Making time for patients becoming an endangered habit

By Annette “Dr. Z” Zaharoff, M.D.

In 2016, a study published in the “Annals of Internal Medicine” found that physicians spend about 27 percent of their work day treating patients. If that doesn’t sound like a lot of time, well, it really isn’t.

Consider that some primary care physicians see up to anywhere from 25 to 35 patients a day. That means they are spending maybe 10 to 15 minutes with each patient. The rest of their time is spent immersed in documentation. Many physicians spending hours of their own time at night playing catchup on paperwork, which insurance companies rightly insist must be in good order for proper reimbursement of health care services.

In their defense, the health care system is facing a shortage of family doctors. That coupled with the way the system rewards physicians based on quantity of care, not quality of care, encourages a factory assembly line approach to the practice of medicine.

That same rewards model is in place in the practice of physical medicine and rehabilitation. What we should be encouraged to do is to really take care of patients. The reputation of my clinic and my staff is of utmost importance, so making sure patients get the right care so they get back on their feet and back to the activities they enjoy, is my priority.

In my practice, I see each patient for their initial evaluation and follow-ups. Each patient has one-on-one time with me and an appointment time dedicated to them. There is no double or triple booking of appointments. I want to invest the time needed to work with my patients so I have as complete an understanding of their health care needs as possible.

Often, patients are conditioned to think they need an MRI or X-ray right away. And while imaging tools (including ultrasound) can be very helpful, a comprehensive clinical examination that includes a thorough history and physical examination can identify the problem 95 percent of the time. The information from the examination is vital to developing a good evidence-based recommendation for the proper course of care and treatment.

I am always surprised when patients tell me they have been to many doctors, but no one has ever actually performed a physical examination of the injured area. If you have a knee injury, I need to palpate and test the ligaments and muscles of the knee joint as well as the areas surrounding the knee. Your range of motion, flexibility, strength and function need to be assessed. I need to observe the way you walk and how your feet absorb shock for you. The same goes for shoulder injuries or joint pain in the feet or wrists, and so on.

Yet treating the injury is only part of the model of care we follow at the Non-Surgical Center of Texas. My goal is to help patients not only to heal, but also to stay healthy. I conduct a thorough history, asking many questions and taking notes to get a clear and comprehensive understanding of why an injury occurred. What pre-existing factors may have contributed to the injury? Are there circumstances in a patient’s life that makes them more pre-disposed to getting hurt? I ask about a patient’s lifestyle, physical activity levels, training habits, sleep habits, and even the kind of shoes they wear every day. Patients may be unaware that issues like these can impact their health.

Let’s take sleep for example: If you are not getting enough sleep, that can make you more prone to injuries. A 2014 study of more than 160 middle and high school students, combined with an online survey of another 112 students, found that sleep deprivation was linked to a higher rate of injuries among young athletes. If you aren’t working with a clear, “woke” state of mind, you are more likely to stumble, react more slowly in a crisis or make poor decisions.

So what can we do about it? Do you watch TV or look at your phone or tablet in bed before you try to go to sleep? Do you eat late at night? These kinds of habits can contribute to poor sleep health. Do you have a regular routine to help you prepare for a good night’s sleep? Making small adjustments in your home life can make a big difference in your overall health.

These are just some ways that having quality time with your physician can impact your quality of care. The next time you are with your doctor, pay attention to the time they spend with you and whether they are truly talking with you, listening to you and engaging you in your plan of care.

Here’s to good health, and good care.

Dr. Annette “Dr. Z” Zaharoff heads the Non-Surgical Center of Texas, focusing on non-surgical treatments to relieve pain and repair injuries. A former professional tennis player who competed on the WTA circuit, Dr. Zaharoff has been utilizing regenerative injection treatments including Stem Cell Therapy, PRP Injection Therapy and Prolotherapy for more than a decade. Learn more about her at www.drzmd.com. You can follow her on Facebook at www.Facebook.com/DrZaharoff.