this post was submitted on 11 Mar 2024
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[–] [email protected] 25 points 8 months ago* (last edited 8 months ago) (3 children)

Our patient visits are set as 15 minute slots standard.

This isn’t enough time to practice good medicine for anything much more than something like a flu or strep throat. How does one squeeze in an entire rooming process followed by a solid HPI, physical, poc testing and then plan review with pt in 15 minutes?

They don’t.

But with how medicine works (in the US) it’s the how clinics make enough money to stay open.

For clarity: I work at a Federally Qualified Health Center, not a for profit clinic.

[–] [email protected] 2 points 8 months ago

One of my doctors clearly has it this way. When I'm there in the afternoon, there are dozens of people waiting because each person takes longer than the appointed slot and so everyone moves back in time... but at least they have good managing there and the receptionist will tell me when I arrive whether it will be 30 or 50 minutes to wait.

My eye doctor, on the other hand... I arrive 15 minutes before my appointment and there are only three other people there, two of whom arrived at the same time as me. How the hell does it take an hour for me until I can go in? What are they doing in there that every patient takes 20-25 minutes for an eye exam?

[–] [email protected] 9 points 8 months ago (1 children)

But with how medicine works (in the US) it’s the how clinics make enough money to stay open.

This is the truth. PCP offices in particular have razor-thin margins and insurance reimbursement goes down every year while supply, fixed, and staff costs go up every year. This is an insurance industry and healthcare system problem. Your doctors' offices are just doing everything they can to stay open.

[–] [email protected] 4 points 8 months ago

Fortunately CMS is rethinking the role of primary care and realizing we can save money if we're able to provide high quality preventive care like we're supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.

[–] [email protected] 7 points 8 months ago (2 children)

I think this is a cross-disciplinary issue.

My last optometrist appointment was wicked fast. Eye test speed run. I think it took 15 minutes for the examination and the optometrist was using the time it took for a patient's pupils to dilate in response to those horrid drops to do the initial exam on another patient, so they always had two patients "being seen" at a given time.

Buck wild. Seems like a bad trend for quality care.

[–] [email protected] 1 points 8 months ago (1 children)

Buck wild. Seems like a bad trend for quality care.

On the one hand, yeah holy shit.

On the there, though, eye exams aren't exactly something that couldnt be administered in a group setting to help speed things along a bit

In my ideal world they'd have a machine for it at Walmart like they do blood pressure that just flips the prescriptive lenses in front of you and asks all the same questions, then sends the results to an optometrist to confirm

[–] [email protected] 1 points 8 months ago

exams aren't exactly something that couldnt be administered in a group setting to

Anyone else imagining a Democratic: Does 1 or 2 look better?

Sorry Alex. Looks like everyone else voted 1 so you're getting the wrong prescription.

[–] [email protected] 5 points 8 months ago

Agreed.

There’s an argument that more appointment slots means more access but if it’s access to poor quality medicine what’s the point?