Does the full time of one’s doctor’s visit affect the caliber of your care?
In a recently available study published in JAMA Network Open Trusted Source, researchers viewed the result that time of day had on cancer screening orders using data from friends greater than 50,000 patients eligible for either colorectal cancer screening or breast cancer screening.
They discovered that because the hours of your day progressed, doctors were less inclined to order these tests.
“What we found was that if you saw your doctor earlier each day, particularly at the beginning of a shift, the morning and afternoon shifts, that you were prone to get cancer screening ordered than in the event that you saw your doctor later in your day,” said Dr. Mitesh Patel, assistant professor of medicine and health care management at the University of Pennsylvania Perelman School of Medicine, staff physician at the Cpl. Michael J. Crescenz Veterans Affairs Medical Center in Philadelphia, and co-author of the study.
However the burden isn’t solely on doctors, either. Patients were followed for a year after and researchers found a similar pattern in completion rates for cancer screening.
People who saw their doctors earlier in your day were prone to have completed their cancer screening 12 months later than should they saw them in the afternoon.
Likely to the physician at 8 a.m. was associated with the best rate for ordered screening tests at 64 percent. The percentage decreased throughout the length of the morning to 49 percent by 11 a.m.
Those numbers received a bump at noon around 56 percent, which Patel attributes to the start of a new shift, before hitting their lowest, 48 percent, in the afternoon.
Well, first, most of these trends aren’t restricted to cancer screening. Similar studies, many of them authored by Patel himself, have noted the exact same patterns of lapses in care emerging in everything from flu vaccination rates Trusted Source to unnecessary antibiotic prescriptions Trusted Source, and even hand-washing in hospitals.
The later in your day you see your doctor, the much more likely quality of care may suffer.
“I do believe it’s not only a matter of not bringing things up, but in addition a matter of creating worse decisions, that we are doing more of what exactly we shouldn’t be doing as well and not doing what exactly we must,” said Patel.
The phrase that is mentioned most regularly to describe this phenomenon is “decision fatigue,” or the straightforward premise that making plenty of decisions during the day can wear you down.
Decision fatigue is just a likely culprit for poor decision making. And it’s not just restricted to doctors.
Can’t resist a bag of chips as you check out from the food store after having a long day? Chalk it around decision fatigue.
“It surely seems that decision fatigue is affecting patients seen later in your day,” said Dr. Barbara Keber, chair of family medicine at Northwell Health’s Glen Cove Hospital in Glen Cove, New York.
Keber wasn’t active in the study.
But also for doctors, the stakes of each individual decision made during the day could be much higher — literal life or death decisions in some cases.
Decision fatigue could be compounded by other factors like scheduling issues and rushed visits, that may force a health care provider to spend less time with a patient and make more decisions.
Again, those issues are similarly true for patients. At the end of your day, a patient may have to get home to produce dinner or grab a young child from school and just not have the full time or mental capacity to share something as complex as cancer screening.
Patel admits that at this time the information indicates that patients who see their doctors earlier in your day are prone to get recommended screenings, but he doesn’t recommend immediately rescheduling your doctor’s visit.
“I’m not advising that people change their appointments to the morning. I do believe what I’m saying is that when individuals are conscious of this issue then you can certainly actually help to stop this,” he said.
For patients, which means being informed about your visit and making the perfect use of it.
Once you see your doctor, prepare yourself and know what is important to you, whether which means cancer screening or an immunization booster.
And don’t hesitate to prompt serious conversations yourself.
Cancer isn’t easy to share — for anybody — but when you’re due for a screening, take the opportunity to handle it together with your healthcare provider.
“The main element takeaway is really to understand that if you’re prepared and you allocate the time, then it shouldn’t matter what time of your day you see your doctor,” said Patel.
In a recently available study, researchers viewed the result that time of day had on cancer screening orders using data from friends greater than 50,000 patients eligible for either colorectal cancer screening or breast cancer screening.
They discovered that because the hours of your day progressed doctors were less inclined to order these tests.
Patients who saw their doctors earlier in your day were prone to have completed their cancer screening 12 months later than should they saw them in the afternoon.