Doctors would need to work 27 hours a day to provide adequate care, study says

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An average doctor would need to work 27 hours a day to provide adequate care for every patient they see, an analysis led by a physician has claimed.

A team lead by researchers from the University of Chicago came up with the staggering estimate after calculating the average annual workload based on clinical guidelines for treating conditions. The team assumed that the average doctor would see 2,500 patients each year.

Many Americans are already dissatisfied with the standard of their healthcare, and most say they are struggling to pay off healthcare debt — even as hospitals post their most profitable year on record in 2019, the latest data available.

But Dr Justin Porter, who led the study and also works at UChicago Medicine, said the results were proof doctors — who are signed up for eight to 12-hour shifts — were struggling because there were too few hours in the day to do their eight-hour job. Porter said moving to a ‘team’-model — with doctors working alongside nurses, counselors and others — saw their days drop to nine hours.

University of Chicago researchers came up with the staggering estimate after calculating a doctor's workload based on clinical guidelines (stock photo)

University of Chicago researchers came up with the staggering estimate after calculating a doctor’s workload based on clinical guidelines (stock photo)

The simulation showed that if a doctor was working alone they would need 27 hours to give every patient adequate care, based on national guidelines. But if they were given care as part of a team they would need about nine hours a day. Medics work eight to 12-hour shifts

The simulation showed that if a doctor was working alone they would need 27 hours to give every patient adequate care, based on national guidelines. But if they were given care as part of a team they would need about nine hours a day. Medics work eight to 12-hour shifts

In the study, published earlier this month in the Journal of General Internal Medicine, researchers modelled a nationally-representative panel of 2,500 patients.

It was based on respondents to the National Health and Nutrition Examination Survey, which aims to assess the health of U.S. adults every year.

To estimate the hours needed, they calculated how long it would take to see each patient following guidelines from official medical bodies.

Americans over 75 years old owe the most for medical bills, report finds 

Americans over 75 years old are suffering from more medical debt than younger cohorts while residents in West Virginia are most likely to still owe money to their doctor, a report found earlier this month.

Analysts from online pharmacy NiceRx said the oldest Americans average $17,510 in debt each — the highest rate in the county and double the $8,995 owed by the average 35 to 44-year-old. But when asked whether they still owed their doctor money nine in ten said they had already paid it off.

It suggests that many over-75s are being forced into tens of thousands of medical debt as they try to pay off costs for eye, ear and teeth treatments which are not routinely covered by Medicare — the U.S.-backed health insurance for over-65s. Many of those in the most debt may also have previously put off care due to costs.

Breaking the figures down by generation showed Gen Z — aged seven to 22 years — had the most debt per person at $19,890. It was unclear why this was the case, although it may be linked to parents putting off paying medical bills.

The report also found that a quarter of Americans in West Virginia were in debt to their hospital, the highest level in any state. For comparison, in Minnesota — where the fewest number of people are in debt — it is an ‘impressively low’ two percent.

For example, with obese patients guidelines say they should see them at least 12 times a year to help them lose weight and measure any changes.

Results showed they would need 14.1 hours per day for preventative care — such as helping someone manage their weight or sorting out vaccinations.

Another 7.2 hours would be needed for chronic conditions — like diabetes and heart disease — while 2.2 were required for acute care — treatment for brief but severe illness such as trauma — and 3.2 hours would be needed to answer emails. 

‘There is a sort of disconnect between the care we’ve been trained to give and the constraints of a clinic workday.

‘We have an ever-increasing set of guidelines, but clinic slots have not increased proportionately.’

He added: ‘If you do surveys with patients about what frustrates them about their medical care, you will frequently hear “My doctor doesn’t follow up”.

‘I think a lot of times this is interpreted as a lack of empathy, or a simple lack of willingness to care for a patient. But the reality — for the majority of doctors — is simply a lack of time.’

Dissatisfaction over the cost of healthcare among Americans is high, with two thirds saying in June they were putting it off because of the price while half said they already could not meet existing debts.

A quarter have also been saddled with debts higher than $5,000 from medical or dental bills, a poll by Kaiser Health News found, and one in five say they will never be able to pay off the bills.

There are also concerns over variable prices, with a 36-year-old woman who was charged nearly $18,000 for a breast biopsy being left feeling sick after finding out she could have got the same procedure for just $2,100 elsewhere.

Dani Yuengling, from Conway in South Carolina, was billed the extortionate amount by the Grand Strand Medical Center after paying on her insurance with Cigna.

But it was later revealed that if she had headed to a nearby hospital and offered to pay in cash they would have billed her barely an eighth of the price.

Anecdotal complaints have also been raised about the quality of care, with many complaining they have been left waiting for hours to see a doctor.

To ensure doctors are able to fit their work into a day, the researchers recommended more hospitals shift to a ‘team-based’ care system — which they said cut the work day to around nine hours.

This is where nurses, physician assistants, counselors and others help to deliver recommended care.

The Chicago study also involved experts from Johns Hopkins university in Baltimore, Maryland, and Imperial College London in the UK.  

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