To celebrate Women in Medicine Month (sponsored by the American Medical Association) we wrote about one of our favorite female physicians, Dr. Michelle Bens. September's Women in Medicine Month serves as a platform to showcase the accomplishments of female physicians and highlights advocacy needs related to professional concerns of women physicians and health issues affecting women patients.
Topics: American Medical Association, Emergency Medicine, Why locum, Doctors are choosing locum tenens, Michelle Bens DO, Michigan State University, Centers for Disease Control and Prevention, College of Osteopathic Medicine, East Lansing, MI, Charleston, SC, AMA, Women in Medicine Month
It's been called the "silent shortage." There are simply far too few psychiatrists and way too many Americans suffering from mental health issues. Drug and alcohol addiction, domestic violence, and suicidal adolescents are only the tip of the iceberg. Lack of timely and appropriate access to psychiatrists leaves others to struggle with life-draining episodes of depression and anxiety.
You’ve passed your exams and completed your residency, but now you have to deal with a list of real-world challenges, like finding a job, paying back student loans, and deciding on which direction you’d like your career to go.
With one eye on the clock and the other on the patient, a doctor hopes the patient will stick to the chief complaint and not bring out a "laundry list" of their health concerns. Predictably, the 15 minute norm for patient consults can quickly turn into a "struggle for control" over the allocation of time, says Dr. Richard J. Baron, president of the American Board of Internal Medicine (Kaiser Health News, April 21, 2014).
"The patient is thinking: 'I'm taking the afternoon off work for this appointment. I've waited three months for it. I've got a list of things to discuss.' The doctor is thinking: 'I've got 15 minutes.' There is almost a built-in tension," says Dr. Alex Lickerman of the University of Chicago.
How did the 15 minute consult become the norm? No one really knows, although it probably goes back to 1992 and Medicare's adoption of a complex formula that changed the way it paid doctors. Up until that time, Medicare had reimbursed doctors based on so-called "usual and customary fees." The "new" formula-determined method relied on "relative value units" (RVUs). "The typical office visit for a primary care patient was pegged at 1.3 RVUs, and the American Medical Association coding guidelines for that type of visit suggested a 15 minute consult," according to Roni Cary Rabin of Kaiser Health News. Private insurers soon changed their fee schedule to be consistent with the Medicare formula. "To avoid income cuts, doctors had to see more patients--instead of doing three an hour, they did four," according to Princeton health economist Uwe Reinhardt. The impact has been especially hard on primary care physicians since they don't generate revenue from procedures like colonoscopies and biopsies.