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Tuesday, June 14, 2005The practices of female primary care physicians are different from those of their male counterparts, according to data collected by Dr. Horner-Ibler, director of the Center for Population Research at the National Institute of Child Health and Human Development at the National Institutes of Health. Typically, women doctors find that their patient panels are highly complex and predominantly female -- often because these patients seek out female physicians..... ....."As a woman physician, I know I spend much more time with patients than my male colleagues," Dr. Horner-Ibler said. "I spend probably double the amount of time in phone calls to patients that my male colleagues spend in a week. What surprised me [in this research] was the fact that nothing in my experience is unique. Women everywhere in every system are experiencing these stressors. ... The data we have thus far clearly show that the essence of the job is different for women because of how patients sort themselves out." To deal with this, practices need to devise a compensation plan that reflects the different patient panels women physicians treat, she said. "Someone has to see these more difficult patients, and who better than women? But practices need to understand that seeing these patients requires more time and energy and that more time needs to be allotted to women physicians [to treat these patients]," Dr. Horner-Ibler said. ..."Revenue sharing in practices, where men are seeing more patients and women are seeing more difficult patients, should be implemented, so that all physicians and all patients find themselves more satisfied, less stressed and healthier," she said. Dr. Horner-Ibler, the article reveals, sees about eight patients per half day and still runs behind. That's thirty minutes a patient. Apparently she never sees anyone for colds or sprained ankles. Maybe her practice uses physician's assistants or nurse practitioners for those. Or maybe she's just not very efficient. Full disclosure - by the standards of this article I practice more like a man than a woman. What's more, I know several men physicians who practice more like a woman than a man. They feel it's necessary to go through every minute detail of a history with patients regardless of the reason the patient has come to see them, and regardless of the value that information will serve in diagnosing and treating the patient. An analogous situation would be a hair dresser who insists on cutting hair only one strand at a time. Would anyone seriously argue that the slow hairdresser should get paid more than those who can cut hair just as well, but more than one strand at a time? What's more, we already have a system that compensates us by the level of complexity of our patients. If a physician truly is spending more time with patients because they are more complex - and not just because the physician isn't skilled enough to direct the flow of conversation properly - then he (or she) can charge the higher price for complex visits. The catch, of course, is that it has to be documented. And listening for thirty minutes as someone talks about their Aunt Millie's colitis hospitalization doesn't cut it with the documentation police. posted by Sydney on 6/14/2005 05:01:00 PM 0 comments 0 Comments: |
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