Heroes Not Zombies

OK, so I’m getting older and I guess I’ve reached that age where I think some things aren’t as good as they were. In particular I’m concerned that the practice of Medicine has become more technical and less human. So, it wasn’t really a surprise to read the details of a study which measured how much time doctors were spending on different activities through their day. The details however are, frankly, shocking.

The study of first year internists at two of Baltimore’s largest academic medical centers, showed that the doctors spent 12% of their time examining and talking to patients, and 40% at a computer.

Now, I reckon only just a tenth of your working time as a doctor spent in direct face-to-face work with patients is surprisingly low, but to be spending almost four times as much time at the computer as you spend with patients?!

Here’s what the researchers thought about their study –

“One of the most important learning opportunities in residency is direct interaction with patients,” says Lauren Block, M.D., M.P.H., a clinical fellow in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine and leader of the study published online in the Journal of General Internal Medicine. “Spending an average of eight minutes a day with each patient just doesn’t seem like enough time to me.” “Most of us went into medicine because we love spending time with the patients. Our systems have squeezed this out of medical training,” says Leonard Feldman, M.D., the study’s senior author and a hospitalist at The Johns Hopkins Hospital (JHH).

The researchers are concerned that the trainee doctors aren’t getting enough time in direct patient care to learn their trade. But worse than that, what are they learning about the way to work as doctors?

Although this isn’t a perspective expressed by the authors, I do wonder if the whole drive towards a mechanistic, reductionist approach to health, coupled with a shift in emphasis from patient experience to group-based statistics, isn’t partly to blame for this finding.

Isn’t it time to organise the practice of Medicine in way which would allow doctors to spend most of their time talking to, examining or directly caring for, or treating, their patients?