Direct Care Is Just What the Patient Ordered
Clare Ansberry's column 'Turning Points: Trust Is Prescription to Heal a Broken Doctor-Patient Bond' (Personal Journal, March 25) raises an increasingly important problem in medical care. The prime reason trust is in short supply is the lack of time physicians have with each patient. When appointments are limited to 15 minutes, there is only 8 to 12 minutes of 'face time.' This is perhaps enough for a simple problem, but certainly inadequate for a patient with several chronic illnesses who is taking multiple prescription medications. This certainly isn't enough time for an older individual with hearing, vision, mobility or cognitive issues. It isn't enough time for the person who has anxiety.
The article hints at the resolution, and I'd like to elaborate and advocate for creating more time using direct primary care (DPC). DPC means same- or next-day appointments, visits as long as necessary, direct access to the physician via cellphone, text messages and email. DPC eliminates the insurer or the corporation that forces short visits. The added time leads to a decrease in the use of specialists, tests and imaging. We also see fewer visits to the emergency room and fewer hospital admissions. DPC allows for two-way listening, resulting in less frustration for both the patient and the doctor, and allowing trusting relationships to develop.
Stephen C. Schimpff, M.D., MACP
Catonsville, Md.
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