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Dr. Magryta: An open letter to parents and patients

Dr. Magryta

Over the years, I have noted with dismay some statements people make related to doctors and care providers.
What I am about to say is not general complaining. Rather, I am hoping that this will give everyone a better understanding of patient care, a doctor’s work load and time constraints and why things happen as they do — often frustrating parents, patients and providers alike.

Over the years, I’ve noted that online reviews for medical providers were generally if not always negative. Once, a gentleman sitting next to me was bragging about his divorce and the fact that when all of the dust settled, he had 5 or so bills left to pay, all of them to his care providers. He said that since they did not need his money he wasn’t going to pay them.
When a patient is late for an appointment, I have received complaints that we make them wait so why is the reverse not fair?
The common theme here is a pervasive belief that we, the care providers, are not good at what we do, not worthy of your time and money, and, apparently worst of all, we take your time for granted.

In my mind, none of these are truths. The unfortunate reality is that a dysfunctional medical system has placed profit over patient care, computer analytics over time spent with a patient and finally, diagnosis and acute treatment over living free of disease through prevention and general health.

I am not by nature a cynic. However, the pervasive changes to medical care over the last decade and a half seem to promote convenience and speed at the cost of quality and happiness.
Studies find that many consumers are happy with these changes, as they fit our convenience culture, regardless of outcome quality.
However, this a juggernaut in the wrong direction. These dysfunctional changes are now officially here and the results are in. And the outcome is not in anyone’s best interest.

Your average provider is tasked by the federal government and local hospital system with navigating a cumbersome, electronic medical record system that does little to improve patient care and is certainly not an improvement over the old “paper” chart.
A colleague recently shared that he routinely stays up until 10 or 11 at night finishing charts in order to be “compliant.” This is a sure recipe for burnout and frustration.
If there was significant value-added from this system, we could stomach the time waste. Alas, there is not. We, as caregivers, should be prioritizing our time in learning and treating the patient, not in cumbersome and wasteful charting.

Your average provider spends hours a day reading in order to keep up to date with the crazy volume of information coming out about the newest disease or treatment. This is on top of a full day of work. This task becomes much more difficult in every successive decade. The information volume is at times overwhelming, forcing many providers to silo their knowledge into specialties to be able to control the learning stress.

Your average provider tries to spend as much time as necessary with each patient to address all of the concerns raised. Now here is where the biggest friction point occurs. If for example, a patient has an 8 a.m. appointment and arrives at 8:05 a.m., the whole schedule just got delayed by 5-10 minutes, while the check in and vital signs are gathered. Then let’s say the patient visit, which is generally 8-15 minutes long, turns out to be a bit complicated. You spend 25 minutes to adequately handle the case and treat the patient in a complete and effective manner.
This is and should be the only way to practice correct and quality medicine. Unfortunately, now the next patient’s appointment is already 15-20 minutes behind schedule, and so forth throughout the day.

This scenario is very common. Thus, I ask for two indulgences on behalf all of my colleagues:
1) Please show up 10 to 15 minutes before your appointment and know that we are trying very hard to be on time;
2) Know that if a child has a severe issue, the entire apple cart may get flipped over for everyone in order for us to be present in the moment and give 100% to this family.

Your average provider really cares about your child and you and wants to spend the time that you need to be educated about whatever is happening at the time.
The big problem here is the disconnect between time and money. Time is neither compensated nor respected by insurers or hospital systems.
A gastroenterologist friend recently informed me that his hospital system overlords are tasking him with seeing new patients with significant diseases like Crohn’s and cancer in 15 minutes or less or else take a pay cut or even be fired.
Frankly, this is not good medicine. The best that this doctor can do is diagnose and prescribe. Forget about teaching disease etiology, prevention and lifestyle changes.
I think that the pendulum will start to swing back in the coming years as time and teaching are recognized as the most important medical tools for healing. I am waiting patiently.

Your average provider went into medicine to heal. It is a long and arduous journey. Money is not the driving force for most, as there are many easier ways to make money.

I will end with this statement. Thank you for trusting us with your loved ones care. We will continue to strive to be the best at what we do for you and all of your family. We will try and navigate the crazy medical system as best as we can.

Thank you for your patience,

Dr. M

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

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