By Timothy Hoff
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Additional resources for Practice under pressure : primary care physicians and their medicine in the twenty-first century
And if you ask me how much time I should spend with a patient, I would say more is better. If I spent twenty minutes with a patient, I would’ve gotten more information and developed a better relationship with them than if I had spent ﬁfteen. And you see doctors who really can’t get it done because they’re in there spending a half hour with every patient. ” (Charlie, family physician) . . You’ve got to see a certain number of patients, it’s that simple. So you learn ways of being more directive in that exam room, with the parents especially.
They earned much less than PCPs, yet insurance reimbursements for their work was on a par with what PCPs received. As a result, this labor was not used in a team-based approach to patient care, as suggested by the medical-home model, where the same patient beneﬁted from a group clinical effort with different individuals who provided unique expertise. Instead, PCPs used NPs and PAs as lower-priced clinicians who could see, on their own, a percentage of the routine care ﬂowing through the ofﬁce on a given day.
Wilma, family physician) . . The two biggest complaints we get here in this practice are fatigue and insomnia. Very nonspeciﬁc. And when you start to delve into it, to try and get a better idea of what they are talking about, a lot of it winds up being social problems. A lot of people expect to be able to take a pill to make them feel better. We see more and more patients come in with these complaints. Antidepressants are in my top ﬁve most prescribed drugs now, whereas they weren’t ﬁfteen years ago.