bottleneck, what are all of those extra staff milling about doing? Could they not move some of the admin workload to those folks so the dr could get better through-put?

I realize it's normal for someone who reengineers processes for a living to ask these kinds of questions, but in the end it all comes down to cost. And last time I checked, healthcare costs were a pretty big issue.

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