Why 7 Minutes Isn’t Enough

Daniel Paull MD insists that quality medicine takes more than 7 minutes.

One of the most common complaints about a physician is, “They didn’t listen to me”.

It happens all the time. In medical school, we are trained to listen to the patient, because they will tell you the diagnosis. We learn to take our time, and be methodical, leaving no stone unturned if need be.

When we get to residency things change. There are so many patients, and time is scarce. This leads to shortcutting, mainly in the form of listening to the main complaint and then ignoring most of the rest. If someone has multiple complaints, the suggestion is for them to make multiple appointments. But what if the problems are interrelated?


If the patient has multiple complaints, the suggestion is for them to make multiple appointments. But what if the problems are interrelated? Click To Tweet


This continues on to when a physician becomes an attending. Most are forced into high volume models that only allow 7 minutes or so of face time with each patient. So we get the quality that 7 minutes provides, which isn’t good. One problem, that’s it. Heaven forbid if a patient has multiple medical problems. Combine that with a poor historian and there is no hope.

The solution is to slow things down and take our time. Quality in medicine is a time based function. You can’t do a great job in 7 minutes. No one can. Things get missed and patients go un-listened to.

Time based care is almost impossible in an insurance based world. The solution it to remove the insurance meddling from the equation. How? Direct care.


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