When physicians get more time, patients get more attention and fewer readmissions
The length of time patients are cared for is critical to the quality of care and health outcomes they receive! In 2018, the National Bureau of Economic Research published a paper by Elena Andreyeva and colleagues at Penn State University examining the impact of the length of home visits1 on patients after they are treated and discharged from the hospital for acute conditions. Based on more than 60,000 home visits by nurse practitioners, physical therapists, and other clinicians***, they found that for every additional minute of visit time, the risk of readmission was reduced by 8%. Of these *** each additional minute spent by caregivers was associated with a 16% reduction in the risk of readmission, while each additional minute spent by nurse practitioners was associated with a 13% reduction in risk. The researchers found that time was the single most important factor likely to influence the risk of readmission!
More visiting time and care for patients reduces readmission rates. pixabay
William Osler also wrote in 1895, "An examination of a case which takes less than half an hour is unsatisfactory! The sick man expects to have a great deal of time spent on him, not a hasty examination of ten or twelve minutes!" This statement is still true today, 120 years later, and will not change in the future!
You can get more out of a patient visit than you think!
David Meltzer, MD, an internist at the University of Chicago, examined the relationship between time spent with a physician and other key factors, including continuity of care: "If you need to go to the big hospital, will the physician who saw you in the clinic see you in the big hospital? The study showed that spending more time with patients reduced hospitalization rates by 20%, which not only saves a lot of money, but also helps avoid the risk of nosocomial infections and other nosocomial mishaps. Kaiser Permanente and Vanderbilt University have since replicated this approach, which offers significant benefits.
These studies confirm the importance of clinicians spending time with their patients, and that longer visits in and out of the hospital not only improve communication and build trust, but also improve patient health and reduce follow-up costs!
It is everyone's desire to be able to work in a humanized way
Like my classmates in 1975, most people who go into medicine are motivated and proud of their ability to care for patients! David Rosenthal and Abraham Verghese explain it well:
Simply put, the vast majority of what we define as "work" has to be done in the studio, on the computer, and at a distance from the patient. As a result, our attention is often not on the people who put their lives, bodies, and souls in our hands, so much so that it has become the norm in our culture for physicians to stare at the screen and ignore the patient! Technology has enabled us to care for patients from a distance from their beds and caregivers, and as a result, we have grown detached from the individual patient and distanced ourselves from our coworkers in favor of working on computers.
Medicine is not a production line!
AI can help us buy valuable time with patients, and in 2018, the Institute for Public Policy Research published a report titled "Better Health and Care for All," estimating that AI will free up more than 25% of the time of clinicians of all kinds, on average. AI is estimated to free up an average of 25 percent or more of clinicians' time for patient care. The most important impact will be to free clinicians from the constraints of electronic health records! At the University of Colorado, moving computers out of the clinic and supporting physicians with medical assistants significantly reduced physician overwork from 53% to 13%. Using natural language processing to assist physicians during patient encounters should have the same effect. But unless people realize that medicine is not a production line, technology alone will not solve the problem! As Ronald Epstein and Michael Privitera wrote in the journal Lancet, "Physicians who feel that their ideals have been shattered by the productivity orientation of management and the lack of recognition of the value of the patient-physician relationship as the source of the physician's sense of mission need enlightened leaders who recognize that healthcare is a human endeavor, not a production line! They're right, except for this: we need all hands on deck, not just leaders! It is impossible to truly give time back to physicians if efficiency gains are simply a means for management to increase productivity so that physicians can see more patients, read more scans or slides, and maximize throughput! It is entirely possible that this could happen! After all, it was physicians themselves who allowed grossly inapplicable EHRs to invade hospitals without ever resisting companies like Epic, which put gag clauses in their contracts with hospitals and physicians that prohibited them from disparaging EHRs and publishing screenshots of EHRs. This time, physicians must stand up for their rights!
Moving computers out of the consulting room and supporting physicians with medical assistants has significantly reduced physician overwork. pixabay
Unfortunately, physician initiatives are unlikely to be supported by professional medical organizations, at least in the United States. One reason for this is that there is no representative body for physicians in the United States, and the American Medical Association (AMA) has less than one-third of the members who are practicing physicians. Worse, such organizations are not necessarily representative of physicians. The primary function of professional medical organizations is to act as unions and to protect the compensation of their members. However, the large amount of capital that such organizations possess creates a potential for influence. In 2017, four of the top seven groups lobbying in the U.S. *** were health care organizations: Pharma Research and Manufacturers ($25.8 million in capital), Blue Cross Blue Shield ($24.3 million), American Hospital Blue Cross Blue Shield ($24.3 million), American Hospital Association ($22.1 million), and the American Medical Association ($21.5 million). Yet each of these groups now protects only the organization's own financial interests, not those of patients or clinicians!
To truly achieve deeper care, physicians must change the way they think about patients and the way they interact with them! Even if technology allows physicians to have more time, it is still not enough to improve the current situation. But time is a prerequisite for these changes to take root!
-- This article is excerpted from AI MEDICINE DEEP MEDICINE, Flagship Publishing, November 20, 2020 Related tags: ai ai medicine sdgs goal 3 | health and social welfare overwork medical resources Popular tags: yahoo neuromuscular pi radar carnation Article Difficulty Just In All Discussions 4 Login to discuss with everyone