Saturday, January 16, 2010

Medical Hell, Part III: 7.5 Minutes

Most doctors schedule four to eight appointments every hour. Eight appointments an hour, which seems to be the norm for orthopedic surgeons, means an average of less than 7.5 minutes per patient, given that the doctor must spend some time walking from room to room, etc. We're probably lucky to get five to fifteen minutes of our doctors' attention in the average appointment. Next time you visit your doctor, look at the sign-in sheet and figure out how little time the doctor has allotted for your consultation or examination.

In these short appointments, we are expected to make important decisions about our health: whether to take a medication, to undergo a procedure, or to just let things be. It is simply impossible to make a good decision in such a limited amount of time, and I can think of no other profession that gives such short shrift to its clients. Yet there is no profession more important than medicine.

I am confident of the problem, but I am less sure of the cause(s) and solution(s). Nevertheless, in the spirit of the internet (speaking out when you are not really sure if you know what you are talking about), here goes:

The underlying problem is that we simply do not have enough doctors to go around. There are two reasons for this. First and foremost, we do not have enough medical schools. There are only about 125 medical schools in the entire United States, about 1 for every 2,500,000 people. As a result, there are many capable students who would be more than happy to pursue a career in medicine, but who are not able to qualify. We would do well to close a few law schools and open a few medical schools.

Second, medical training is unnecessarily long. Many doctors --dermatologists, for example -- do not use even a fraction of what they learn in medical school. These specialists should be given separate degrees, with training focused on what they will need in their practice. Think of dentists, for example. Reducing the length of training means that each medical school can produce more doctors.

Clearly, there is a need for some doctors who know all fields well, and there is a need for all medical practitioners to have a certain minimum understanding of how the human body works. But, in a world of limited resources, it makes sense to allocate education more carefully.


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Provisional Eastonlow said...

The two comments I deleted were apparently written in Chinese. I don't read Chinese, and when I put those comments into Google's translator, all I got was gibberish that did not seem to have anything to do with the original post, to the extent it was intelligible at all. So, I figured I might as well delete them.