Why Time Matters: 5 Strategies to Enhance Your Doctor Visits

As a physician raising the bar in palliative and end-of-life care, I've witnessed firsthand how our healthcare system's emphasis on quantity over quality has profoundly impacted the doctor-patient relationship. The standard 15-minute appointment has become an unfortunate norm in the U.S. healthcare system, driven by insurance reimbursement models that prioritize patient volume over meaningful interactions.

This time constraint is problematic in any medical context, but it becomes particularly challenging when dealing with end-of-life care. The complexity of medical decisions, the emotional toll, and the need for thorough understanding during this sensitive time require more than just brief interactions with your doctor.

Research consistently shows that increased time with your physician correlates directly with better patient outcomes. Yet, our current healthcare system continues to disincentivize doctors from spending quality time with patients, primarily because insurance payments are based on the number of visits rather than their quality or impact.

Through my decades of medical practice, I've identified five essential strategies that patients and families should implement to maximize the effectiveness of your doctor visits:

1) Prepare a Written List

Before your appointment, document your questions, concerns, and observations. This written record serves multiple purposes: it helps ensure you don't forget important points during an emotionally charged visit and provides a clear structure for the conversation with your physician. This will help your doctor address your concerns systematically. I've found that patients who come prepared with written lists typically receive more comprehensive care because we can focus on their specific needs.

2) Prioritize Your Concerns

Understanding that time might be limited, organize your concerns in order of importance. Start with the most pressing issues—whether they're physical symptoms, medication side effects, or questions about prognosis. This prioritization helps ensure that critical matters receive the attention they deserve.

3) Be Clear and Direct

Clear and direct communication is crucial in medical care, particularly when dealing with end-of-life issues. Instead of saying, "I'm not feeling well," be clearer: "I've been experiencing increased pain in my lower back for the past three days, and it's affecting my ability to sleep." This direct communication helps your physician better understand your situation and develop targeted solutions.

4) Bring a Support Person

Having a trusted family member or loved one present during medical visits can be helpful. They provide emotional support, help remember important information, ask questions you might not think of, and serve as an additional set of ears for complex medical discussions. This support person can also help advocate for you when necessary and assist in implementing care plans at home.

5) Take Notes and Request a Summary and/or Record the Visit

During appointments, take notes or ask your support person to do so. Additionally, request a written summary of the visit, including any changes to your care plan such as new medications. Alternatively, you can ask to record the conversation. This documentation becomes particularly valuable for maintaining continuity of care, especially when multiple healthcare providers are involved.

The implementation of these strategies becomes even more crucial given the constraints of our current healthcare system. While we continue to advocate for systemic changes that would allow for more extended patient visits with physicians, these strategies can help maximize the effectiveness of the time you do get with your physician.

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Until the current system's emphasis on volume over value is changed, patients and families that are proactive and have a plan to maximize time with their physicians see better health outcomes. Collaborating with your doctor to manage your serious illness starts with intentionally planning each doctor appointment.

Remember, end-of-life care isn't just about managing symptoms—it's about understanding, supporting, and honoring each individual's journey. This requires time, attention, and presence that simply cannot be rushed or compressed into standardized time slots. Implementing these five strategies will ensure you receive the comprehensive and compassionate care you deserve at the end of life.