Doctors Minus The Bedside Manner

The New York Times has put up an article concerning the increasing rudeness of doctors towards patients. This post goes along with the earlier one on concierge medicine and the effects of increasing patient loads for future doctors. The article states how neglectful and rude doctors are becoming more common in the United States. Also, it seems that most of these unsympathetic doctors do not even recognize the problems they are causing for their patients.
The cases in the article seem mighty extreme such as one doctor chastising a woman for being sexually active and not married. Another, where a doctor says to an overweight woman, "I could wire your jaws shut so tight that you can't move your jaws to talk, and if you can't talk you can't eat." Though these are pretty crazy (and hopefully rare) cases, it does seem from the explanations in the articles that doctors today have to carry a more time consuming role at the office. The article proposes some solutions for current doctors:

At the Rochester Independent Practice Association in New York, with 3,000 doctors, patients are surveyed, and their satisfaction scores can account for 20 percent of a doctor's pay. At Tufts Health Plan, 3,000 to 4,000 doctors had all or part of their bonuses withheld last year because their patients did not rate them highly, said Richard Lynch, the plan's vice president of network contracting.

In California, said Dr. Ronald Bangasser, the past president of the California Medical Association, eight major health insurers have a new program in which they divide $30 million among 35,000 physicians depending on how their patients rate them. "It could be $3,000, $4,000 or $5,000 per physician," Dr. Bangasser said. "That would get their attention."

As for doctors in training, it seems that many residency programs are teaching doctors how to be "nice" and they are also reviewed by a fake patient's feedback. Something as simple as teaching doctors to nod and say, "uh huh," made a dramatic difference.

There is one last thing to be noted from the article that is HUGE for future doctors and how they will be practicing medicine. The article highlights the increasing use of physician's assistants in hospitals and offices. The medical system seems to be going in the direction of separating out the work over different tiers, with the doctors overseeing the final findings of physician's assistants and nurses. Patients and I think a lot of pre-med students are dismayed by this, but it seems to be where this overly strained field is headed.